CARDIOVASCULAR DISEASE BIOMARKERS
Cardiovascular disease remains one of the leading causes of death in Australia and is recognised as a national health priority. According to the 2003 Australian Burden of Disease Study, high blood cholesterol, which is closely associated with ischaemic heart disease and stroke, accounted for 6% of the burden of disease in the Aboriginal and Torres Strait Islander population. Cardiovascular disease was the leading specific cause of death.1 The onset of cardiovascular disease can be delayed or prevented through reducing risk factors such as lowering cholesterol, following a healthy diet and avoidance of smoking.
The main indicators of cardiovascular disease that were measured in the National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS) were cholesterol, including total, high density lipoprotein (HDL) and low density lipoprotein (LDL), and triglycerides. Another indicator that has been linked to cardiovascular disease, which was also measured in the NATSIHMS, is Apolipoprotein B.
Self reported data on cardiovascular disease was also collected in the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) and the National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS). The biomedical results from the NATSIHMS can be used together with the self reported data to estimate disease prevalence rates. For details on self reported cardiovascular disease data, see the relevant heart and circulatory conditions chapter in this product.
An indicator of cardiovascular disease that was reported in the NATSIHMS is dyslipidaemia. Dyslipidaemia refers to a number of different lipid disorders (that is, conditions where there are too many fats in the blood). In the NATSIHMS, dyslipidaemia was defined as having at least one abnormal test result of cholesterol (either total, HDL or LDL) or triglycerides, or the person indicated that they took lipid-lowering medication. The results for this item were obtained from selected persons aged 18 years and over, who participated in the NATSIHMS and fasted for 8 hours or more prior to providing a blood sample.
In the NATSIHMS, a person was classified as having dyslipidaemia if they had one or more of the following:
- Taking lipid-lowering medication
- Total cholesterol greater than or equal to 5.5 mmol/L
- HDL cholesterol less than 1.0 mmol/L for men and less than 1.3 mmol/L for women
- LDL cholesterol greater than or equal to 3.5 mmol/L
- Triglycerides greater than or equal to 2.0 mmol/L.
Estimates of dyslipidaemia from the NATSIHMS can be used to determine how many Aboriginal and Torres Strait Islander people have at least one lipid disorder and therefore have an increased risk of heart disease.
Points to be considered when interpreting data for this topic include the following:
Comparability with other surveys
- Dyslipidaemia results do not confirm a specific diagnosis without consultation with a health professional.
- Fasting over 8 hours is required for several components of this indicator to accurately assess the levels of lipids (fat) circulating in the blood. Only persons who fasted were included into the dyslipidaemia data.
The NATSIHMS is the first ABS Aboriginal and Torres Strait Islander survey to collect biomedical information. Given it was also the first national level survey (ABS or otherwise) to collect such data for the Aboriginal and Torres Strait Islander population, no comparisons with previous surveys for this population are possible.
However, biomedical data was also collected for all Australians in the 2011-12 National Health Measures Survey (NHMS) and information about comparisons between the NHMS results and those of non-ABS surveys is available from the Comparisons with other Australian surveys
section of the Biomedical Results for Chronic Diseases, 2011-12
More information regarding the biomedical tests and cut off points can be found in the relevant subsections of this Users' Guide.
Vos T, Barker B, Stanley L, Lopez AD 2007. The Burden of Disease and Injury in Aboriginal and Torres Strait Islander peoples 2003, School of Population Health, The University of Queensland, Brisbane, <http://www.lowitja.org.au/sites/default/files/docs/Indigenous-BoD-Summary-Report_0.pdf
>, Last accessed 08/09/2014.