Risk and protective factors

The risk factors that contribute to cardiovascular disease (CVD) among Aboriginal and Torres Strait Islander people are complex. They reflect a combination of broad historical, social, cultural, and economic factors, as well as the more commonly described behavioural and biomedical risk factors [24669].

Behavioural or ‘lifestyle’ risk factors common to many types of CVD include:

• smoking tobacco
• being inactive
• an unhealthy diet [34579].

Biomedical risk factors shared by many types of CVD include:

• high cholesterol
• high blood pressure
• diabetes
• being overweight.

A high proportion of Aboriginal and Torres Strait Islander people report having one or more of these risk factors [32052][27711][28321].

A number of tools have been developed to identify people at risk of CVD who may benefit from the early introduction of preventive therapies [33621]. The current Australian Guidelines for the management of absolute CVD risk recommend that a prediction algorithm called the Framingham Risk Equation be used to identify Aboriginal and Torres Strait Islander adults who are at high risk of developing CVD over a five-year period [23381]. The Framingham tool takes into account a number of traditional risk factors: age, sex, high blood total cholesterol, low high-density lipoprotein (HDL) cholesterol level, high systolic blood pressure, the presence of diabetes, and smoking. Australian researchers are interested in improving the accuracy with which this tool predicts CVD for Aboriginal and Torres Strait Islander patients [33463], and identifying additional risk factors that increase the currently unmeasured risk of CVD in Aboriginal and Torres Strait Islander peoples [33621].