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Aboriginals at greater risk of heart attacks

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Larry Amos counts his blessings he was in Winnipeg a decade ago when he suffered a heart attack at the age of 53.

Amos, a self-employed business consultant to First Nations across Manitoba, started to feel ill as he drove his son to school one November morning.

He managed to make it home, where a person who had come in to do child care took one look at him and called 911. Within two hours, he was in surgery.

"I'll tell you, if I was anywhere else but Winnipeg, I would have been a goner," said Amos, who was raised in Fisher River and is a member of Peguis First Nation.

A national study released Thursday says First Nations people are more likely to suffer a heart attack than non-aboriginals and they're more likely to fall victim to one at a younger age.

The report, from the Canadian Institute for Health Information (CIHI), found the heart attack rate in communities with high First Nations populations was 76 per cent higher than in communities with low-aboriginal populations.

The median age in which a patient suffered a first heart attack was 64 in high-First Nations areas and 71 in communities with a low aboriginal population, according to the study, which gleaned information from health records between 2004 and 2011.

It also found people living in communities with a high-aboriginal population -- those with more than one-third of the population identifying as First Nations in the 2006 census -- received certain cardiac procedures less frequently than those in communities with low-aboriginal populations.

For instance, they were less likely to receive coronary angiography, a diagnostic procedure that gives a picture of the heart's arteries to determine the extent of coronary disease, or PCI (percutaneous coronary intervention), a non-surgical procedure that involves inserting and inflating a balloon to open a blocked artery.

Dr. Mike Moffatt, executive director of research and applied learning with the Winnipeg Regional Health Authority, said unfortunately, there are "not too many real surprises" in the report.

The frequency of heart attacks in First Nations communities is linked with high blood pressure, obesity, a sedentary lifestyle and the presence of other health complications, such as diabetes.

Better health screening, a greater emphasis on prevention programs and a reduction in poverty would lessen the likelihood of heart attacks in these communities, he said.

Moffatt, a pediatrician who regularly travels to Norway House in northern Manitoba and to Nunavut, said such communities need better and more integrated primary health care.

"I'm a pediatrician, so my patients aren't having heart attacks today, but I can see lots of them that are going to have heart attacks 20 to 40 years from now," he said.

A big challenge in obtaining information about heart attack rates for aboriginal people is that patients' ethnicity is not consistently recorded by hospitals across the country, so the institute did a statistical analysis comparing areas with high-aboriginal and low-aboriginal populations, using 2006 census data as a reference point.

In Manitoba, communities with a high-First Nations population included Norway House, Kelsey (northeast of Thompson) and Churchill. Also included were specific areas within Winnipeg, which researchers didn't identify. Communities with low-aboriginal populations, used for comparison purposes, included towns like Hanover, Winkler and Piney.

Provincial breakdowns were not released because the numbers were not sufficiently high to be statistically significant on their own, said Sushma Mathur, manager of the Canadian Population Health Initiative at CIHI.

Health officials said Thursday First Nations people in remote locations may not receive certain cardiac procedures as frequently as they must be performed within a few hours of a heart attack.



Statistical data from new report

The heart attack rate is 76 per cent higher for residents in communities with a high-First Nations population in Canada than for residents of low-aboriginal population areas (277 vs. 157 per 100,000 people).

Heart attack patients tend to be younger in high-First Nations areas (median age of 64 vs. 71 in low-aboriginal population areas).

Heart attack patients are more likely to suffer from one other health condition in high-First Nations population communities.

Residents of high-First Nations population areas are more likely to travel long distances for cardiac care. Thirty-eight per cent travelled more than 250 kilometres between 2004 and 2011, compared with eight per cent from low-aboriginal areas.

Heart attack patients from high-First Nations population areas were less likely to receive certain cardiac procedures.


-- source: Hospital Care for Heart Attacks Among First Nations, Inuit and Métis, a report of the Canadian Institute for Health Information

Republished from the Winnipeg Free Press print edition February 1, 2013 A5

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