Cardiovascular risk among urban Aboriginal people.

Abstract

To describe the results of a program for detecting high cardiovascular risk in an urban Aboriginal community. Cardiovascular risk assessment program conducted between January 1998 and October 1999. Participants completed a questionnaire and underwent a physical assessment and biochemical tests. 738 self-selected members of the Perth Aboriginal community (332 men, 406 women; age range, 18-79 years). The participants represented approximately a fifth of the Perth Aboriginal population aged 25-64 years (those aged 18-24 years comprised < 5% of Aboriginals aged 15-24 years in Perth). Eighty-four per cent fell within National Heart Foundation "high risk" or "highest risk" categories for cardiovascular disease; 15% of men and 6% of women had an absolute risk of a cardiovascular event of over 15% within 10 years. A high proportion of participants reported diabetes, hypertension, smoking, overweight and obesity. A fasting plasma glucose level indicative of diabetes or impaired fasting glucose was found in 8.6% (95% CI, 6.2%-11%) of people not previously known to have diabetes. Obesity and smoking were twice as prevalent in study participants as in the general population. Less than a third of subjects with hypertension and diabetes had attained recommended target levels for blood pressure reduction or glycaemic control, and only a third of those at high risk and one in six of those at highest risk had attained recommended lipid-level targets. A cardiovascular risk assessment program with strong community support in an urban Aboriginal population can identify a significant number of people with high cardiovascular risk who are candidates for intensive risk-factor reduction strategies.