Stemming the tide: reducing cardiovascular disease and renal failure in Australian Aborigines*

Hoy, W. E.; Kelly, Angela M.; Jacups, Susan P.; McKendry, K.; Baker, Philip; Macdonald, Sharon; Wang, Zhiqiang; Punguatji, N.; Kerinauia, J.; Tipiloura, E.; Harrison, Claire

doi:10.1111/j.1445-5994.1999.tb00746.x

Cited by 22 publications

(21 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diabetes is an enormous health problem in Australian Aborigines and Torres Strait Islanders; the overall prevalence is estimated to be 10 -30% (43). Furthermore, the associated macrovascular and microvascular complications result in significant premature mortality and ill health among the Australian Indigenous population (44). Further research, including sample surveys using the AusDiab methodology, is planned to address the significant gap in our knowledge of the complex mechanisms that underlie the high prevalence of diabetes and its complications in Aboriginal and Torres Strait Islander communities.…”

Section: Secular Trends: 1981 To 1999 -2000mentioning

confidence: 99%

The Rising Prevalence of Diabetes and Impaired Glucose Tolerance

et al. 2002

View full text Add to dashboard Cite

OBJECTIVE -To determine the population-based prevalence of diabetes and other categories of glucose intolerance (impaired glucose tolerance [IGT] and impaired fasting glucose [IFG]) in Australia and to compare the prevalence with previous Australian data. RESEARCH DESIGN AND METHODS-A national sample involving 11,247 participants aged Ն25 years living in 42 randomly selected areas from the six states and the Northern Territory were examined in a cross-sectional survey using the 75-g oral glucose tolerance test to assess fasting and 2-h plasma glucose concentrations. The World Health Organization diagnostic criteria were used to determine the prevalence of abnormal glucose tolerance.RESULTS -The prevalence of diabetes in Australia was 8.0% in men and 6.8% in women, and an additional 17.4% of men and 15.4% of women had IGT or IFG. Even in the youngest age group (25-34 years), 5.7% of subjects had abnormal glucose tolerance. The overall diabetes prevalence in Australia was 7.4%, and an additional 16.4% had IGT or IFG. Diabetes prevalence has more than doubled since 1981, and this is only partially explained by changes in age profile and obesity.CONCLUSIONS -Australia has a rapidly rising prevalence of diabetes and other categories of abnormal glucose tolerance. The prevalence of abnormal glucose tolerance in Australia is one of the highest yet reported from a developed nation with a predominantly Europid background. Diabetes Care 25:829 -834, 2002

show abstract

Section: Secular Trends: 1981 To 1999 -2000mentioning

confidence: 99%

The Rising Prevalence of Diabetes and Impaired Glucose Tolerance

et al. 2002

View full text Add to dashboard Cite

show abstract

“…To this end, we introduced a treatment programme into the study community in late 1995, using the long-acting angiotensin-converting enzyme (ACE) inhibitor perindopril (Coversyl, Servier, Australia) as the primary agent. [21][22][23][24][25] Eligibility criteria were hypertension (systolic blood pressure ≥ 140 or diastolic blood pressure ≥ 90 mmHg), diabetes with ACR 3.4+ (microalbuminuria threshhold) regardless of blood pressure and overt albuminuria (ACR 34+) that was progressing regardless of blood pressure and diabetes status.…”

Section: Figmentioning

confidence: 99%

Renal disease and the environment: lessons from Aboriginal Australia*

et al. 2001

View full text Add to dashboard Cite

SUMMARY: Aborigines in remote Australia are living in profound socio‐economic disadvantage and epidemiological transition. They are also experiencing an epidemic of cardiovascular disease, with deaths increased > threefold and renal failure increased > 20‐fold. Dialysis costs pose a crisis, but premature death is the greater human catastrophe. In one high‐risk group, we identified renal disease through the urinary albumin/creatinine ratio and assessed it distribution, its correlations, its associations with other morbidities and overall mortality and its natural history. We later introduced systematic antihypertensive and renal‐protective treatment for afflicted persons. Albuminuria was detected in 55% of adults. It was inversely correlated with glomerular filtration rate (GFR) and generally progressed over time. It was strongly correlated with cardiovascular risk, and its intensity predicted not only renal failure but also all‐cause natural death. Factors correlated with renal disease included increasing age, low birthweight and infant malnutrition, adult weight gain and its syndrome X metabolic accompaniments, skin infections, post‐streptococcal glomerulonephritis, heavy drinking, multiparity and a family history of renal disease. Nephron endowment probably also influences risk, with birthweight being one important driving force. Ironically, improved health services have probably contributed to the epidemic of renal failure in at least two ways: increased survival of low‐birthweight infants and increased longevity in adults, allowing the full progression or renal disease to its terminal state. The treatment programme was associated with swift and massive reductions in end‐stage renal failure, overall mortality and costs. Renal disease is multideterminant, with the simultaneous operation of several risk factors amplifying the increase in albuminuria and decrease in GFR that accompany increasing age. While many risk factors and mechanisms remain to be identified, our findings provide ample grounds for immediate intervention in similarly afflicted communities, with expectation of excellent outcome. Improved services will probably result in additional ascertainment of disease and more opportunity for its expression, so that disease prevention and modification become even more pressing obligations. Major shifts in our political, social, academic and clinical priorities are needed to effectively address these issues for all Aboriginal communities.

show abstract

“…By self report, 66% were taking their medicines "most of the time"; 27%, "sometimes" or "occasionally"; and 7%, "rarely or never" (13).…”

Section: Resultsmentioning

confidence: 99%

Secondary Prevention of Renal and Cardiovascular Disease

Hoy¹,

Wang²,

Baker³

et al. 2003

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Abstract. Australian Aborigines are experiencing an epidemic of renal and cardiovascular disease. In late 1995 we introduced a treatment program into the Tiwi community, which has a three-to fivefold increase in death rates and a recent annual incidence of treated ESRD of 2760 per million. Eligible for treatment were people with hypertension, diabetics with micro or overt albuminuria, and all people with overt albuminuria. Treatment centered around use of perindopril (Coversyl, Servier), with other agents added to reach BP goals; attempts to control glucose and lipid levels; and health education. Thirty percent of the adult population, or 267 people, were enrolled, with a mean follow up of 3.39 yr. Clinical parameters were followed every 6 mo, and rates of terminal endpoints were compared with those of 327 historical controls matched for baseline disease severity, followed in the pretreatment program era. There was a dramatic reduction in BP in the treatment group, which was sustained through 3 yr of treatment. Albuminuria and GFR stabilized or improved. Rates of natural deaths were reduced by an estimated 50% (P ϭ 0.012); renal deaths were reduced by 57% (P ϭ 0.038); and nonrenal deaths by 46% (P ϭ 0.085).

show abstract

Stemming the tide: reducing cardiovascular disease and renal failure in Australian Aborigines*

Cited by 22 publications

References 5 publications

The Rising Prevalence of Diabetes and Impaired Glucose Tolerance

The Rising Prevalence of Diabetes and Impaired Glucose Tolerance

Renal disease and the environment: lessons from Aboriginal Australia*

Secondary Prevention of Renal and Cardiovascular Disease

Contact Info

Product

Resources

About