Screening to prevent sudden cardiac death in young Indigenous people in remote northern Australia

Associate Professor Jessica Orchard, University of Sydney

Vanguard Grant

Years funded: 2026 - 2028

Screening to prevent sudden cardiac death in young Indigenous people in remote northern Australia: Hearts In FOCUS

BACKGROUND Indigenous Australians have disproportionately high rates of premature coronary heart disease. Rheumatic heart disease (RHD) is near endemic in some areas. A review of sudden cardiac death (SCD) cases in young Indigenous Australians in the Northern Territory (2019-2023) found the annual rate was 15 times higher than the general population. The most common cause was coronary artery disease, followed by RHD.

The Heart Foundation recommends cardiovascular risk factor screening in Indigenous Australians from age 18 years. Targeted RHD screening of high-risk groups is recommended.

PROBLEMS Uptake of cardiac screening in this population remains low. Screening in Indigenous communities must be more than accessible – it must be ethically and culturally sound and responsive to the communities it aims to serve. There is a critical need to develop and implement novel strategies that are culturally safe and community-led, including a clear pathway to care. Screening programs must be requested, welcomed and shaped by the community.

PROJECT Sport may offer a novel setting and approach. Sport screening programs achieve almost universal uptake by performing tests at the training ground, which is familiar and convenient.

We will translate and tailor this model. Screening will be offered to 4 Australian Rules Football teams (male and female) in the West Kimberley Football League (Broome, WA), with: - Personal/family history and physical examination, including blood pressure - Electrocardiogram - Echocardiogram - Cardiovascular risk factor assessment, finger-prick test for cholesterol and blood sugar levels.

CPR training and education will be provided.

The program will be co-designed with Indigenous community members, physicians and athletes to ensure it is culturally safe, actively supporting trust and participation. Our team has expertise in screening, cardiology, cardiac imaging and sports medicine. It includes local experts, CI Luies (first Indigenous Sports Physician in Australia) and CI Marangou (cardiologist with RHD expertise), with close links to the West Kimberley Football League and Broome Regional Aboriginal Medical Service.

IMPACT & OUTCOMES Hearts In FOCUS could provide a new model for cardiac screening that could be expanded. It could: - Address a critical identified community priority; - Close gaps in implementation of guidelines through expanded uptake of critical cardiac screening programs; - Improve cardiovascular outcomes through early detection and treatment; and - Provide important data in this high-risk population.

The ultimate goal is to reduce SCD in northern Australia, with a program grounded in in principles of cultural security, equity and incorporation of Aboriginal knowledge systems.