HEART AND CIRCULATORY CONDITIONS

Definition

This topic refers to those persons ever told by a doctor or nurse that they have one or more heart or circulatory conditions, and who consider they currently have one or more such conditions. Non-remote respondents were asked whether a condition was expected to last for 6 months or more to determine if they were long-term, while any condition a remote respondent currently suffered was assumed to be long-term.

The following conditions were assumed to be current, long-term conditions for all persons who reported them:

• rheumatic heart disease
• heart attack
• heart failure
• stroke
• angina.

The scope of this topic differs according to the particular data aspect being considered.

For data collection purposes, and for data output relating to heart and circulatory conditions as a group of conditions, heart and circulatory conditions were defined broadly to include a range of heart, vascular and related conditions.

In addition to self report data for heart and circulatory conditions, information on cardiovascular disease was also collected from the NATSIHMS. For more details on this biomedical component, see the Biomedical Measures chapter of this Users' Guide.

Population

Information was obtained for all persons in the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) (with certain questions only asked of specific groups, as identified below) and persons aged 2 years and over in the National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS).

Methodology

Information about heart and circulatory conditions was collected in both the NATSIHS and NATSINPAS surveys. Information on heart and circulatory conditions was first published in the First Results publication based on the NATSIHS only sample of approximately 9,300 people of all ages. Updated results on heart and circulatory conditions for the larger, combined NATSIHS and NATSINPAS sample, known as the Core sample, of approximately 12,900 people aged two years and over were published in the Updated Results publication. For comparison of heart and circulatory conditions with NATSIHS only items or the 0-1 year old population, the NATSIHS file should be used and similarly, for comparison with NATSINPAS only items, the NATSINPAS file should be used. However, for the most accurate information for heart and circulatory conditions alone or comparison with other items collected in the Core, the Core file should be used. For more information on the structure of the AATSIHS, see the Structure of the Australian Aboriginal and Torres Strait Islander Health Survey page of this Users’ Guide.

Respondents were asked if they had ever been told by a doctor or nurse that they had a heart or circulatory condition (including conditions controlled by medication for persons in non-remote areas). A prompt card showing examples of conditions was provided to respondents. The following predefined condition categories were included on the questionnaire, with provision for interviewers to record three additional conditions if required:

• rheumatic heart disease
• heart attack
• heart failure
• stroke (including after effects of stroke)
• angina
• high blood pressure or hypertension
• low blood pressure or hypotension
• hardening of the arteries, atherosclerosis or arteriosclerosis
• fluid problems, fluid retention or oedema
• high cholesterol
• rapid or irregular heartbeats, tachycardia or palpitations
• heart murmur or heart valve disorder
• haemorrhoids
• varicose veins
• other (up to three conditions could be recorded).

More than one response was allowed.

Please note, while high cholesterol is collected as part of the 'heart and circulatory' module and includes data for additional NATSIHS heart and circulatory items, it is classified as an endocrine condition in the ICD-10.

The use of the prompt card in the questionnaires effectively established this as the most detailed level of information on heart and circulatory conditions available from the survey. Very limited further detail may be available for those conditions recorded in the 'other specify' category.

Respondents were then asked if they currently had any heart or circulatory conditions, including conditions currently controlled by medications, and for those in non-remote areas whether any/which of these conditions had lasted or were expected to last for six months or more. The list of predefined conditions was again used for these questions, and any 'other' responses identified in the initial question.

NATSIHS respondents in non-remote areas aged 18 to 44 years, who specified that they had a current heart or circulatory condition and aged 45 years or over, were asked whether their cholesterol level had been checked in the last 5 years, and if so, whether their cholesterol level had been checked in the last 12 months. Those respondents aged 18 years and over reporting current heart or circulatory conditions in remote areas were asked if cholesterol was tested in the last 12 months only.

NATSIHS respondents in non-remote areas aged 18 years or over were asked whether their blood pressure had been checked in the last two years and, if so, whether it had been checked in the last 12 months. Respondents in remote areas aged 18 years and over were only asked if it had been checked in the last 12 months. Respondents were then asked who usually performs the check (GP, specialist, other health professional, somebody else (e.g. family member)).

NATSIHS respondents aged 18 years or over with a current heart or circulatory condition were also asked whether they took aspirin on a daily basis, and whether this had been on the advice of a doctor.

Specific medications were not collected in the NATSIHS, however, NATSIHS respondents who had a heart or circulatory condition were asked whether they took medication for it in the two weeks prior to the interview.

Data items

The data items and related output categories for this topic are available in Excel spreadsheet format from the Downloads page of this product.

Interpretation

Points to be considered in interpreting data for this topic include the following:

• As this is a household-based survey, people with heart or circulatory conditions who are resident in hospitals, nursing or convalescent homes, or similar accommodation, were outside the scope of this survey. As a result, the survey will under-represent those with more severe conditions.
• In this survey, persons who reported they had been told they had rheumatic heart disease, a heart attack, heart failure, angina or stroke are counted as having a current and long-term condition. Even though these conditions are usually short-term events, they often result in some form of residual damage or effects, and have been treated in this survey as current long-term conditions on that basis.
• Those cases of heart or circulatory conditions reported through the 'Long-term conditions' module, rather than the 'heart and circulatory conditions' module, have not necessarily been diagnosed by a doctor or nurse. Data for these respondents only appear on the NATSIHS file, and are identified by their conditions status of 4: Not known if ever told or not ever told, but condition current and long-term.
• The conditions recorded are as reported by respondents. In some cases it could be expected that some conditions reported may be symptoms of other heart or circulatory conditions, or other conditions. For example, oedema may be a symptom of a heart valve disorder. Respondents were not asked to associate conditions in this way, such that both symptoms and underlying conditions may have been reported in some cases, and only symptoms or only conditions in other cases. As a result, in looking at the prevalence of certain conditions, data users should consider how related or associated conditions should be treated.

Comparability with 2004-05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS)

Data from 2004-05 NATSIHS and 2012-13 NATSIHS are considered comparable. It should be noted that there may have been some under reporting of these condition in 2004-05 due to the list of heart and circulatory conditions not including heart failure, and for remote respondents also not including haemorrhoids or varicose veins. Respondents could have stated these conditions in 'Other'.

Comparability with 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS)

Heart and circulatory conditions information was not collected in 2008 NATSISS, therefore no comparisons can be made.

Comparability with 2011-12 Australian Health Survey (AHS)

Data collected in the 2011-12 AHS and 2012-13 AATSIHS are considered to be comparable, however it should be noted that for the remote population in the 2012-13 AATSIHS, conditions are assumed to be long-term if they are current, whereas the non-remote population and the 2011-12 AHS population are asked whether current conditions have lasted or are expected to last for 6 months or more to determine whether they are long-term. Any occurrence of the following conditions in both AHS and AATSIHS are considered to be long-term and current regardless of remoteness and therefore comparable: rheumatic heart disease, heart attack, heart failure, stroke and angina.

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