Heart failure, ventricular dysfunction and risk factor prevalence in Australian Aboriginal peoples: the Heart of the Heart Study

Abstract

The burden of HF, ALVD and risk factors in this population was extremely high. This study highlights potentially modifiable targets on which to focus resources and screening strategies to prevent HF in this high-risk Indigenous population.

Heart Failure in Minority Populations - Impediments to Optimal Treatment in Australian Aborigines

“…Geographically, in the total cohort only 1.9% of Indigenous clients resided in a metropolitan address and 17.2% were from remote areas. The authors noted remoteness contributes to variable access to health care and is an independent predictor for poorer health outcomes [5, 6, 7, 31, 32]. Despite these significant gaps there is evidence to show that we are capable of making inroads, but this requires common sense and getting’s some basics right [33].…”

“…Risk factors for CHF are also at epidemic levels where, diabetes rates are 3-10 times, obesity rates twice and renal impairment 4-10 times those of non-Indigenous Australians [63-66]. In addition alcohol consumption is excessive and rheumatic heart disease rates are among the highest in the world [31]. Metabolic syndromes including impaired glucose tolerance, diabetes and hyperlipidaemia are more likely to be adversely affected by beta-blockers.…”

“…Key risk factors include coronary artery disease, hypertension, diabetes mellitus, obesity, rheumatic heart diseases [31], and renal impairment [66]. Pharmacokinetic differences should also be considered.…”

Contextualizing Genetics for Regional Heart Failure Care

“…The findings include from this younger chort, age 44±14 years and 64% women were; CHF diagnoses in 5.3% (95% CI 3.2% to 7.5%) when only 35% were previously diagnosed; Asymptomatic CHF cases in 13% (95% CI 9.4% to 15.7%);risk factor prevalence included body mass index (BMI) ≥30 kg/m(2) 42%, hypertension 41%, diabetes mellitus 40%, coronary artery disease (CAD) 7% and history of acute rheumatic fever or rheumatic heart disease 7% [73]. When the authors specifically explored the determinants of disease with an extensive assessment socio-demographic, psychosocial, cardiovascular and metabolic status it was noted that depression increases CVD risk two fold (OR 2.03; 1.07-3.88; p<0.05).…”

Response to Letter to the Editor: Essential Service Standards for Equitable National Cardiovascular Care for Aboriginal and Torres Strait Islander people

“…For example, the most recent Australian Aboriginal and Torres Strait Islander Health Survey 2012-13 found that the age-adjusted prevalence of hypertension among Aboriginal and Torres Strait Islander people was only 8.4% and diabetes 13.9% [3]. We (and others) have previously measured rates of hypertension and diabetes close to 40% in Central Australia and other Aboriginal communities across the country [4].…”