Increasing Rates of Ischemic Heart Disease in the Native Population of Ontario, Canada

Abstract
ISCHEMIC HEART disease (IHD) is the leading cause of mortality in most Western countries. In Canada, rates of IHD have been steadily declining after peaking in the 1960s.1 Similarly, a recent study of 4 American communities showed declining mortality from IHD.2 Much of the reduction in incidence and mortality has been attributed to behavior and lifestyle changes and other forms of primary and secondary prevention.3 However, this overall improvement in IHD mortality may not extend to all subgroups of the population.