Maori rate of heart failure alarms health experts

By BRIDGET CARTER

Middle-aged Maori are nearly nine times more likely to die from heart failure than other New Zealanders the same age, to the alarm of medical experts.

Their heart-failure rate is nearly four times that of Maori over 65, and many will suffer heart failure at least once.

In a study published in this week's New Zealand Medical Journal, heart failure, hospitalisation and mortality rates for Maori aged over 45 were compared with those of other New Zealanders.

The findings have shocked health experts, who say Maori are suffering from heart failure far too early in life.

They also say the study has revealed for the first time that there is a surprisingly big gulf between heart failure rates of Maori and other nationalities.

Tania Riddell, Public Health Medicine Registrar with the National Heart Foundation and project manager for the Maori cardio-vascular group, said what was startling about the findings was that young Maori were dying of a disease that normally afflicted the elderly.

Just how enormous the gap was for heart failure rates between Maori and other New Zealanders was another surprising thing.

Ethnic differences were worldwide, but were less marked.

According to the study, the age-adjusted death rate from heart failure for the black population aged under 65 in the US was about 2.5 times that of whites and hospitalisation rates were 33 to 50 per cent higher for blacks than for whites.

Other findings in the New Zealand study included the revelation that 66 per cent of Maori men who died of heart failure were younger than 65, compared with 23 per cent of non-Maori men.

Of the Maori women who died of heart failure, 41 per cent were aged under 64, compared with 7 per cent of heart failure deaths in other women in the same age bracket.

Maori women aged 45 to 64 were 9.5 times more likely to be diagnosed with heart failure than others the same age, with men 8.2 times more likely.

The findings also revealed that nearly 40 per cent of Maori heart-failure patients had made at least two trips to hospital each year for the condition, compared with 33 per cent of other patients in hospital for heart disease.

Dr Riddell said she believed the figures related to an increase in conditions such as diabetes among Maori, which could trigger heart failure, but a lack of access to health-care intervention was also a problem.

"The treatment is quite basic for preventative measures ... access to diagnosis, however, is hard because you have to go to a specialist and it costs and you can't get proper treatment unless you are treating the diagnosis."

She said that although there was strong emphasis on health promotion in New Zealand, for many, a healthy lifestyle was difficult.

Some people could not afford a gym membership and would return to a home where a number of people were smoking.

The National Heart Foundation medical director Diana North said Maori needed to receive treatment much earlier.

Work had to be done in that area, she said, although the Ministry of Health had already set up a Maori advisory committee.

Dr North said the most common cause of the heart failing to pump blood around the body was from a heart attack.

Causes of heart attacks included an unhealthy diet, smoking and diabetes and high blood pressure, which were common among Maori.

In New Zealand, cardiovascular diseases still accounted for the greatest number of deaths.

Hospitalisations due to heart failure are estimated to account for about 1 per cent of the total health budget. Admissions for heart failure increased by more than 50 per cent between 1988 and 1997.

nzherald.co.nz/health