Abstract
BackgroundRural Australians are known to experience a higher burden of ischaemic heart disease (IHD) than their metropolitan counterparts and the reasons for this appear to be highly complex and not well understood. It is not clear what interventions and prevention efforts have occurred specifically in rural Australia in terms of IHD. A summary of this evidence could have implications for future action and research in improving the health of rural communities. The aim of this study was to review all published interventions conducted in rural Australia that were aimed at the primary and/or secondary prevention of ischaemic heart disease (IHD) in adults.MethodsSystematic review of the peer-reviewed literature published between January 1990 and December 2015. Search terms were derived from four major topics: (1) rural; (2) ischaemic heart disease; (3) Australia and; (4) intervention/prevention. Terms were adapted for six databases and three independent researchers screened results. Studies were included if the published work described an intervention focussed on the prevention or reduction of IHD or risk factors, specifically in a rural population of Australia, with outcomes specific to participants including, but not limited to, changes in diet, exercise, cholesterol or blood pressure levels.ResultsOf 791 papers identified in the search, seven studies met the inclusion criteria, and one further study was retrieved from searching reference lists of screened abstracts. Typically, excluded studies focused on cardiovascular diseases without specific reference to IHD, or presented intervention results without stratification by rurality. Larger trials that included metropolitan residents without stratification were excluded due to differences in the specific needs, characteristics and health service access challenges of rural populations. Six interventions were primary prevention studies, one was secondary prevention only and one included both primary and secondary intervention strategies. Two interventions were focussed exclusively on Aboriginal and Torres Strait Islander (Australian Indigenous) populations.ConclusionsFew interventions were identified that exclusively focussed on IHD prevention in rural communities, despite these populations being at increased risk of IHD in Australia, and this is consistent with comparable countries, internationally. Although limited, available evidence shows that primary and secondary interventions targeted at IHD and related risk factors can be effective in a rural setting.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3548-1) contains supplementary material, which is available to authorized users.
Highlights
Rural Australians are known to experience a higher burden of ischaemic heart disease (IHD) than their metropolitan counterparts and the reasons for this appear to be highly complex and not well understood
Cardiac Rehab programs in rural areas are successful in reducing risk factors for IHD and improving quality of life
There is a lack of published research on comprehensive interventions to reduce IHD, especially in rural populations [26], despite the recognition that prevention efforts at population level, aimed at modifiable risk factors, can be both cost-effective and sustainable approaches to reducing IHD burden in high risk communities [11, 26, 27]
Summary
Rural Australians are known to experience a higher burden of ischaemic heart disease (IHD) than their metropolitan counterparts and the reasons for this appear to be highly complex and not well understood. It is not clear what interventions and prevention efforts have occurred in rural Australia in terms of IHD. IHD has been the leading single cause of death in Australia since 2000 [2] These conditions appear to affect some populations more than others [3], those living in rural areas, people of Aboriginal and Torres Strait Islander (ATSI) heritage and people of lower socio-economic status (SES) [4, 5]. Overall IHD mortality rates in Australia decreased substantially between 2001 and 2010, though these decreases were smaller in more remote areas than in major cities (−4.1 % for males and −4.3 % for females in major cities, compared to −2.4 % and −3.9 % in remote areas) [5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
