An analysis based on a proposed heart failure risk prediction tool reveals that the incidence of heart failure may be 2- to 3-fold higher among American Indian adults compared to people in other population groups. The risk prediction equation focused on diabetes control and kidney damage indicates that smoking, Type 2 diabetes, high blood pressure, previous heart attack and diabetes-related kidney damage are associated with increased risk of developing heart failure among American Indian adults. The findings suggest a need to develop population-level preventive strategies in American Indian communities, researchers said.