- The overarching aim of the CRISP study is to improve the capacity of existing high-quality epidemiological data to advance our understanding of the long-term impact of cardiovascular disease (CVD) risk factors, including diabetes and kidney disease on risk of mortality and cardiovascular disease events (including heart attacks and strokes) in Aboriginal and Torres Strait Islander Peoples.
(i) To analyse the accuracy of absolute CVD risk scores currently recommended for Aboriginal and Torres Strait Islander Australians (e.g. CARPA guidelines), and, if required, develop an improved CVD risk score.
(ii) To explore the relative contribution of “non-traditional” risk factors (abdominal obesity, hyperglycaemia, chronic inflammation and albuminuria) compared to “traditional” risk factors (smoking, cholesterol and blood pressure) to mortality and the development of CVD in Aboriginal and Torres Strait Islander Peoples, and to examine CVD risk in younger (aged <45 years) adults and in women.
(iii) To identify the profiles of individuals who are at high risk of CVD but currently not identified as being at high risk with existing clinical risk assessments (such as those recommended by Central Australian Rural Partitioners Association (CARPA).
This research consortium will obtain crucial information on mortality and CVD risks by pooling individual participant data from five high-quality epidemiological surveys conducted in WA, NT and QLD. The CRISP study includes individual-level epidemiological data on ~5,000 adults with a median of 14 years follow-up for CVD events and mortality. The project will identify the profiles of Aboriginal and Torres Strait Islander People, including women and younger adults (<45 years) who are at high risk of CVD but currently not detected as being at high risk with existing clinical risk assessments. In doing this, it will examine the impact of “non-traditional” risk factors (abdominal obesity, hyperglycaemia, chronic inflammation and albuminuria) compared to “traditional” risk factors (smoking, cholesterol and blood pressure); and how socio-economic factors modify CVD risk. This knowledge will inform CVD risk prediction protocols, including the development of a CVD risk score/s for use in Aboriginal and Torres Strait Islander populations, to better assess and manage individuals to prevent CVD.
Implications for policy and practice:
CRISP investigators have extensive experience in collaborating and engaging with Aboriginal and Torres Strait Islander communities and individuals, and will also utilise long-standing and successful relationships with key stakeholders, including community controlled and government health services to ensure key research findings are translated to policy and practice. Improved CVD prevention strategies address the large disparity in CVD health between Aboriginal and Torres Strait Islander Peoples and non-Indigenous Australians.
Our research has found:
The first stage of our program of research has been published in Heart. The findings from this analysis support the use of the Central Australian Rural Practitioners Association (CARPA) adjusted CVD risk algorithm in Aboriginal and Torres Strait Islander People. Assessment of other CVD risk scores without regard for clinical criteria showed that CVD risk was underestimated, with underestimation greater in women than men, and in younger adults than older adults. On-going research will investigate CVD risk in younger adults and in women, and whether further modifications to CVD risk algorithm/s can improve CVD risk prediction.
Start date - End date:
Menzies School of Health Research, Charles Darwin University
- Dr Elizabeth Barr
- Prof Louise Maple-Brown
- Prof Kerin O’Dea
- Prof Joan Cunningham
- Prof Zhiqiang Wang
- Prof Steve Guthridge
- Prof Alan Cass
Darwin Aboriginal Community
- Mr Shaun Tatipata
The University of Queensland
- Prof Wendy Hoy
- A/Prof Federica Barzi
- Prof Julie Brimblecombe
University of Western Australia
- A/Prof Pamela Bradshaw
- Prof Peter Thompson
Perth Aboriginal community
- Ms Lyn Dimer
James Cook University
- Prof Robyn McDermott
South Australian Health and Medical Research Institute
- Prof Alex Brown
Northern Territory Department of Health
- Dr Christine Connors
Baker Heart and Diabetes Institute
- Dr Elizabeth Barr
- Prof Jonathan Shaw
- Barr, E.L.M., Barzi, F., Rohit, A., Cunningham, J., Tatipata, S., McDermott, R., Hoy, W.E., Wang, Z., Bradshaw, P.J., Dimer, L., Thompson, P.T., Brimblecombe, J., O’Dea, K., Connors, C., Burgess, P., Guthridge, S., Brown, A.D.H., Cass, A., Shaw, J.E. & Maple-Brown, L.J. (2020). Performance of cardiovascular risk prediction equations in Indigenous Australians. Heart, 106(16), 1252-1260. doi: 10.1136/heartjnl-2019-315889.