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Rapid Communication| Volume 91, ISSUE 11, P1379-1382, June 01, 2003

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Prevalence and correlates of rheumatic heart disease in American Indians (The Strong Heart Study)*

DOI:https://doi.org/10.1016/S0002-9149(03)00338-2
Prevalence and correlates of rheumatic heart disease in American Indians (The Strong Heart Study)**This study presents views of the authors and not necessarily those of the Indian Health Service.
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      With the exception of isolated outbreaks, acute rheumatic fever has all but disappeared from developed nations, and its sequela, chronic rheumatic heart disease (RHD), has become uncommon. Prevalence estimates for RHD vary, from 0.6/1,000 among American school-age children
      • Miller R.A.
      • Stamler J.
      • Smith J.M.
      • Milne W.S.
      • Paul M.H.
      • Abrams I.
      • Hastreiter A.R.
      • Restivo R.M.
      • DeBoer L.
      The detection of heart disease in children.
      Circulation. 1965; 32: 956-961
      to <0.05/1,000 among hospital discharge diagnoses.

      Jamison DT, Mosley WH, Measham AR, eds. Disease Control Priorities in Developing Countries. Oxford University Press, 1993:222

      In developing nations, rheumatic fever and RHD continue unabated, with RHD affecting an estimated 5 to 30 million worldwide.
      • Soler-Soler J.
      • Galve E.
      Worldwide perspective of valve disease.
      Heart. 2000; 83: 721-725
      Documented outbreaks of streptococcal infections in American Indian communities
      • Zimmerman R.A.
      • Cross W.M.
      • Miller D.R.
      A streptococcal epidemic in an isolated civilian population with institution of mass prophylaxis.
      J Pediatr. 1966; 69: 40-45
      ,
      • Anthony B.F.
      • Kaplan E.L.
      • Wannamaker L.W.
      • Briese F.W.
      • Chapman S.S.
      Attack rates of acute nephritis after type 49 streptococcal infection of the skin and of the respiratory tract.
      J Clin Invest. 1969; 48: 1697-1704
      and retrospective studies of valvular heart disease
      • Coulehan J.
      • Grant S.
      • Reisinger K.
      • Killian P.
      • Rogers K.D.
      • Kaltenbach C.
      Acute rheumatic fever and rheumatic heart disease on the Navajo reservation, 1962–77.
      Public Health Rep. 1980; 95: 63-68
      ,
      • Becker T.M.
      • Wiggins C.L.
      • Key C.R.
      • Samet J.M.
      Ethnic differences in mortality from acute rheumatic fever and chronic rheumatic heart disease in New Mexico, 1958–1982.
      West J Med. 1989; 150: 46-50
      suggest that this population may have a high prevalence of RHD. Therefore, the Strong Heart Study (SHS) assessed the prevalence and correlates of RHD in American Indians.
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      Article info

      Publication history

      Accepted: February 24, 2003
      Received in revised form: February 24, 2003
      Received: October 21, 2002

      Footnotes

      This study was supported in part by grants U01-HL41642, U01-HL41652, and U01-HL41654 from the National Heart, Lung, and Blood Institute and grant M10RR0047-34 (GCRC) from the National Institutes of Health, Bethesda, Maryland.

      Identification

      DOI: https://doi.org/10.1016/S0002-9149(03)00338-2

      Copyright

      © 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.

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