Wing-Lun, Edwina

Marschner, Simone

Quintans, Desi

Taylor, Sean

Troy, Jakelin

Chow, Clara

Zaman, Sarah

2025-03-24

Coronary heart disease (CHD) is the primary cause of mortality in Australia and the largest contributor to the 'gap' in cardiovascular disease deaths between Aboriginal and Torres Strait Islander (First Nations) people and non-indigenous Australians.To assess secondary prevention of CHD in First Nations people in primary care in Australia.Retrospective cohort study of patients with CHD under active primary care management using electronic medical records from 406 general practices across Australia. Ultimately, 50 088 people with CHD were included in the study, and 3.5% of those were First Nations people. After 5.9 years (standard deviation 5.0) in primary care adjusting for gender, age, remoteness, comorbidities, smoking status and continuity of care, First Nations peoples received equal statin (adjusted odds ratio (aOR): 0.9; 95% CI:0.8-1.1, P = 0.28), angiotensin-converting enzyme inhibitors/angiotensin II receptor antagonists (aOR:1.0; 95% CI:0.9-1.2, P = 0.85) and beta blockers (aOR:0.9;95% CI:0.8-1.1, P = 0.41) prescriptions. First Nations peoples were more likely to achieve BP <1.8 in similar proportions (35.2% vs 36.9%, P = 0.16) but less likely to have HDL-C >1.0 mmol/L (57.5% vs 73.7%, P < 0.001), triglycerides<2.0 mmol/L (61.7% vs 76.0%, P < 0.001) and HbA1C ≤ 53 mmol/mol (7.0%) (67.7% vs 82.1%, P < 0.001). A higher proportion of First Nations people had HbA1c measured (75.7% vs 66.6%, P < 0.001).First Nations peoples with CHD under active primary care management received similar secondary prevention medications and achieved BP and LDL-C targets as frequently as non-indigenous Australians. A focus on easier access to facilitate attending primary care is needed to close the gap as well as addressing social determinants of health and structural inequities.

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.

Department of Cardiology, Royal Darwin Hospital, Darwin, Australia.

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

Onemda: Aboriginal and Torres Strait Islander Health and WellBeing, The University of Melbourne, Melbourne, Victoria, Australia.

Faculty of Arts and Social Sciences, University of Sydney, Sydney, New South Wales, Australia.

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia.

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia.

Intern Med J . 2025 Mar 24. doi: 10.1111/imj.70025. Online ahead of print.

1445-5994

0000-0002-5484-9144

https://pubmed.ncbi.nlm.nih.gov/40129175/?otool=iaurydwlib

https://hdl.handle.net/10137/14205

Aboriginal and Torres Strait Islander People

cardiovascular risk factors

coronary heart disease

primary care

Secondary prevention of coronary heart disease in Aboriginal and Torres Strait Islander people in primary care.

Journal Article

Publication