Heart failure among Indigenous Australians: a systematic review

BMC Cardiovascular Disorders

Sandra C Thompson²  Patricia M Davidson³  Judith M Katzenellenbogen¹  John A Woods² 

[1] Curtin Health Innovation Research Institute, Centre for International Health, Curtin University of Technology, GPO Box U1987, Perth, WA, 6845, Australia;Combined Universities Centre for Rural Health, PO Box 109, Geraldton, WA, 6531, Australia;Faculty of Nursing, Midwifery and Health, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia

关键词: Heart disease;    Cardiovascular;    Cardiac failure;    Torres Strait Islander;    Aboriginal;    Indigenous;    Australia;    Heart failure;   

Others  :  1084552
DOI  :  10.1186/1471-2261-12-99

 received in 2012-06-28, accepted in 2012-10-26,  发布年份 2012

【 摘 要 】

Background

Cardiovascular diseases contribute substantially to the poor health and reduced life expectancy of Indigenous Australians. Heart failure is a common, disabling, progressive and costly complication of these disorders. The epidemiology of heart failure and the adequacy of relevant health service provision in Indigenous Australians are not well delineated.

Methods

A systematic search of the electronic databases PubMed, Embase, Web of Science, Cinahl Plus, Informit and Google Scholar was undertaken in April 2012 for peer-reviewed journal articles relevant to the topic of heart failure in Indigenous Australians. Additionally, a website search was done to identify other pertinent publications, particularly government reports.

Results

There was a paucity of relevant peer-reviewed research, and government reports dominated the results. Ten journal articles, 1 published conference abstract and 10 reports were eligible for inclusion. Indigenous Australians reportedly have higher morbidity and mortality from heart failure than their non-Indigenous counterparts (age-standardised prevalence ratio 1.7; age-standardised hospital separation ratio ≥3; crude per capita hospital expenditure ratio 1.58; age-adjusted mortality ratio >2). Despite the evident disproportionate burden of heart failure in Indigenous Australians, the accuracy of estimation from administrative data is limited by poor indigenous identification, inadequate case ascertainment and exclusion of younger subjects from mortality statistics. A recent journal article specifically documented a high prevalence of heart failure in Central Australian Aboriginal adults (5.3%), noting frequent undiagnosed disease. One study examined barriers to health service provision for Indigenous Australians in the context of heart failure.

Conclusions

Despite the shortcomings of available published data, it is clear that Indigenous Australians have an excess burden of heart failure. Emerging data suggest that undiagnosed cases may be common in this population. In order to optimise management and to inform policy, high quality research on heart failure in Indigenous Australians is required to delineate accurate epidemiological indicators and to appraise health service provision.

【 授权许可】

   
2012 Woods et al.; licensee BioMed Central Ltd.

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