TY - JOUR T1 - Prevalence, control, and treatment of diabetes, hypertension, and high cholesterol in the Amish JF - BMJ Open Diabetes Research & Care JO - BMJ Open Diab Res Care DO - 10.1136/bmjdrc-2019-000912 VL - 8 IS - 1 SP - e000912 AU - Shisi He AU - Kathleen A Ryan AU - Elizabeth A Streeten AU - Patrick F McArdle AU - Melanie Daue AU - Donna Trubiano AU - Yvonne Rohrer AU - Patrick Donnelly AU - Maryann Drolet AU - Sylvia Newcomer AU - Susan Shaub AU - Nancy Weitzel AU - Alan R Shuldiner AU - Toni I Pollin AU - Braxton D Mitchell Y1 - 2020/08/01 UR - http://drc.bmj.com/content/8/1/e000912.abstract N2 - 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. ER -