An epidemic of cardiovascular disease (CVD) and end stage renal disease (ESRD) has developed among Aborigines in the Northern Territory ; CVD deaths increased over the 1980s (tripling among women !), and are now more than five times those of non-Aboriginal people, while ESRD rates are increasing more than 20-fold and are doubling every three to four years.
Dialysis costs (>$75,000 per person/year) pose a crisis for health care budgets, but premature mortality is the greater human catastrophe.
Health services are not meeting the challenge of timely diagnosis, prevention and containment.
We screened 90% of adults (20+years) in one community, with CVD mortality among the highest in Australia, and ESRD rates increased 60-fold.
Seventy-five per cent of persons were smokers.
Central obesity was common, but BMIs only modestly increased by Caucasian standards, 23% had hypertension (>140/90), 29% had diabetes or impaired glucose tolerance (IGT) (peaking at 65% of persons aged 40-49 years), high triglyceride and insulin levels were common, and 55% had albuminuria (albumin/creatinine ratio (ACR),>3.4 gm/moL).
Progressive albuminuria predicted renal failure.
ACR was correlated with age, BMI, blood pressure, lipid, glucose and insulin levels, heavy drinking and past and current skin infections, and, inversely with birth weight.
ACR correlated strongly with a composite CV risk score, and in a two to five year follow-up, microalbuminuria (ACR 3. (...)
Mots-clés Pascal : Insuffisance rénale, Homme, Aborigène, Appareil circulatoire pathologie, Australie, Océanie, Facteur risque, Prévention, Diagnostic, Stade précoce, Traitement, Programme sanitaire, Appareil urinaire pathologie, Rein pathologie
Mots-clés Pascal anglais : Renal failure, Human, Aboriginal, Cardiovascular disease, Australia, Oceania, Risk factor, Prevention, Diagnosis, Early stage, Treatment, Sanitary program, Urinary system disease, Kidney disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0387636
Code Inist : 002B14A04. Création : 22/03/2000.