Background: A considerable body of research has been accumulated regarding the pathogenesis and treatment of hypertension in Whites (Caucasians) and in Blacks. This research has led to more effective therapies geared specifically towards these ethnic groups. Unfortunately, very little information is available regarding the pathogenesis of hypertension and the effect of antihypertensive treatment in Native Americans (North-American Indians). Ethnic variability in the response to adrenergic mediated stimulation has been previously described, and reduced compliance of the venous system has been suggested among the possible mechanisms responsible for essential hypertension. The aim of this study was to compare venous responsiveness between Native Americans and Whites to vasoactive substances.
Methods: The alpha1-adrenergic agonist, phenylephrine and the beta2-adrenergic agonist isoproterenol were studied in 10 Native American and White volunteers. The dorsal hand vein technique was used, which is a simple, relatively non-invasive method to study the response to vasoactive substances, in vivo.
Results: The maximal venodilatory response to isoproterenol in the Native American group was 53.2+/-27.5%; while in the White group it was 103.4+/-66.0% (p<0.05). The maximal venoconstriction for phenylephrine in the Native American subject group was similar to that of the White group (85.4+/-24.0% vs. 89.4+/-10.9%) (p = n.s.).
Conclusions: Based on our findings, we can anticipate that Native Americans may respond differently to antihypertensive therapy. However, further investigation needs to be done with an eye towards the development of drug therapy and treatment strategies tailored to this specific population.
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JAMA Netw Open
January 2025
Ronald O. Perelman Department of Emergency Medicine, New York University Langone Health, New York.
Importance: Increasing underrepresented in medicine (URIM) physicians among historically underserved communities helps reduce health disparities. The concordance of URIM physicians with their communities improves access to care, particularly for American Indian and Alaska Native, Black, and Hispanic or Latinx individuals.
Objectives: To explore county-level racial and ethnic representation of US internal medicine (IM) residents, examine racial and ethnic concordance between residents and their communities, and assess whether representation varies by presence of academic institutions or underserved settings.
Cien Saude Colet
January 2025
Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil.
The aim is to identify the epidemiological profile of mortality among Brazilian indigenous children under five years of age, through an integrative review. Articles that evaluated the mortality of indigenous Brazilian children under one and/or five years of age, from 2000 to 2020, in Portuguese, English, and/or Spanish, in the LILACS, SciELO, and MEDLINE databases were included. Of the 3,229 publications found, 22 were included in the review.
View Article and Find Full Text PDFGlob Public Health
December 2025
Indigenous Wellness Core, Alberta Health Services, Edmonton, Alberta, Canada.
Connecting with traditional knowledge and culture promotes the well-being of Indigenous parents and creates healthy environments for child development. Community Elders in a remote northern community in Alberta, Canada, collaborated with researchers to design a pilot Elders Mentoring Program. The programme aims to support young Indigenous mothers(-to-be), bringing back cultural traditions and teachings.
View Article and Find Full Text PDFGlob Adv Integr Med Health
January 2025
Alameda County Health, San Leandro, CA, USA.
Background: Food as Medicine is a rapidly developing area of health care in the United States, aimed at concurrently addressing nutrition-sensitive chronic conditions and food and nutrition insecurity. Recipe4Health (R4H) is a Food as Medicine program with an integrative health equity focus. It provides prescriptions for locally grown produce ('Food Farmacy') with or without integrative group medical visits, alongside training for clinic staff.
View Article and Find Full Text PDFBMC Med Educ
January 2025
Department of Paediatrics, Faculsty of Medicine and Dentistry, College of Health Sciences, University of Alberta, 3-490 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, AB, T6G 1C9, Canada.
Background: To gain culturally appropriate awareness of First Nations, Inuit and/or Métis Health, research suggests that programs focus on sending more trainees to First Nations, Inuit and/or Métis communities Working within this context provides experiences and knowledge that build upon classroom education and support trainees' acquisition of skills to engage in culturally safe healthcare provision. This study examines residents' and faculty members' perceptions of how residency training programs can optimize First Nations, Inuit and/or Métis health training and support residents in gaining the knowledge, skills, and experiences for working in and with First Nations, Inuit and/or Métis communities.
Methods: A qualitative approach was used, guided by a relational lens for collecting data and a constructivist grounded theory for data interpretation.
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