The Genetics of Cardiovascular Disease in Canadian and International Aboriginal Populations

Abstract

For Aboriginal populations, as in all populations, understanding the genetic component of cardiovascular disease informs effective treatment and prevention strategies. The term, "genetics of cardiovascular disease," broadly includes the genetics of susceptibility for atherosclerosis, cardiomyopathy, arrhythmia, and congenital heart disease, collectively a major cause of mortality and morbidity throughout the life course. Aboriginal populations are often genetically and culturally distinct, and as would be expected with distinct ethnic differences, there are also differences in rates and types of heart disease, which supports the importance of understanding possible genetic factors that might alter susceptibility. In Canada, higher rates of congenital heart malformations have been identified in some Inuit and First Nations than in the non-Aboriginal population. Moreover, at least 3 different First Nations communities in Canada have been found to have disproportionately higher rates of congenital long QT syndrome, a genetic predisposition to arrhythmia and sudden cardiac death. Although rates of ischemic heart disease historically have been lower in Aboriginal populations, more recent evidence suggests equal or higher rates than in non-Aboriginal populations. Although relatively few Aboriginal communities in Canada have participated in research to explore the genetic component of cardiovascular disease, recent progress in research standards of practice that require collaborative approaches have opened the doors for more involvement. Herein we present what has been learned to date through research and the apparent gaps in the understanding of the genetics of heart disease in Canadian, American, Circumpolar, and other international Indigenous populations.