THE HEART DISEASE MORTALITY RATES of the Chippewa and Menominee, who reside in the upper Midwest, are higher than the rates of most other tribes in the U.S.. Little is known, however, about the prevalence of hypertension, diabetes, and obesity among these communities. The Inter-Tribal Heart Project (ITHP) was designed to determine the prevalence of risk factors for heart disease and to implement community-based heart disease prevention programs. Age-stratified random samples of active users of the tribal-Indian Health Service (IHS) clinics, ages 25 and older, were drawn from three communities within the Bemidji Service Area. Between September 1992 and June 1994, 1396 people completed an extensive questionnaire and underwent a physical exam for heart disease risk factors. Preliminary data indicate mean blood pressure levels of 126 mmHg for systolic blood pressure (SBP) and 74.4 mmHg for diastolic blood pressure (DBP). Mean SBP and DBP were higher among men than women. Mean body mass index (BMI), which did not vary by gender, was 30.6 mmHg. The prevalence of hypertension was 33%; and diabetes, 33%. Men had a higher prevalence of hypertension than women, but there was little gender difference in the prevalence of diabetes. These preliminary data suggest that the prevalences of hypertension, diabetes, and obesity in these communities are higher than the recent estimates for the total U.S.. The next stage of the ITHP will focus on policies and programs to prevent and treat these conditions.