“ This is a great step in reducing the burden of cardiovascular disease in Aboriginal and Torres Strait Islander people.”
Our people have greater rates of heart disease and screening from a younger age will contribute to longer healthier lives. NACCHO encourages all Aboriginal Community Controlled Health Organisations to implement these new guidelines in their practices.”
The Chair of the National Aboriginal Community Controlled Health Organisation, Donnell Mills
The updated recommendations are for Aboriginal and Torres Strait Islander individuals to receive:
- Combined early screening for diabetes, chronic kidney disease and other cardiovascular (CVD) risk factors from the age of 18 years at latest;
- Assessment of absolute CVD risk using an Australian CVD risk calculator from the age of 30 years at the latest.
The recommendations were endorsed by the National Aboriginal Community Controlled Health Organisation, Royal Australian College of General Practitioners, Central Australian Rural Practitioners Association and the Australian Chronic Disease Prevention Alliance, led by the Heart Foundation.
The approach to early screening was developed in partnership with the Australian National University’s Aboriginal Reference Group (Thiitu Tharrmay) and other Aboriginal and Torres Strait Islander leaders in CVD prevention.
Take home messages
- Most heart attacks and strokes can be prevented, and in the last 20 years, the rate of deaths from CVD in Aboriginal and Torres Strait Islanders peoples has almost halved.
- High risk of cardiovascular disease begins early among Aboriginal and Torres Strait Islander peoples and is mainly due to diabetes and renal disease. It is recommended that there should be:
- Combined early screening for diabetes, chronic kidney disease and cardiovascular disease risk factors from the age of 18 years. This should include assessment of blood glucose level or glycated haemoglobin, estimated glomerular filtration rate, serum lipids, urine albumin to creatinine ratio, and other risk factors such as blood pressure, history of familial hypercholesterolaemia, and smoking status.
- Assessment of absolute CVD risk using an Australian CVD risk calculator from the age of 30 years. Outside of Communicare, the best CVD risk calculator to use is auscvdrisk.com.au/risk-calculator/
- What you can do: Assessment of CVD risk as part of a health check. The most important part of this check-up is working with your doctor to manage your risk factors to improve your heart health and help you live a healthier, longer life.
” Around 80% of heart attacks and strokes can be prevented with optimal care. Cardiovascular disease (CVD) remains a leading contributor to Aboriginal and Torres Strait Islander mortality despite a 40% decrease in deaths in the past two decades and significant decreases in smoking prevalence.
High risk of CVD begins early among Aboriginal and Torres Strait Islander peoples, mainly in people with diabetes and/or renal disease.
Our program of work, funded by the Australian Government Department of Health, is focused on improving prevention of cardiovascular disease for Aboriginal and Torres Strait Islander peoples through:
- Revision and alignment of clinical practice guidelines ( see part 2 below )
- Revision and enhanced Medicare Benefits Schedule items for prevention of chronic disease
- Workforce education and engagement
To combat high risk of heart attack and strokes, Aboriginal and Torres Strait Islander people should have had their heart checked by a GP by age 18 at the latest, according to new national recommendations.
As part of a regular health check with a GP, the recommendations launched today have moved the age Indigenous people should get screened for Cardiovascular Disease (CVD) down from 35 to 18.
Based on research from The Australian National University (ANU), a host of health professionals and Aboriginal and Torres Strait Islander CVD experts have agreed on the latest efforts to continue closing the gap on early heart attacks among Indigenous Australians.
“We have seen great improvements in CVD prevention and this was highlighted in this year’s Closing the Gap speech,” said ANU lead researcher, Dr Jason Agostino.
“However, it remains a leading cause of preventable death in Aboriginal and Torres Strait Islander peoples. We need to be doing all we can to prevent it.
“Just about every Aboriginal person I know has a family member or a community member who’s died young from a heart attack or stroke. We need to change that.
“We can improve things by picking up conditions like diabetes and kidney disease early and starting conversations about treatment.”
In the last 20 years, the rate of deaths from heart attacks and strokes among Aboriginal and Torres Strait Islanders peoples have almost halved.
However, three out of four Aboriginal and Torres Strait Islander adults under 35 have at least one CVD risk factor.
Rheumatic Heart Disease Australia’s Senior Cultural Advisor, Vicki Wade, is a 62-year-old cardiac nurse who has heart disease. She said it is important to remind community and health workers about the risks of CVD.
“Although rates have improved, the statistics are frightening. We have generations of Aboriginal people who are not seeing their grandchildren growing up because of heart attack and stroke,” Mrs Wade said.
“This is a chance for local solutions, community engagement and health workers to be educated.”
Fellow author, Heart Foundation Chief Medical Adviser, cardiologist Professor Garry Jennings, said: “Evidence shows that Indigenous Australians have CVD risk factors like diabetes, high blood pressure and high cholesterol at a young age. We need to prevent, identify and treat these.”
Aboriginal and Torres Strait Islanders should now undergo CVD risk factor screening from 18 years, at the latest, and use Australian CVD risk calculators from age 30.
“It’s easy to do. The assessment involves the normal parts of a health check with a blood and urine test. It is quick and can be done by your local GP,” said Dr Agostino.
“For the vast majority it will be bulk-billed and free.”
The move is backed by the Royal Australian College of General Practitioners, the National Aboriginal Community Controlled Health Organisation, The Australian Chronic Disease Prevention Alliance, and the Editorial Committee for Remote Primary Health Care Manuals.
“This is about getting consistency everywhere. This is what Aboriginal and Torres Strait Islander leaders and the evidence is telling us we should do,” Dr Agostino said.
“Many GPs are already screening as early as 15 but some GPs and nurses don’t know about the need to test early.
“This is about doing what we can to pick up risk factors early and close the gap on early heart attacks and strokes.”
RACGP Aboriginal and Torres Strait Islander Health Chair, Associate Professor Peter O’Mara welcomed the new recommendations, saying they could make a real difference in improving health outcomes for Aboriginal and Torres Strait Islander peoples.
“We cannot hope to close the gap without making evidence-based changes – these new recommendations are a positive step to improving early detection and treatment of CVD.
“The RACGP has over 40,000 members, including 10,000 members in the faculty of Aboriginal and Torres Strait Islander health. While many GPs know about early screening not all do. These new recommendations will help spread awareness among GPs, improving access to early screening and quality care.”
Under the new recommendations, young adults with type 2 diabetes and microalbuminuria, kidney disease, and very high blood pressure or high cholesterol will be identified as high- risk of CVD.
Want more information and resources?
A team at ANU is developing a toolkit on risk communication in CVD: Healing Heart Communities. Designed as a resource for all clinical staff in primary care, it aims to support conversations about CVD risk.
During development, the team has consulted the Australian National University’s Aboriginal Reference Group (Thiitu Tharrmay) and partnered with We are Saltwater People, an Indigenous-owned graphic design company based in QLD to create original artwork, design and layout.