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    Prevalence, control, and treatment of diabetes, hypertension, and high cholesterol in the Amish

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    Author
    He, Shisi
    Ryan, Kathleen A
    Streeten, Elizabeth A
    McArdle, Patrick F
    Daue, Melanie
    Trubiano, Donna
    Rohrer, Yvonne
    Donnelly, Patrick
    Drolet, Maryann
    Newcomer, Sylvia
    Shaub, Susan
    Weitzel, Nancy
    Shuldiner, Alan R
    Pollin, Toni I
    Mitchell, Braxton D
    Show allShow less

    Date
    2020
    Journal
    BMJ open diabetes research & care
    Publisher
    BMJ Publishing Group
    Type
    Article
    Other
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1136/bmjdrc-2019-000912
    Abstract
    BACKGROUND: The burden of diabetes and cardiovascular risk is not uniform across the USA, with much of this disparity tracking differences in socioeconomic status, cultural practices and lifestyle. To further evaluate disparities in these disorders, we assessed the prevalence of diabetes, hypertension, and hypercholesterolemia in an Old Order Amish community that is characterized by distinctive sociocultural practices that include a very cohesive social structure and limited use of modern technologies and medications. We compared prevalence of these conditions with that of the overall US population. METHOD: We performed a community-wide survey in 5377 Amish individuals aged 18 years and older from the Lancaster County, Pennsylvania, Amish settlement that included a basic physical examination and fasting blood draw during the period 2010-2018. We then compared the prevalence of diabetes, hypertension, and high cholesterol, defined using standard criteria, between the Amish and the European Caucasian subsample of the 2013-2014 US National Health and Nutrition Examination Survey (NHANES). RESULTS: Prevalence rates for diabetes, hypertension and hypercholesterolemia were 3.3%, 12.7%, and 26.2% in the Amish compared with 13.2%, 37.8% and 35.7% in NHANES (p<0.001 for all). Among individuals with these disorders, Amish were less likely to be aware that they were affected, and among those aware, were less likely to be treated with a medication for their disorder. CONCLUSION: There is substantially lower prevalence of diabetes, hypertension and hypercholesterolemia in the Amish compared with non-Amish Caucasians in the USA. Possible factors contributing to this disparity include higher physical activity levels in the Amish or other protective sociocultural factors, a greater understanding of which could inform risk reduction interventions for these chronic diseases.
    Rights/Terms
    © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
    Keyword
    adult diabetes
    cardiovascular disease risk
    epidemiology
    population studies
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/13659
    ae974a485f413a2113503eed53cd6c53
    10.1136/bmjdrc-2019-000912
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