Assessing Cardiovascular Disease (CVD) Risk in Aboriginal People

澳大利亚土著人的心血管疾病(CVD)死亡率比其他澳大利亚人高，年轻人和中年人的死亡率增加了15倍或更多。考虑所有风险因素的多因素方法是识别和降低心血管疾病风险的最佳策略。在个体中选择降低风险治疗的第一步是评估他/她的风险状态和干预的益处。几种结合了传统风险因素的风险评估工具是从西方人口中开发出来的。它们最适合应用于与研究样本相似的个人；它们在澳大利亚土著人中的有效性尚未得到评估，也没有专门为土著人制定风险预测公式。最近的报告表明，其他各种非传统危险因素也影响心血管疾病的风险，包括中枢脂肪沉积、炎症、营养、酒精使用和早期生长的标志物。鉴于许多土著人民处境不利，其中一些因素很可能正在影响他们患心血管疾病的风险。申请者收集了一个土著社区志愿者的基线风险因素数据，并跟踪了他们的进程，包括十多年来的心血管死亡和心血管住院。根据这一超出传统风险标记物的基线信息，以及从其他测量方法，如出生体重，以及在提取的血清中分析的炎症和营养标记物，我们将开发各种模型来预测这一群体的心血管疾病风险。我们还将制定计划，在其他土著群体中评估这些工具。更好地了解这一人群中心血管疾病的原因对于影响预防心血管疾病的公共卫生政策是重要的。这些模型将是社区一级有用的健康教育工具，并将允许针对个人风险概况对个人进行治疗或生活方式干预。

Aboriginal Australians have higher death rates from cardiovascular disease (CVD) than other Australians, with rates in young and middle aged people increased 15-fold or more. A multi-factor approach, which considers all the risk factors, is the best strategy to identify and reduce CVD risk. The first step for selection of risk-reduction therapy in an individual is to assess his-her risk status and the benefit of intervention. Several risk assessment tools, incorporating traditional risk factors, have been developed from Western populations. They would be most appropriately applied to individuals who resemble the study sample; their validity in Aboriginal Australians has not been evaluated and no risk prediction formulae have been developed specifically for Aboriginal people. Recent reports suggest that a variety of other non-traditional risk factors also influence CVD risk, including markers of central fat deposition, inflammation, nutrition, alcohol use and early growth. Given the disadvantaged circumstances of many Aboriginal people, it is likely that some of the factors are influencing their CVD risk. The applicants have collected baseline risk factor data on volunteers in one Aboriginal community and followed their course, including CVD deaths and CVD hospitalisations, for more than a decade. From this baseline information, which goes beyond traditional risk markers, and from additional measures like birthweight, and markers of inflammation and nutrition assayed in retrieved serum, we will develop a variety of models for predicting a CVD risk in this group. We will also lay plans to evaluate these tools in other Aboriginal groups. A better understanding of the causes of CVD in this population is important to influence public health policy for CVD prevention. The models will be helpful health education tools at the community level and will allow therapeutic or lifestyle intervention in individuals to be targeted at their individual risk profile.