Key resources
Bibliography
Health promotion
Yarning places
message stick
Programs
Organisations
Conferences
Courses
Funding
Jobs
Key resources
Print
Please select category from the dropdown list below.
Cardiovascular disease (CVD; ICD ‘diseases of the circulatory system’) presents a significant burden for Indigenous people in terms of prevalence, hospitalisation, and mortality [1]. CVD includes all diseases and conditions that affect the heart and blood vessels. Rheumatic heart disease, ischaemic heart disease, cerebrovascular disease, and hypertension are of particular importance to Indigenous people.
The conventional risk factors for CVD can be divided into two main categories: behavioural and biomedical [1]. Behavioural risk factors are based on an individual’s behavior, but can be influenced by underlying social, economic, psychological, and cultural factors. Behavioural factors include tobacco smoking, physical inactivity, poor nutrition, and risky alcohol consumption. Biomedical risk factors - including high blood pressure (hypertension), high blood cholesterol, and, overweight and obesity, diabetes, and chronic kidney disease - can be influenced by modifications to behaviour, lifestyle, or the use of medical interventions.
As important as these factors may be, they should be considered within a broad social determinants of health framework, with the following aspects being important contributors to the development of CVD disease among Indigenous people:
The most recent source of population-level information about the extent of CVD among Indigenous people is the 2004-2005 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) [6]. Almost one-in-eight Indigenous people (12%) reported having a long-term heart or related condition, with the proportion being slightly higher for those living in remote areas (14%) than in non-remote areas (11%). The proportions represent a slight increase from those reported in the 2001 National Health Survey (NHS) (11%).
After adjusting for differences in the age structures of the Indigenous and non-Indigenous populations, heart and circulatory problems/diseases were around 1.3 times more common for Indigenous people than for non-Indigenous people [6]. Hypertensive disease was 1.5 times more common for Indigenous people than for non-Indigenous people, and other diseases of the heart and circulatory system were 1.2 times more common.
Overall, a lower proportion of Torres Strait Islander people (9%) than Aboriginal people (12%) reported having a heart and circulatory problem/disease, but the proportion was 11% for Torres Strait Islander people living in the Torres Strait area [6].
At 31 December 2009, there were almost 1,400 Indigenous people living in the Top End of the NT and the NT part of Central Australia registered as having rheumatic heart disease (RHD) [7]. Almost two-thirds (65%) of these people were females. The rates of RHD in the Indigenous population in both the Top End of the NT and Central Australia were significantly higher than the rates for non-Indigenous people in these areas. The rates for Indigenous males were 38 times as high in the Top End of the NT and 14 times as high in Central Australia as the corresponding rates for non-Indigenous males. Rates of RHD for Indigenous females were 23 times as high in the Top End of the NT and 20 times as high in Central Australia than the corresponding rates for non-Indigenous females. The rate of RHD for Indigenous people was highest in the 45-54 years age-group (34.5 per 1,000). The highest ratios between Indigenous and non-Indigenous rates were for the 0-14 and 25-34 years age-groups, with rate ratios of 178 and 108 respectively.
There were 9,149 hospital separations identified as Indigenous for CVD in NSW, Vic, Qld, WA, SA and the NT in 2009-10 [8]. The most recent information on hospitalisation rates for Indigenous people and non-Indigenous people was for 2008-09, when the rate was 1.9 times higher for Indigenous people than for non-Indigenous people [9].
For ischaemic heart disease (also known as coronary heart disease), there were around 7,200 hospital admissions of Indigenous people in NSW, Vic, Qld, WA, SA and the NT in the two-year period July 2006 to June 2008 [7]. Of these admissions, around 2,870 were for acute myocardial infarction (heart attack). Admission rates for Indigenous males were 1.7 times higher for ischaemic heart disease and 2.2 times higher for acute myocardial infarction than the corresponding rates for other Australian males. Rates for Indigenous females were 2.8 times higher for ischaemic heart disease and 3.1 times higher for acute myocardial infarction than the corresponding rates for other Australian females.
For cerebrovascular disease (including stroke), there were around 1,330 admissions to hospital of Indigenous people in NSW, Vic, Qld, WA, SA and the NT in July 2006 to June 2008 [7]. Admission rates for Indigenous males were 1.6 times higher for cerebrovascular disease overall and 1.7 times higher for stroke than the corresponding rates for other males. The rates for Indigenous females were 1.9 and 2.1 times higher, respectively, than those for other females.
Hospitalisation rates for hypertension for Indigenous people living in NSW, Vic, Qld, WA, SA and the NT in July 2006 to June 2008 were considerably higher than those for non-Indigenous people: 2.6 times higher for males and 2.5 times higher for females [7]. The highest ratios were for the 35-44 and 45-54 years age-groups where Indigenous rates were between four and five times higher than non-Indigenous rates.
In 2004-2008 in Qld, WA, SA and the NT, CVD was the leading cause of death accounting for 27% of all deaths of Indigenous people [7]. The death rate of Indigenous people was 1.8 times that of non-Indigenous people. The rate for Indigenous males was 1.8 times that of non-Indigenous males, and the rate for Indigenous females 1.7 times that of their non-Indigenous counterparts. Ischaemic heart disease was responsible for around than three-fifths (60%) of the deaths of Indigenous males from CVD and for around one-half (46%) those of Indigenous females. Cerebrovascular disease was responsible for 16% of the deaths of Indigenous males from CVD and for 21% of deaths of Indigenous females.
The striking difference between Indigenous people and non-Indigenous people in CVD mortality is the much greater impact among young and middle-aged Indigenous adults. In 2002-2005 in Qld, WA, SA and the NT, for all CVD, the death rates for Indigenous people in the 35–44 and 45–54 year age-groups were 8 to 12 times higher than corresponding non-Indigenous rates [1]. The death rates for Indigenous people in these age-groups were similar to those for non-Indigenous people many years older.
Helping to 'close the gap' by providing the evidence base to inform practice and policy in Aboriginal and Torres Strait Islander health
