In keeping with its priority to reduce the disproportionate burden of heart, lung, and blood diseases in minority populations, the National Heart, Lung, and Blood Institute has established an outreach project called Building Healthy Hearts for American Indians and Alaska Natives. This background report provides an overview of the cardiovascular health status of this population to guide development of the project. Section 1 discusses the limitations of data on the health of Native people. The second section presents demographic characteristics of Native Americans. Section 3 discusses cardiovascular disease mortality, major cardiovascular risk factors, and effects of these risk factors on Native people. The fourth section describes health knowledge, beliefs, and behaviors of Native Americans including their perceptions of health. Section 5 highlights several existing community-based health promotion and disease prevention programs targeted at Native Americans. The sixth section presents recommended strategies for designing community-based health promotion programs for Native Americans based on the success of existing programs. Section 7 discusses five theoretical models of health promotion programs targeting Native people. The final section offers recommendations for improving the heart health of Native Americans based on existing literature, evaluations of current programs, and telephone interviews with people working to improve Native health. (Contains 60 references.) (TD)