Associations of Cultural Characteristics with Sedentary Behaviour and Screen Time Among Indigenous Adults in Saskatchewan.

BACKGROUND: Indigenous Peoples: First Nations, Métis and Inuit, have experienced significant disruptions of physical, mental, emotional and spiritual health and well-being through centuries of ongoing colonization and assimilation. Consequently, breakdown of cultural connections, increasingly sedentary lifestyles and high levels of screen time contribute to health inequity experiences. PURPOSE: The purpose of this study is to examine associations of cultural connectedness with sedentary behaviour and the influence of relocation from home communities for Indigenous Peoples in Saskatchewan. METHODS: Cultural connectedness, sedentary and screen time behaviour were evaluated through online questionnaires among 106 Indigenous adults. Within Indigenous identities, 2 × 2 factorial ANOVA compared cultural connectedness scores with sedentary behaviour and traditional activity participation by relocation from home communities. RESULTS: Among First Nations and specifically Cree/Nehiyawak who relocated from home communities, positive associations of cultural connectedness scores with sedentary behaviour and screen time were identified, with no associations identified among those not relocating. Among Métis who did not relocate, greater ethnic identity, identity, spirituality and cultural connectedness (57.8 ± 5.36 vs. 81.25 ± 16.8; p = 0.02) scores were reported among those reporting 5 or more hours of continuous sitting. CONCLUSIONS: Cultural connectedness associations with sedentary behaviour depend on relocation from home communities and differ between First Nations and Métis. Understanding associations of sedentary behaviour specific to First Nations and Métis populations may enable appropriate strategies to improve health outcomes.

Ethnic differences in the cardiac responses to aerobic exercise.

Background: Cardiovascular disease disproportionately affects North American Indigenous populations. Ethnic differences in cardiac responses to exercise are known, though Indigenous populations response is unknown. To evaluate cardiac responses to aerobic exercise among Canadian Indigenous and European adults. Methods: Indigenous (N = 12, 4 females, 1 male incomplete) and European (N = 12, all completed) Canadian age and sex-matched adults 19-40 years and free of cardiovascular disease or diabetes completed a cycle ergometer maximal aerobic power test and 30 min at 60% maximal aerobic capacity on two separate days. Echocardiographic assessments preceded and immediately followed exercise. Results: Responses to maximal exercise were similar among ethnicities including decreases in stroke volume index, cardiac output index and ejection fraction, and increases in arterial-ventricular coupling. However, following submaximal exercise, only Indigenous adults demonstrated reductions in end systolic volume, end diastolic volume (154.8 ± 40.6 mL to 136.5 ± 33.0 mL, p = 0.01, vs. 149.4 ± 22.4 mL to 147.1 ± 27.0 mL; p = 0.81), stroke volume index (44.9 ± 8.7 mL m-2 to 38.0 ± 6.5 mL m-2, p = 0.002, vs. 46.4 ± 7.1 mL m-2 to 44.0 ± 6.5 mL m-2; p = 0.28) and arterial compliance. Conclusion: Indigenous and European adults demonstrated similar cardiac responses to maximal exercise, though only Indigenous adults demonstrated cardiac responses to submaximal exercise.

A systematic review and meta-analysis of cardiorespiratory fitness among Indigenous populations in North America and circumpolar Inuit populations.

Indigenous populations experience health disparities including increased obesity, diabetes and cardiovascular disease rates. Cardiorespiratory fitness is beneficial for maintaining positive health outcomes. The objective of this systematic review is to evaluate cardiorespiratory fitness among Indigenous populations including comparisons across genders, Indigenous identities, age groups, decades, socio-demographic variables and in comparison to non-Indigenous groups. Included articles reported various cardiorespiratory fitness measures using maximal treadmill or cycle ergometer tests, 20 m shuttle run, 1 mile run/walk test and 6 min walk test. From 14 databases searched in March 2017, including MEDLINE, EMBASE and Scopus, 1069 citations were evaluated and 39 articles included, representing 32 investigations and 10,579 individuals. First Nations/American Indian (FN/AI) adults have greater cardiorespiratory fitness than Inuit. Inuit and FN/AI men and boys have higher cardiorespiratory fitness than women and girls. Lower cardiorespiratory fitness is associated with obesity, metabolic syndrome and a western lifestyle. Cardiorespiratory fitness has declined among Inuit adults, averaging 51.7 ±â€¯7.9 mL·kg-1·min-1 in 1970 to 37.7 ±â€¯6.9 mL·kg-1·min-1 in 2000. Among men, FN/AI have greater cardiorespiratory fitness compared to European-descents, and European-descents have greater cardiorespiratory fitness compared to Inuit. The 1 mile run/walk time showed that FN/AI boys, girls, and youth had faster times compared to European-descendants, but 20 m shuttle run showed that European-descent boys and youth advanced to further stages compared to FN/AI populations. Cardiorespiratory fitness is declining, and among some Indigenous populations to lower levels than European-descent populations. Improving cardiorespiratory fitness for Indigenous populations should be considered a primary health strategy.

Exercise volume and intensity: a dose-response relationship with health benefits.

INTRODUCTION: The health benefits of exercise are well established. However, the relationship between exercise volume and intensity and health benefits remains unclear, particularly the benefits of low-volume and intensity exercise. PURPOSE: The primary purpose of this investigation was, therefore, to examine the dose-response relationship between exercise volume and intensity with derived health benefits including volumes and intensity of activity well below international recommendations. METHODS: Generally healthy, active participants (n = 72; age = 44 ± 13 years) were assigned randomly to control (n = 10) or one of five 13-week exercise programs: (1) 10-min brisk walking 1×/week (n = 10), (2) 10-min brisk walking 3×/week (n = 10), (3) 30-min brisk walking 3×/week (n = 18), (4) 60-min brisk walking 3×/week (n = 10), and (5) 30-min running 3×/week (n = 14), in addition to their regular physical activity. Health measures evaluated pre- and post-training including blood pressure, body composition, fasting lipids and glucose, and maximal aerobic power (VO2max). RESULTS: Health improvements were observed among programs at least 30 min in duration, including body composition and VO2max: 30-min walking 28.8-34.5 mL kg(-1) min(-1), 60-min walking 25.1-28.9 mL kg(-1) min(-1), and 30-min running 32.4-36.4 mL kg(-1) min(-1). The greater intensity running program also demonstrated improvements in triglycerides. CONCLUSION: In healthy active individuals, a physical activity program of at least 30 min in duration for three sessions/per week is associated with consistent improvements in health status.

A scoping review of Indigenous community-specific physical activity measures developed with and for Indigenous Peoples in Canada, Australia, and New Zealand.

Historical factors including colonization and ongoing socioeconomic inequities impact Indigenous Peoples' ability to mitigate chronic disease risks such as achieving recommended physical activity (PA) levels. Reliably assessing, reflecting, and promoting PA participation among Indigenous Peoples may be impacted by a lack of culturally appropriate assessment methods and meaningful engagement with Indigenous communities throughout the research process. The objectives of this scoping review were to examine: (1) How PA research with Indigenous Peoples used community-specific PA measures developed with and/or for Indigenous Peoples in Canada, Australia, and New Zealand; and (2) How the studies utilized community-based participatory research (CBPR) principles to engage communities. A systematic search was conducted in four electronic databases (Web of Science, Medline, University of Saskatchewan Indigenous Portal, and ProQuest Dissertations and Theses Global). Thirty-one (n = 31) articles were identified and data extracted for narrative synthesis. Studies using community-specific PA measures have been increasing over time. Adapting questionnaires to traditional Indigenous activities such as cultural dances, ceremonies, and food-gathering activities were the most frequent adjustments undertaken to use community-specific measures. There are, however, gaps in research partnering with communities with only 6% of studies including all eight CBPR principles. Practical ways researchers can engage Indigenous communities and build capacity such as training and employing community members were highlighted. More needs to be done to facilitate community self-determination and develop long-term sustainable initiatives. Using culturally appropriate and relevant methodologies including partnering with Indigenous communities may help identification and implementation of culturally relevant and sustainable health-promoting initiatives.

The Canadian Women's Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women - Chapter 7: Sex, Gender, and the Social Determinants of Health.

Women vs men have major differences in terms of risk-factor profiles, social and environmental factors, clinical presentation, diagnosis, and treatment of cardiovascular disease. Women are more likely than men to experience health issues that are complex and multifactorial, often relating to disparities in access to care, risk-factor prevalence, sex-based biological differences, gender-related factors, and sociocultural factors. Furthermore, awareness of the intersectional nature and relationship of sociocultural determinants of health, including sex and gender factors, that influence access to care and health outcomes for women with cardiovascular disease remains elusive. This review summarizes literature that reports on under-recognized sex- and gender-related risk factors that intersect with psychosocial, economic, and cultural factors in the diagnosis, treatment, and outcomes of women's cardiovascular health.

Les profils de facteurs de risque, les facteurs sociaux et environnementaux, le tableau clinique, le diagnostic et le traitement des maladies cardiovasculaires montrent des différences importantes entre les femmes et les hommes. Il est plus probable que les femmes expérimentent des problèmes de santé complexes et multifactoriels, qui sont souvent en relation avec les disparités dans l'accès aux soins, la prévalence des facteurs de risque, les différences biologiques entre les sexes, les facteurs liés au genre et les facteurs socioculturels. De plus, la sensibilisation à la nature et à la relation intersectionnelles des déterminants socioculturels de santé, notamment les facteurs liés au sexe et au genre, qui influencent l'accès aux soins et les résultats cliniques des femmes atteintes d'une maladie cardiovasculaire demeure insaisissable. La présente revue résume la littérature qui porte sur les facteurs de risque liés au sexe et au genre peu reconnus qui se recoupent aux facteurs psychosociaux, économiques et culturels dans le diagnostic, le traitement et les résultats cliniques en lien avec la santé cardiovasculaire des femmes.

The Canadian Women's Heart Health Alliance Atlas on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women - Chapter 6: Sex- and Gender-Specific Diagnosis and Treatment.

This chapter summarizes the sex- and gender-specific diagnosis and treatment of acute/unstable presentations and nacute/stable presentations of cardiovascular disease in women. Guidelines, scientific statements, systematic reviews/meta-analyses, and primary research studies related to diagnosis and treatment of coronary artery disease, cerebrovascular disease (stroke), valvular heart disease, and heart failure in women were reviewed. The evidence is summarized as a narrative, and when available, sex- and gender-specific practice and research recommendations are provided. Acute coronary syndrome presentations and emergency department delays are different in women than they are in men. Coronary angiography remains the gold-standard test for diagnosis of obstructive coronary artery disease. Other diagnostic imaging modalities for ischemic heart disease detection (eg, positron emission tomography, echocardiography, single-photon emission computed tomography, cardiovascular magnetic resonance, coronary computed tomography angiography) have been shown to be useful in women, with their selection dependent upon both the goal of the individualized assessment and the testing resources available. Noncontrast computed tomography and computed tomography angiography are used to diagnose stroke in women. Although sex-specific differences appear to exist in the efficacy of standard treatments for diverse presentations of acute coronary syndrome, many cardiovascular drugs and interventions tested in clinical trials were not powered to detect sex-specific differences, and knowledge gaps remain. Similarly, although knowledge is evolving about sex-specific difference in the management of valvular heart disease, and heart failure with both reduced and preserved ejection fraction, current guidelines are lacking in sex-specific recommendations, and more research is needed.

Ce chapitre présente un résumé sur le diagnostic et le traitement des tableaux cliniques aigus/instables et non aigus/stables des maladies cardiovasculaires chez les femmes, et les différences propres à chacun des deux sexes. Les lignes directrices, les énoncés scientifiques, les revues systématiques/méta-analyses et les études de recherche originale sur le diagnostic et le traitement des coronaropathies, des maladies vasculaires cérébrales (AVC), des valvulopathies cardiaques et de l'insuffisance cardiaque chez les femmes ont été examinés. Les données probantes sont résumées sous forme narrative et, lorsqu'elles sont disponibles, des recommandations en matière de pratique et de recherche pour chacun des deux sexes sont présentées. Les tableaux cliniques du syndrome coronarien aigu et les délais d'attente à l'urgence sont différents selon qu'une femme ou un homme en est atteint. L'angiographie coronarienne reste l'examen de référence pour le diagnostic des coronaropathies obstructives. D'autres examens d'imagerie diagnostique (p. ex. la tomographie par émission de positons, l'échocardiographie, la tomographie d'émission à photon unique, la résonance magnétique cardiovasculaire, l'angiographie coronarienne par tomodensitométrie) se sont avérés utiles pour la détection des cardiopathies ischémiques chez les femmes. Le recours à ces modalités dépend de l'objectif de l'évaluation personnalisée et des ressources disponibles. La tomodensitométrie sans agent de contraste et l'angiographie par tomodensitométrie sont utilisées pour le diagnostic des AVC chez les femmes. Malgré les différences entre les sexes quant à l'efficacité des traitements de référence des divers tableaux cliniques du syndrome coronarien aigu, bon nombre des médicaments et des interventions cardiovasculaires qui ont fait l'objet d'essais cliniques n'avaient pas la puissance statistique nécessaire pour détecter des différences selon les sexes, de sorte que les connaissances restent fragmentaires sur ce sujet. De même, malgré l'évolution des connaissances sur les différences sexuelles quant à la prise en charge des valvulopathies cardiaques et de l'insuffisance cardiaque avec fraction d'éjection réduite ou préservée, on ne trouve pas de recommandations pour chaque sexe dans les lignes directrices actuelles, d'où la pertinence d'études supplémentaires portant sur cette question.

The Canadian Women's Heart Health Alliance Atlas on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women - Chapter 4: Sex- and Gender-Unique Disparities: CVD Across the Lifespan of a Woman.

Women have unique sex- and gender-related risk factors for cardiovascular disease (CVD) that can present or evolve over their lifespan. Pregnancy-associated conditions, polycystic ovarian syndrome, and menopause can increase a woman's risk of CVD. Women are at greater risk for autoimmune rheumatic disorders, which play a role in the predisposition and pathogenesis of CVD. The influence of traditional CVD risk factors (eg, smoking, hypertension, diabetes, obesity, physical inactivity, depression, anxiety, and family history) is greater in women than men. Finally, there are sex differences in the response to treatments for CVD risk and comorbid disease processes. In this Atlas chapter we review sex- and gender-unique CVD risk factors that can occur across a woman's lifespan, with the aim to reduce knowledge gaps and guide the development of optimal strategies for awareness and treatment.

Les femmes présentent des facteurs de risque de maladies cardiovasculaires (MCV) uniques, liés au sexe et au genre, qui peuvent se manifester ou évoluer tout au long de leur vie. Les troubles médicaux associés à la grossesse, le syndrome des ovaires polykystiques et la ménopause peuvent augmenter le risque de MCV chez une femme. Les femmes sont plus exposées aux troubles rhumatologiques auto-immuns, qui jouent un rôle dans la prédisposition et dans la pathogenèse des MCV. L'influence des facteurs de risque traditionnels pour les MCV (par exemple, le tabagisme, l'hypertension, le diabète, l'obésité, la sédentarité, la dépression, l'anxiété et les antécédents familiaux) est plus importante chez les femmes que chez les hommes. Enfin, il existe des différences entre les sexes dans la réponse aux traitements du risque de MCV et des processus pathologiques comorbides. Dans ce chapitre de l'Atlas, nous passons en revue les facteurs de risque de MCV propres au sexe et au genre qui peuvent survenir tout au long de la vie d'une femme, dans le but de réduire les lacunes dans les connaissances et d'orienter l'élaboration de stratégies optimales de sensibilisation et de traitement.

The effectiveness of community based physical activity interventions with Aboriginal peoples.

UNLABELLED: Though historically rare, Aboriginal individuals continue to experience greater levels of cardiovascular disease than the general Canadian population. Increasing evidence indicates rising sedentary behaviors from the traditional healthy and active lifestyles of this population. OBJECTIVE: This investigation aimed to examine the health benefits of a community-based physical activity intervention for Aboriginal Canadians. METHODS: From 2007-2010, 273 participants from the province of British Columbia, Canada were recruited through 21 Aboriginal communities representing male and females of wide ranging ages and health statuses. Participants attended identical testing of body composition, blood pressure, total and high density lipoprotein cholesterols, and physical activity behavior pre-and post-training. Participants completed one of three self-selected 13 week interventions: walking (n=149), walk/running (n=86), or running (n=27). RESULTS: Improvements in health measures were observed for both male and female participants of all age groups and all three training programs. Male and female participants' improvements included waist circumference: 2.7 cm and 2.2 cm, total cholesterol: 0.18 mmol/L and 0.12 mmol/L, and systolic blood pressure: 2.6mm Hg and 1.5mm Hg, respectively. CONCLUSIONS: The self-selected intensities program was successful in improving health status and physical activity for Aboriginal adults of all ages, genders and activity programs.

Social determinants associated with physical activity among Indigenous adults at the University of Saskatchewan.

Colonization impacts Indigenous Peoples' way of life, culture, language, community structure and social networks. Links between social determinants of health and physical activity (PA) among Indigenous Peoples in Saskatchewan, with 16% Indigenous residents, are unclear. This cross-sectional study, guided by Indigenous Community Advisors, compared moderate-to-vigorous PA (MVPA), traditional Indigenous PA and musculoskeletal PA with social determinants of Indigenous (n = 124), including First Nations (n = 80, including 57 Cree/Nehiyawak) and Métis (n = 41), adults in Saskatchewan. Participants completed Godin-Shephard Leisure-Time PA, Social Support Index and traditional Indigenous PA participation questionnaires. Regression associated positive perception of social support with MVPA (R = 0.306, p = 0.02), while residential school experiences (R = 0.338, p = 0.02) and community support (R = 0.412, p = 0.01) were associated with traditional Indigenous PA participation. Among Métis, discrimination experiences were associated with traditional Indigenous PA participation (R = 0.459, p = 0.01). Traditional Indigenous PA participation was associated with community support among First Nations (R = 0.263, p = 0.04), and also foster care placement (R = 0.480, p = 0.01) for Cree/Nehiyawak First Nations specifically. Among Cree/Nehiyawak, family support (R = 0.354, p = 0.04), discrimination experiences (R = 0.531, p = 0.01) and positive perceptions of support (R = 0.610, p = 0.003) were associated with musculoskeletal PA. Greater community, family and perceived social support, and experiences of discrimination, residential school and foster care are associated with more PA for Indigenous Peoples. Novelty: Positive support perceptions predict physical activity among Indigenous Peoples. Family support, discrimination experiences and positive support perceptions predict physical activity for Cree/Nehiyawak First Nations. Traditional physical activity was predicted by residential school experiences and community support (Indigenous Peoples), discrimination experiences (Métis), community support (First Nations), and foster care experiences (Cree/Nehiyawak).

The Canadian Women's Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women-Chapter 2: Scope of the Problem.

BACKGROUND: This Atlas chapter summarizes the epidemiology of cardiovascular disease (CVD) in women in Canada, discusses sex and gender disparities, and examines the intersectionality between sex and other factors that play a prominent role in CVD outcomes in women, including gender, indigenous identity, ethnic variation, disability, and socioeconomic status. METHODS: CVD is the leading cause of premature death in Canadian women. Coronary artery disease, including myocardial infarction, and followed by stroke, accounts for the majority of CVD-related deaths in Canadian women. The majority of emergency department visits and hospitalizations by women are due to coronary artery disease, heart failure, and stroke. The effect of traditional cardiovascular risk factors and their association with increasing cardiovascular morbidity is unique in this group. RESULTS: Indigenous women in Canada experience increased CVD, linked to colonization and subsequent social, economic, and political challenges. Women from particular racial and ethnic backgrounds (ie, South Asian, Afro-Caribbean, Hispanic, and Chinese North American women) have greater CVD risk factors, and CVD risk in East Asian women increases with duration of stay in Canada. CONCLUSIONS: Canadians living in northern, rural, remote, and on-reserve residences experience greater CVD morbidity, mortality, and risk factors. An increase in CVD risk among Canadian women has been linked with a background of lower socioeconomic status, and women with disabilities have an increased risk of adverse cardiac events.

CONTEXTE: Ce chapitre de l'Atlas condense l'épidémiologie des maladies cardiovasculaires (MCV) chez les femmes au Canada, aborde les disparités entre les sexes et les genres, et examine l'interrelation entre le sexe et d'autres facteurs qui jouent un rôle important dans l'émergence des MCV chez les femmes, notamment le genre, l'identité autochtone, les variations ethniques, le handicap et le statut socio-économique. MÉTHODES: Les MCV sont la principale cause de décès prématuré chez les femmes canadiennes. Les maladies coronariennes, y compris l'infarctus du myocarde, suivies des accidents vasculaires cérébraux, sont à l'origine de la majorité des décès liés aux MCV chez les femmes canadiennes. La majorité des visites aux urgences et des hospitalisations des femmes sont dues à des maladies coronariennes, des insuffisances cardiaques et des accidents vasculaires cérébraux. L'effet des facteurs de risque cardiovasculaire traditionnels et leur association avec l'augmentation de la morbidité cardiovasculaire est unique dans ce groupe. RÉSULTATS: Les femmes autochtones du Canada connaissent un accroissement des maladies cardiovasculaires, liée à la colonisation et aux défis sociaux, économiques et politiques qui en découlent. Les femmes d'origines raciales et ethniques spécifiques (par exemple les femmes sud-asiatiques, afro-caribéennes, hispaniques et chinoises d'Amérique du Nord) présentent des facteurs de risque de MCV plus importants, et le risque de MCV chez les femmes d'Asie de l'Est augmente avec la durée de leur séjour au Canada. CONCLUSIONS: Les canadiens qui vivent dans les régions nordiques, rurales, éloignées et dans les réserves présentent une morbidité, une mortalité et des facteurs de risque de MCV plus élevés. L'augmentation du risque de MCV chez les femmes canadiennes a été associée à un statut socio-économique plus bas, et les femmes handicapées ont un risque accru de survenue d'événements cardiaques indésirables.

A Systematic Review of Musculoskeletal Fitness Among Indigenous Populations in North America and Circumpolar Inuit Populations.

BACKGROUND: North American indigenous populations experience higher rates of obesity and chronic disease compared with nonindigenous populations. Improvements in musculoskeletal fitness can mitigate negative health outcomes, but is not well understood among indigenous populations. This review examines musculoskeletal fitness measures among North American indigenous populations. METHODS: A total of 1632 citations were evaluated and 18 studies were included. RESULTS: Comparisons of musculoskeletal fitness measures between North American indigenous men and boys and women and girls were generally not reported. The greatest left and right combined maximal grip strength and maximal leg strength among Inuit boys and men and girls and women were observed among 20-29 years age group. Maximal combined right and left grip strength declined from 1970 to 1990, by an average of 15% among adults and 10% among youth. Maximal leg extension among Inuit has declined even further, averaging 38% among adults and 27% among youth from 1970 to 1990. Inuit men demonstrate greater grip strength and lower leg strength than Russian indigenous men, whereas Inuit women demonstrate greater leg strength. CONCLUSIONS: Further research is needed to better understand physical fitness among indigenous peoples and the potential for improving health and reducing chronic disease risk for indigenous peoples through physical fitness.

Cultural connectedness as a determinant of physical activity among Indigenous adults in Saskatchewan.

Cultural connectedness has been associated with increased self-esteem and mental health among Indigenous Peoples. Physical activity is an important contributor to health, although the importance of culture as a determinant of physical activity for Indigenous Peoples in Canada is unclear. The purpose of this study is to evaluate differences in cultural connectedness between Indigenous adults in Canada achieving high and low physical activity levels. Questionnaires evaluated cultural connectedness and physical activity. Indigenous adults were classified into high and low physical activity groups at the specific group mean and as meeting or not meeting musculoskeletal activity guidelines of twice per week. First Nations and specifically Cree/Nehiyaw First Nations adults who were more physically active reported greater identity, spirituality, traditions, exploration, commitment, affirmation/belonging, and overall cultural connectedness. Cultural connectedness elements of commitment, exploration, identity, affirmation/belonging, traditions, spirituality, and overall cultural connectedness were not different between high and low physical activity Métis adults. Musculoskeletal activity was not associated with any elements of cultural connectedness among any Indigenous identity. Cultural connectedness is a protective factor for physical activity among First Nations and Cree/Nehiyaw First Nations adults, but not among Métis adults in Canada. Novelty Musculoskeletal activity was not associated with cultural connectedness. Cultural connectedness is a protective factor of physical activity for First Nations adults. Moving away from one's home community was associated with lower cultural connectedness for Indigenous Peoples.

Ethnic differences in vascular function and factors contributing to blood pressure.

OBJECTIVE: Indigenous populations experience greater proportions of cardiovascular disease, diabetes, and obesity, though lower rates of hypertension. This investigation evaluated blood pressure relationships with vascular measures, anthropometry, cultural identity, and smoking status among Canadian Indigenous and European adults. METHODS: In 2013, in Vancouver, Canada, blood pressure, anthropometry, cultural identity, smoking status, pulse wave velocity (PWV), arterial compliance, baroreceptor sensitivity, and intima-media thickness (IMT) were directly measured among 58 Indigenous (39 ± 18 years, 31 female) and 58 age- and sex-matched European Canadian (42 ± 18 years) adults. Systolic (SBP) and diastolic (DBP) blood pressures were related to vascular measures, and hypertension was related to anthropometry, cultural identity, and smoking status. RESULTS: Similar vascular measures were recorded between Indigenous and European adults, respectively (PWV 5.3 ± 2.4 vs. 6.2 ± 3.4 m s-1, p = 0.12; IMT 0.59 ± 0.11 vs. 0.61 ± 0.11 mm, p = 0.40; and large arterial compliance 16.1 ± 6.4 vs. 17.5 ± 6.6 mL mmHg-1 × 10, p = 0.26). Similar relationships between vascular measures with SBP and DBP were identified between Indigenous and European adults (spectral baroreceptor sensitivity and SBP, r = 0.48, p = 0.001 vs. r = - 0.11, p = 0.44; ethnic difference p = 0.38; PWV; and DBP, r = 0.23, p = 0.09 vs. r = 0.06, p = 0.65, ethnic difference p = 0.23). Anthropometry only related to blood pressures among Europeans. Cultural identity only related to blood pressures among Indigenous populations. Smoking was not related to hypertension. CONCLUSION: Similar vascular measures between Indigenous and European Canadians were identified among populations experiencing similar social determinants of health.

Cardiovascular dynamics of Canadian Indigenous peoples.

Limited understanding of Indigenous adults' cardiovascular structure and function exists despite high rates of cardiovascular disease. This investigation characterised cardiovascular structure and function among young Indigenous adults and compared to age- and sex-matched European descendants. Echocardiographic assessments included apical two- and four-chamber images, parasternal short-axis images and Doppler. Analyses included cardiac volumes, dimensions, velocities and strains. Cardiovascular structure and function were similar between Indigenous (n=10, 25 ± 3 years, 4 women) and European-descendant (n=10, 24 ± 4 years, 4 women,) adults, though European descendants demonstrated greater systemic vascular resistance (18.19 ± 3.94 mmHg∙min-1∙L-1 vs. 15.36 ± 2.97 mmHg∙min-1∙L-1, p=0.03). Among Indigenous adults, women demonstrated greater arterial elastance (0.80 ± 0.15 mmHg·mL-1·m-2 vs. 0.55 ± 0.17 mmHg·mL-1·m-2, p=0.02) and possibly greater systemic vascular resistance (17.51 ± 2.20 mmHg∙min-1∙L-1 vs. 13.93 ± 2.61 mmHg∙min-1∙L-1, p=0.07). Indigenous men had greater cardiac size, dimensions and output, though body size differences accounted for cardiac size differences. Similar cardiac rotation and strains were observed across sexes. Arterial elastance and cardiac size were different between Indigenous men and women while cardiovascular structure and function may be similar between Indigenous and European descendants.

Ethnic differences in vascular responses to aerobic exercise.

UNLABELLED: Indigenous populations currently experience greater rates of cardiovascular disease. Although ethnic differences in cardiovascular responses to exercise have previously been identified, these responses among indigenous populations are unknown. PURPOSE: This investigation aimed to evaluate the vascular responses to aerobic exercise of Canadian indigenous and European adults. METHODS: Twelve age- and sex-matched indigenous and European adults completed a cycle ergometer maximal aerobic power test and submaximal 30 min of 60% maximal aerobic capacity on two separate days. Blood pressure, pulse wave velocity, baroreceptor sensitivity, arterial compliance, vascular resistance, and intima-media thickness were directly measured before and after aerobic exercises. RESULTS: Vascular responses to exercise were generally similar between indigenous and European adults including decreases in baroreceptor sensitivity and vascular resistance after maximal exercise. No changes in intima-media thickness, pulse wave velocity, and arterial compliance were observed after exercise in either group. However, after submaximal exercise, only European adults demonstrated reductions in baroreceptor sensitivity (spectral: 9.2 ± 4.3 to 11.5 ± 6.7 ms·mm Hg, P = 0.41, vs 15.8 ± 8.3 m·s to 8.9 ± 5.7 ms·mm Hg, P = 0.02; sequence: 14.6 ± 5.4 to 16.5 ± 11.0 ms·mm Hg, P = 0.48, vs 26.2 ± 10.5 m·s to 15.4 ± 9.4 ms·mm Hg, P = 0.02). Similarly, decreases in blood pressure after exercise were observed only among European adults. CONCLUSIONS: Indigenous adults demonstrated vascular responses similar to those demonstrated by European adults, although blood pressure was only observed to decrease among European adults after maximal and submaximal exercise, and baroreceptor sensitivity, after submaximal exercise.