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Therapeutic drug safety for Indigenous Australians: how do we close the gap?

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In the setting of significant disease burden, lack of data on drug safety for Australia’s Indigenous population is concerning

Indigenous Australians have a high burden of disease and are at increased risk of premature death compared with the general Australian population. Cardiovascular disease accounts for a large proportion of this burden, with high prevalence of type 2 diabetes and chronic renal failure being underlying risk factors.1 Traditional cardiovascular risk calculators underestimate risk in Aboriginals and Torres Strait Islanders. For example, observed numbers of coronary events for Indigenous Australians who live in remote areas are 2.5 times higher than predicted using the Framingham risk calculator, and younger women in this population have 30 times the predicted rate of events.2 While this suggests that solely focusing on management of traditional risk factors may not be the complete answer, this high burden of disease in the Indigenous population can drive recommendations for early and extensive use of medicines.

National guidelines recommend using lower thresholds to screen for and manage cardiovascular risk factors such as hyperlipidaemia in the Aboriginal and Torres Strait Islander population.3 Aggressive primary preventive measures for asymptomatic and young people, including early use of statin therapy,…