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Heart failure, ventricular dysfunction and risk factor prevalence in Australian Aboriginal peoples: the Heart of the Heart Study
  1. Michele McGrady1,
  2. Henry Krum1,
  3. Melinda J Carrington2,
  4. Simon Stewart2,
  5. Christopher Zeitz3,
  6. Geraldine A Lee1,2,
  7. Thomas H Marwick4,
  8. Brian A Haluska5,
  9. Alex Brown2
  1. 1Monash Centre for Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Australia
  2. 2Population Profiling and Studies, Baker IDI. Heart and Diabetes Institute, Melbourne, Australia
  3. 3University of Adelaide, Adelaide, Australia
  4. 4The Cleveland Clinic, Cleveland, Ohio, USA
  5. 5School of Medicine, University of Queensland, Brisbane, Australia
  1. Correspondence to Dr Michele McGrady, Department of Epidemiology and Preventive Medicine, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia; michele.mcgrady{at}centralsydneycardiology.com.au

Abstract

Background Limited strategies have been developed to evaluate and address the alarming discrepancy in early mortality between Indigenous and non-Indigenous populations.

Objective To assess heart failure (HF), HF risk factors and document cardiac characteristics in an Australian Aboriginal population.

Design, setting, participants Adults were enrolled across six Aboriginal communities in Central Australia. They undertook comprehensive cardiovascular assessments, including echocardiography, to determine HF status, asymptomatic ventricular dysfunction and underlying risk factor profile.

Results Of 436 participants (mean age 44±14 years; 64% women) enrolled, 5.3% (95% CI 3.2% to 7.5%) were diagnosed with HF, only 35% of whom had a pre-existing HF diagnosis. Asymptomatic left ventricular dysfunction (ALVD) was seen in 13% (95% CI 9.4% to 15.7%) of the population. Estimates of HF risk factor prevalence were as follows: body mass index (BMI) ≥30 kg/m2 42%, hypertension 41%, diabetes mellitus 40%, coronary artery disease (CAD) 7% and history of acute rheumatic fever or rheumatic heart disease 7%. In logistic regression analysis (after adjustment for age and gender), HF was associated with CAD (OR=9.6, p<0.001), diabetes (OR=5.4, p=0.002), hypertension (OR=4.8, p=0.006), BMI ≥30 kg/m2 (OR=2.9, p=0.02), acute rheumatic fever or rheumatic heart disease (OR=5.6, p=0.001) and B-type natriuretic peptide (OR=1.02, p<0.001).

Conclusion 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.

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Footnotes

  • Funding The study was funded by the Heart Foundation, J. T. Reid Trust and cardiovascular lipids research grants. MM was supported by National Health and Medical Research Council (NHMRC), Heart Foundation and Cardiac Society of Australia and New Zealand scholarships. SS and MC are supported by NHMRC Fellowships. AB is supported by a Heart Foundation Fellowship.

  • Competing interests None.

  • Ethics approval Central Australia human ethics committee and Monash University standing committee on ethics in research involving humans (project number CF08/0867—2008000250).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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