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Better prevention and management of heart failure in Aboriginal Australians

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Striking disparities in heart failure incidence and outcomes warrant urgent attention

Heart failure (HF), a common sequel of many cardiovascular diseases and predisposing risk exposures, remains a major health problem despite recent advances in medical therapy.1 HF in Aboriginal Australians is characterised by a substantial and distressingly familiar excess in incidence (Box),2 morbidity and mortality, particularly at younger ages.24

Strategies to enhance the prevention and early detection of heart failure

The primary prevention of HF in Aboriginal people is paramount and must occur concomitantly with treatment efforts. This requires population-based approaches to address underpinning social determinants of health5 (eg, poverty, marginalisation, environmental factors); cardiovascular risk factor reduction (smoking, obesity, diabetes, hypertension, dyslipidaemia); increased physical activity; and early detection and management of structural heart disease. Prevention must include multisectoral strategies to address the structural–systemic factors that undermine Aboriginal people’s opportunities throughout life. Additionally, screening, monitoring and treatment of HF antecedents in the community…