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Background and Aims: Cardiovascular disease (CVD) poses significant health challenges globally. While substantial data exists for most populations, the Arctic Inuit's CVD incidence rates remain understudied. This research aimed to change this by estimating CVD incidence and mortality rates in Greenland from 1994 to 2021., Methods: Using nationwide registers, a retrospective observational study was conducted, focusing on individuals born in Greenland to Greenlandic-born parents. Data were sourced from the Greenlandic Hospital Discharge Register and the nationwide electronic medical record., Results: A total of 65,824 individuals were included. the age- and sex-specific incidence rates (IR) of ischemic heart disease, stroke, and heart failure (HF) declined from 1994 to 2021, with the most substantial decline observed for HF among women. Conversely, the IR of atrial fibrillation/flutter increased in both men and women, while the IR of myocardial infarction rose among men. The IR for stroke was particularly elevated compared to other CVD subgroups. Mortality rates for those diagnosed with CVD were 2.4 times higher than those without. Men exhibited a 40 % elevated mortality risk relative to women., Conclusion: The study provides pivotal insights into CVD trends within the Arctic Inuit population, highlighting both positive developments and areas of concern. Given the increasing elderly demographic in Greenland, proactive health strategies are crucial. Emphasizing primary prevention and addressing specific CVD risks, particularly the elevated stroke IR, is imperative for future public health efforts., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: HEL reports financial support was provided by Karen Elise Jensen Foundation. HEL reports financial support was provided by Novo Nordisk Foundation. HEL reports travel was provided by A. P. Møller Foundation. HEL reports travel was provided by Ketty and Ejvind Lyngsbæks Foundation. FG reports a relationship with Bayer that includes: consulting or advisory. FG reports a relationship with Pfizer that includes: consulting or advisory. FG reports a relationship with Astra-Zeneca that includes: consulting or advisory. FG reports a relationship with Ionis that includes: consulting or advisory. FG reports a relationship with Alnylam that includes: consulting or advisory. FG reports a relationship with Pharmacosmos that includes: consulting or advisory. FG reports a relationship with Abbott that includes: consulting or advisory. FG reports a relationship with Novartis that includes: speaking and lecture fees. FG reports a relationship with Orion Pharma that includes: speaking and lecture fees. MEJ reports a relationship with Astra-Zeneca that includes: funding grants. MEJ reports a relationship with Sanofi Aventis that includes: funding grants. MEJ reports a relationship with Boehringer Ingelheim that includes: funding grants. MEJ reports a relationship with Novo Nordisk that includes: funding grants. MEJ reports a relationship with Novo Nordisk that includes: equity or stocks. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Low-density lipoprotein cholesterol (LDL-C) is a well-established risk factor for development of cardiovascular diseases. Based on available clinical data, we aimed to investigate the plasma lipid profile in the Greenlandic population, the proportion on cholesterol-lowering treatment and the adherence to local indications for cholesterol-lowering therapy., Methods: This is an observational cross-sectional study of the adult (≥21 years) Greenlandic population with focus on clinically determined lipid levels from 2017 to early 2022. We investigated levels of dyslipidemia and assessed cholesterol-lowering medication usage in individuals with an indication according to current Greenlandic guidelines, which include a) LDL-C >5 mmol/l, b) diabetes, c) diagnosed atherosclerotic disease and 4) a SCORE2 >7.5%., Results: In the adult Greenlandic population of 40,565 individuals a lipid profile was available in 13,895 with a mean LDL-C of 3.0 mmol/L and 976 (7%) had a LDL-C >5 mmol/l. One or more indications for cholesterol-lowering medication was present in 3988 individuals and a total of 5464 adult Greenlanders either fulfilled local criteria for statin therapy or received a statin (some without current indication) and among these, 2232 (41%) individuals received no statin., Conclusion: These findings indicate that clinically significant dyslipidemia is common in the adult Greenlandic population and that the cardiovascular preventive potential of cholesterol-lowering therapy is currently underutilized., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Henning Bundgaard reports receiving lecture fees from MSD, BMS, Amgen and Sanofi. Marit E Jørgensen reports receiving research grants from AMGEN, Astra Zeneca, Boehringer Ingelheim, 10.13039/501100004191Novo Nordisk and Sanofi Aventis and holds shares in 10.13039/501100004191Novo Nordisk A/S. The remaining authors report no conflicts of interest., (© 2022 The Authors.)