Heart experts are calling for better screening for Indigenous Australians to protect them from high and growing rates of a common heart condition linked to deadly strokes.
Specialists at the Heart Research Institute in Sydney are warning that guidelines to screen Aboriginal people for atrial fibrillation (AF) are needed to help prevent cardiovascular disease in this at-risk population.
"New research shows Indigenous Australians are experiencing these catastrophic strokes at a much younger age than other Australians," says Professor Ben Freedman, HRI's Heart Rhythm and Stroke Prevention Group Leader.
"We're looking at introducing life-saving screening from Australians aged over 65 but that's too late for half of Aboriginal sufferers. We're calling on culturally-specific screening guidelines that will protect this at-risk population from an earlier age."
Dr Nicole Lowres, a postdoctoral scientist in the HRI group, and Professor Freedman issued the warning in an editorial published in The Medical Journal of Australia.
AF is common, affecting more than 500,000 Australians. It is an irregular heart rhythm disorder which interferes with the normal pumping of the heart. Irregular pumping causes poor blood flow to the body and allows large blood clots to form. These clots can break off and enter the arteries, blocking blood flow to the brain and causing a stroke. AF-related strokes tend to be larger, more severe and harder to survive than strokes due to other causes.
"The good news is that most of these strokes are preventable with blood thinners but you need to know you have the condition in order to be treated," says Dr Lowres. "Unfortunately in Australia too many people are not getting diagnosed until after the stroke has occurred." Dr Lowres is an expert on screening for unknown AF to prevent stroke.
Change is afoot to introduce screening from the age of 65 in the general population, but Professor Freedman warns that age 65 is too late for many Aboriginal Australians. "There is a growing body of research showing Aboriginal people develop AF at a younger age, have higher cardiovascular risk, and have a much poorer prognosis than non‐Indigenous people," he says. "While the reasons aren't clear, earlier AF might be linked to genes, greater alcohol consumption, and undetected rheumatic valvular heart disease."
Professor Freedman and Dr Lowres called for new screening guidelines for this group to close the health gaps. They also warn that recommendations for opportunistic screening, usually by GPs, may not be suited to Indigenous Australians. Challenges also exist to persuade these patients to begin treatment and stick with it over time.
"We really want to get the message out that AF is a major health risk for this population, especially for those in their 40s, 50s and older," says Professor Freedman.
"We want to educate people about the considerable life-saving benefits of getting tested for AF and getting onto treatment. Medication works. You just need to know to get on it."
The editorial, Time to develop guidelines for screening and management of atrial fibrillation in Indigenous Australians, can be viewed here.
