American Indians and Alaska Natives have a considerable CVD burden, according to a study published in JAMA Network Open. Lauren A. Eberly, MD, MPH, and colleagues conducted a population based cohort study from January 2015 to December 2019 among American Indian and Alaska Native Medicare beneficiaries (N=220,598; median age, 72.5). During the study, 44.8% of the cohort were diagnosed with diabetes, 61.3% with hyperlipidemia, and 72.2% with hypertension. The prevalence of CAD was 38.6% in 2015 and 36.7% in 2019. Incidence of acute myocardial infarction also increased, from 6.9 to 7.7 per 1,000 person years in 2015 and 2019. Prevalence of heart failure was 22.9% in 2015 and 21.4% in 2019; the prevalence of atrial fibrillation was stable in 2015 and 2019. Half the patients reported at least one severe cardiovascular condition, and the overall mortality rate was 19.8%. “The path forward requires engagement to support community-led initiatives and targeted investment in Indigenous communities,” Dr. Eberly and colleagues wrote.