Primary prevention of cardiovascular disease in minority Indigenous populations: a systematic review

Merone, Lea, McDermott, Robyn, Mein, Jacki, Clarke, Philip, and McDonald, Malcolm (2019) Primary prevention of cardiovascular disease in minority Indigenous populations: a systematic review. Heart, Lung and Circulation. (In Press)

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Abstract

Introduction: Cardiovascular disease (CVD) is the commonest cause of death across the globe; incidence and prevalence rates are increasing. Together, CVD and diabetes mellitus are responsible for a quarter of the health gap observed between Aboriginal Australians and Torres Strait Islanders, and non-Indigenous Australians. Numerous programs have been proposed and implemented to Close the Gap; ideally, these should be evidence-based.

Objective: The aim of this review is to evaluate primary prevention measures and programs that aim to reduce CVD risk in minority Indigenous populations around the world.

Methods: A search of PubMed, the Cochrane Library and the Elsevier Scopus Database was initially conducted using the terms “cardiovascular disease”, “population groups”, “primary prevention”, "health services, indigenous”, "indigenous health", "risk assessment" and “risk management”. Results were then assessed per inclusion/exclusion criteria. A second reviewer independently evaluated the publications and review process to ensure agreement.

Results: The initial search produced 37 publications; 19 met the inclusion criteria and were incorporated into a comparative table. Most were descriptive, mixed-methods, audit or intervention studies. Heterogeneity of study design prevented statistical analysis.

Conclusion: Addressing CVD risk in minority Indigenous populations is a multifactorial challenge; there is substantial room for improvement in routine risk assessment and management. Holistic approaches need to embrace local cultural perceptions of health and wellbeing. Validated risk reduction tools, individualised management plans, polypills and computer based decision support tools are promising to improve outcomes for those at risk.

Item ID: 60960
Item Type: Article (Research - C1)
ISSN: 1444-2892
Keywords: cardiovascular, risk, indigenous, management
Funders: James Cook University, National Health and Medical Research Council of Australia (NHMRC)
Projects and Grants: NHMRC Project Grant 1107140
Date Deposited: 19 Nov 2019 00:18
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 34%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 33%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111716 Preventive Medicine @ 33%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 34%
92 HEALTH > 9203 Indigenous Health > 920303 Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions) @ 33%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920404 Disease Distribution and Transmission (incl. Surveillance and Response) @ 33%
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