Background: Indigenous Australians experience poorer health outcomes than non-Indigenous Australians and a significant life expectancy gap exists. Ischaemic heart disease (IHD) represents the leading specific cause of death in Indigenous Australians and is a significant, if not the most significant, contributor to the mortality gap. With this narrative review we aim to describe the burden of IHD within the Indigenous Australian community and explore the factors driving this disparity.

Methods: A broad search of the literature was undertaken utilising an electronic search of the PubMed database along with national agency databases–the Australian Institute of Health and Welfare (AIHW) and the Australian Bureau of Statistics (ABS).

Results: A complex interplay between multiple factors contributes to the excess burden of IHD in the Indigenous Australian population:

○ Socioeconomic/psychosocial disadvantage ○ Excess ‘traditional’ risk factors for development of IHD ○ Relatively high proportion of Indigenous Australians residing in rural and remote areas ○ Inequitable access to relevant diagnostic and therapeutic procedures ○ Increased morbidity and mortality in the longer term following revascularisation procedures

Conclusions: In terms of IHD, Indigenous Australians experience disadvantage at multiple stages of the disease process. Ongoing efforts are needed to continue to inform clinicians of both this disadvantage and strategies to assist negating it. Further research is needed to develop evidence based practices which may help reduce this disparity in outcomes.