Current studentsExisting staffContact us
 

Lipid treatment guidelines and cardiovascular risk for Aboriginal people in Central Australia

Simple item page
dc.contributor.authorLuke, J.N.
dc.contributor.authorBrown, A.
dc.contributor.authorO'Neal, D.N.
dc.contributor.authorO'Dea, K.
dc.contributor.authorJenkins, A.J.
dc.contributor.authorKelaher, M.
dc.contributor.authorBest, J.D.
dc.contributor.authorRowley, K.G.
dc.date.issued2009
dc.description.abstractObjective: To evaluate the extent to which the current Pharmaceutical Benefits Scheme (PBS) guidelines for patient eligibility for lipid-lowering medication are applicable to Aboriginal people in Central Australia. Design, setting and participants: A 10-year cohort study of 659 Aboriginal people who participated in population-based cardiovascular disease (CVD) risk factor surveys in 1995 and who were free of CVD at baseline, for the period from 1995 to 2004–2005 or until first CVD event. Evidence of atherosclerotic CVD (ischaemic heart disease, ischaemic stroke, and peripheral vascular disease) was sought from hospital, primary health care and death records. PBS eligibility was assigned according to the current PBS criteria, which were amended in 2006 to include Aboriginal-specific criteria, using participants’ baseline (1995) and 10-year follow-up data Main outcome measures: Proportions of PBS-eligible and PBS-ineligible participants who had CVD events during the study period; sensitivity and specificity of the criteria. Results: Of 42 participants who had CVD events during the study period, 35 were PBS-eligible (incidence, 1130/100 000 person-years; relative risk compared with PBS-ineligible population, 4.87 [95% CI, 2.19–10.80]) and seven were PBS-ineligible. PBS eligibility was associated with older mean age (37 v 32 years) and male sex (48% v 37%), with 50.7% of participants (334/659) meeting eligibility criteria. The mean high-density lipoprotein cholesterol level at baseline was very low in both groups (0.81 v 0.87 mmol/L). The current PBS guidelines have low specificity (52%) in this population, which was found to improve (to 71%–82%) by incorporating additional non-lipid criteria (age and multiple non-lipid risk factors). Conclusion: The current PBS lipid treatment criteria, which include any Aboriginal person with diabetes and less stringent cholesterol thresholds than the previous version, identify a group at very high risk of CVD. Global risk assessment may better identify those at risk.
dc.identifier.citationMedical Journal of Australia, 2009; 190(10):552-556
dc.identifier.doi10.5694/j.1326-5377.2009.tb02561.x
dc.identifier.issn0025-729X
dc.identifier.issn1326-5377
dc.identifier.orcidBrown, A. [0000-0003-2112-3918]
dc.identifier.urihttps://hdl.handle.net/1959.8/115615
dc.language.isoen
dc.publisherAustralasian Medical Publishing Company
dc.relation.fundingNHMRC “HOMELANDS” Program
dc.relation.fundingNHMRC Senior Research Fellowship
dc.rightsCopyright 2009 Australasian Medical Publishing Company
dc.source.urihttps://doi.org/10.5694/j.1326-5377.2009.tb02561.x
dc.subjectdensity-lipoprotein cholesterol
dc.subjectcoronary-heart-disease
dc.subjectsimvastatin
dc.subjectprevalence
dc.subjectplasma
dc.subjectHumans
dc.subjectCardiovascular Diseases
dc.subjectDiabetes Complications
dc.subjectHydroxymethylglutaryl-CoA Reductase Inhibitors
dc.subjectRisk Factors
dc.subjectFollow-Up Studies
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectOceanic Ancestry Group
dc.subjectInsurance, Pharmaceutical Services
dc.subjectAustralia
dc.subjectFemale
dc.subjectMale
dc.subjectHyperlipidemias
dc.subjectYoung Adult
dc.titleLipid treatment guidelines and cardiovascular risk for Aboriginal people in Central Australia
dc.typeJournal article
pubs.publication-statusPublished
ror.fileinfo12143332140001831 13143330420001831 9915910862901831_53133809710001831.pdf
ror.mmsid9915910862901831

Files

Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
9915910862901831_53133809710001831.pdf
Size:
271.14 KB
Format:
Adobe Portable Document Format
Description:
Published version
Download

Collections