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Overcoming cardiovascular disease in Indigenous Australians

Alex Brown and Leonard Kritharides
Med J Aust 2017; 206 (1): . || doi: 10.5694/mja16.00693
Published online: 16 January 2017

Despite the profound impact of cardiovascular disease on Indigenous Australians, much remains to be achieved

Cardiovascular disease (CVD), including heart disease and stroke, is the major cause of premature death experienced by Aboriginal and Torres Strait Islander Australians.1 Our understanding of CVD, its causes and treatment, has improved dramatically over the past 40 years, resulting in substantial reductions in age- and sex-adjusted mortality.2 Unfortunately, the disparities in cardiovascular health between the overall population and Aboriginal and Torres Strait Islander people have persisted. Perhaps the most concerning feature is the age at which CVD strikes among Aboriginal and Torres Strait Islander people — between 10 and 20 years younger than seen in other Australians.3 The emotional, societal and economic implications of premature CVD mortality and disability are devastating and, in many ways, impossible to measure and fully comprehend.


  • 1 South Australian Health and Medical Research Institute, Adelaide, SA
  • 2 University of South Australia, Adelaide, SA
  • 3 Concord Hospital, Sydney, NSW
  • 4 ANZAC Research Institute, Sydney, NSW



  • 1. Australian Institute of Health and Welfare. Contribution of chronic disease to the gap in adult mortality between Aboriginal and Torres Strait Islander people and other Australians (AIHW Cat. No. IHW 48). Canberra: AIHW, 2011.
  • 2. Roth GA, Forouzanfar MH, Moran AE, et al. Demographic and epidemiologic drivers of global cardiovascular mortality. N Engl J Med 2015; 372: 1333-1341.
  • 3. Brown A. Addressing cardiovascular inequalities among indigenous Australians. Glob Cardiol Sci Pract 2012; 2.
  • 4. Brown A, Kritharides L. Cardiovascular disease. Heart Lung Circ 2010; 19: 263.
  • 5. Brown A, Kritharides L. Overview: the 2nd Indigenous Cardiovascular Health Conference of the Cardiac Society of Australia and New Zealand. Heart Lung Circ 2012; 21: 615-617.
  • 6. Brown A, O’Shea RL, Mott K, et al. Essential service standards for equitable national cardiovascular care for Aboriginal and Torres Strait Islander people. Heart Lung Circ 2015; 24: 126-141.
  • 7. Brown A, Tonkin A, White H, et al. The Cardiac Society Inaugural Cardiovascular Health Conference: conference findings and ways forward. Heart Lung Circ 2010; 19: 264-268.
  • 8. Gray C, Brown A, Thomson N. Review of cardiovascular health among Indigenous Australians. HealthInfoNet, 2012. http://www.healthinfonet.ecu.edu.au/chronic-conditions/cvd/reviews/heart_review (accessed Aug 2016).
  • 9. Kritharides L, Brown A, Brieger D, et al. Recommendations arising from the inaugural CSANZ Conference on Indigenous Cardiovascular Health. Heart Lung Circ 2010; 19: 269-272.
  • 10. Aspin C, Brown N, Jowsey T, et al. Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study. BMC Health Serv Res 2012; 12: 143.
  • 11. Tibby D, Corpus R, Walters D. Establishment of an Innovative Specialist Cardiac Indigenous Outreach Service in Rural and Remote Queensland. Heart Lung Circ 2010; 19: 361-366.
  • 12. White H, Walsh W, Brown A, et al. Rheumatic heart disease in Indigenous populations. Heart Lung Circ 2010; 19: 273-281.
  • 13. Walsh W, Brown A, Carapetis J. The diagnosis and management of chronic rheumatic heart disease — an Australian guideline. Heart Lung Circ 2008; 17: 271-289.
  • 14. Australian Heatlhcare and Hospitals Association. News. Lighthouse project shines a light on best practice healthcare for Aboriginal and Torres Strait Islander patients. 10 Apr 2015. http://ahha.asn.au/news/lighthouse-project-shines-light-best-practice-healthcare-aboriginal-and-torres-strait-islander (accessed Sept 2016).
  • 15. Brown A, O’Shea RL, Mott K, et al. A strategy for translating evidence into policy and practice to close the gap — developing essential service standards for Aboriginal and Torres Strait Islander cardiovascular care. Heart Lung Circ 2015; 24: 119-125.
  • 16. Marmot M, Friel S, Bell R, et al. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet 2008; 372: 1661-1669.
  • 17. Australian Institute of Health and Welfare. The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples: 2015 (AIHW Cat. No. IHW 147). Canberra: AIHW, 2015. http://www.aihw.gov.au/publication-detail/?id=60129550168 (accessed Sept 2016).
  • 18. Tideman P, Tirimacco R, Senior DP, et al. Impact of a regionalised clinical cardiac support network on mortality among rural patients with myocardial infarction. Med J Aust 2014: 200: 157-160. <MJA full text>
  • 19. Lyerly MJ, Wu T-C, Mullen MT, et al. The effects of telemedicine on racial and ethnic disparities in access to acute stroke care. J Telemed Telecare 2016; 22: 114-120.
  • 20. National Health and Medical Research Council. Strengthening cardiac rehabilitation and secondary prevention for Aboriginal and Torres Strait Islander peoples. Canberra: Australian Government, 2005. https://www.nhmrc.gov.au/guidelines-publications/ind1-ind2 (accessed Sept 2016).
  • 21. Lawrence M, Dodd Z, Mohor S, et al. Improving the patient journey: achieving positive outcomes for remote Aboriginal cardiac patients. Darwin: Cooperative Research Centre for Aboriginal Health, 2009.
  • 22. Einsiedel LJ, van lersel E, McNamara R, et al. Self-discharge by adult Aboriginal patients at Alice Springs Hospital, Central Australia: insights from a prospective cohort study. Aust Health Rev 2013; 37: 239-245.

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