Native Americans have a lot more cardiovascular disease than the population in general, but what we don't know is how much of their increased risk is due to their genetic background and how that background is modified by Western lifestyles and environmental factors.

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We as physicians have spent a great deal of time studying how best to treat our patients while in the hospital, so now we need to focus on better understanding the barriers to improved compliance outside of acute medical settings. This will be a much more difficult problem, since it involves so many different factors.

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We also found that other drugs that have been proven to save lives are even less consistently used than aspirin, such as beta-blockers, cholesterol-lowering drugs and ACE inhibitors. Our analysis showed that consistent use of these medicines could lead to significant reductions in risk for patients with coronary artery disease.

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