693 Are Indigenous Australian Females at Particular Disadvantage in Terms of Ischaemic Heart Disease?

Abstract

There is evidence to suggest Indigenous Australian females are at comparatively greater disadvantage than Indigenous Australian males in terms of ischaemic heart disease (IHD). We explored data in this regard. A search of the literature was undertaken utilising relevant databases. Reference lists of retrieved articles were examined to identify additional relevant studies. Framingham risk prediction equations have been demonstrated to perform more poorly when applied to Indigenous Australian females when compared to males, underestimating risk. A greater disparity in prevalence rates of smoking, obesity and diabetes has also been shown in the Indigenous Australian female population. Indigenous Australian females have been demonstrated to be over-represented in published coronary artery bypass grafting (CABG) series to date. Our group reporting on percutaneous coronary intervention (PCI) at a metropolitan centre demonstrated that Indigenous Australian females were again over-represented in comparison to non-Indigenous females. Additionally Indigenous Australian females presented at a similar age to Indigenous Australian males, differing from the non-indigenous cohort (females significantly older). Historical data suggests higher standardised mortality ratios comparing to the non-Indigenous population for Indigenous Australian females than males. More recent data suggest these ratios do not differ significantly. Indigenous Australian females have been shown to be over-represented in reported revascularisation series to date. Variations in risk factor profiles are likely one contributor. Despite this, more recent mortality data does not suggest greater disparity from IHD deaths in female Indigenous Australians compared to males.