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First Nations people and the Heart Health Check

Heart Health Check Toolkit

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First Nations people and the Heart Health Check

Cardiovascular disease (CVD) in First Nations people

CVD is the single largest contributor to mortality and accounts for a quarter of all deaths among First Nations people.1

Emerging evidence shows1,2,3:

  • heart disease is the leading cause of death among First Nations people, causing 1 in 10 deaths
  • cardiovascular events such as heart attack and stroke occur 10 to 20 years earlier in First Nations people than in non-Indigenous Australians
  • three out of four First Nations people under 35 years have one or more risk factors for CVD
  • First Nations women experience higher rates of CVD compared with non-Indigenous women

The Australian guideline for assessing and managing cardiovascular disease risk contains specific recommendations to assess CVD risk in First Nations people from ages 30–79 years. It further recommends assessing First Nations people aged 18–29 years based on their individual CVD risk factors.4

Recommendations

First Nations people without existing CVD should undergo a CVD risk assessment from age 30 years. This aligns with the Heart Health Check MBS item (699 and 177) eligibility criteria. Assessment should occur as part of an annual health check or opportunistically. Subsequent reviews should be conducted according to the level of risk.

Where possible, CVD risk assessment should be completed as part of a holistic health assessment for First Nations people, with appropriate follow up and management. In alignment with the National Agreement on Closing the Gap, all care should be taken to ensure cultural safety, shared decision-making, informed consent and ownership of information.

The following CVD risk factors should be screened for in First Nations people ages 18–29 years:

  • smoking status
  • blood pressure
  • blood glucose level or glycated haemoglobin
  • estimated glomerular filtration rate
  • serum lipids
  • urine albumin-to-creatinine ratio
  • history of familial hypercholesterolaemia.

CVD risk calculation forms part of a health assessment for First Nations people (MBS item 715).

How to incorporate CVD risk assessment into the 715 assessment

  1. Ensure good continuity of care by registering First Nations people under Closing the Gap targets.
  2. Establish systematic practice processes for eligible patients, e.g.
    1. include CVD pathology requirements in recall process
    2. revise practice templates to incorporate CVD risk calculation
    3. allow sufficient time to cover family history
    4. set the next appointment before the patient exits the practice.

The Heart Health Check compared to the MBS item 715 assessment

Key differences between the Heart Health Check (MBS item 699 or 177) and the health assessment for First Nations people (MBS item 715).

Comparison of MBS items 699 or 177 and MBS item 715
MBS item 699 or 177 MBS item 715
Patient group Adults not already known to have CVD All people of Aboriginal & Torres Strait Islander descent
Age group ≥45 years (≥30 years for Aboriginal & Torres Strait Islander people) All ages
Assessment CVD risk factors & absolute CVD risk score Broad assessment of patient’s health, physical, psychological & social function
Management Initiate interventions (e.g. medicines) and referrals to reduce CVD risk. Implement ongoing management plan Provide information & referral to interventions
Practice nurses or Aboriginal health workers can assist GP Yes Yes
Duration ≥20 minutes No designated time, GP’s discretion
Frequency Every 12 months Every 9 months
Schedule fee (as of August 2020)
699: Fee = $75.05
Benefit = 100% rebate
177: Fee = $60.05
Benefit = 100% rebate
715: Fee = $218.90
Benefit = 100% rebate
Use with other health assessment items Item 699 or 177 cannot be claimed if item 715 has been claimed in the previous 12 months
Healthcare worker checking blood pressure of a patient in a wheelchair
CVD risk assessment for First Nations people

Recommendations for assessing CVD risk in Aboriginal and Torres Strait Islander peoples

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Get a heart check (animation) for Aboriginal and/or Torres Strait Islander Peoples

A one-minute video for your waiting room or practice website

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External site – Listing of the Medicare services subsidised by the Australian Government.

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What is a Heart Health Check?

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Templates for assessment and management

  1. J Agostino, D Wong, E Paige, V Wade, C Connell, ME Davey, DP Peiris, D Fitzsimmons, CP Burgess, R Mahoney, E Lonsdale, P Fernando, L Malamoo, S Eades, A Brown, G Jennings, RW Lovett and E Banks, ‘Cardiovascular disease risk assessment for Aboriginal and Torres Strait Islander adults aged under 35 years: a consensus statement’, Med J Aust, 2020; 212(9):422-427, doi:10.5694/mja2.50529.

  2. Australian Institute of Health and Welfare. Cardiovascular disease in women. Cat. no. CDK 15. Canberra: AIHW; 2019.

  3. Australian Bureau of Statistics. Causes of Death, Australia. 2022. Accessed 4 Jan 2024. https://www.abs.gov.au/statistics/health/causes-death/causes-death-australia/latest-release 

  4. Australian Chronic Disease Prevention Alliance. Australian guideline for assessing and managing cardiovascular disease risk. 2023. https://www.cvdcheck.org.au/managing-cvd-risk   

Last updated26 October 2026

Last reviewed22 September 2026