Heart, stroke and vascular disease: Australian facts

All heart, stroke and vascular disease

An estimated 39,300 First Nations adults (6.5%) were living with heart, stroke and vascular disease, based on self-reported data from the Australian Bureau of Statistics (ABS) 2022–23 National Aboriginal and Torres Strait Islander Health Survey (AIHW analysis of ABS 2025a).

Hospitalisations 

In 2023–24, there were around 20,200 hospitalisations with a principal diagnosis of cardiovascular disease (CVD) among First Nations people, corresponding to a rate of 2,000 per 100,000 population.

Hospitalisation rates increased with age and were highest among people aged 85 and over (14,800 per 100,000 population for both males and females). Among those aged under 85, males had higher hospitalisation rates than females (Figure 1).

Deaths 

In 2024, there were around 1,100 CVD deaths (underlying cause) among First Nations people. In jurisdictions with adequate Indigenous identification, the rate was 106 deaths per 100,000 population. 

The CVD death rate was 1.3 times as high among males as females (121 and 91 deaths per 100,000 population, respectively).

For more information about jurisdictions with adequate Indigenous identification, and reporting of deaths and death rates, see AIHW National Mortality Database in Data sources.

Coronary heart disease

An estimated 22,000 First Nations adults (3.6%) had coronary heart disease (CHD), based on self-reported data from the ABS 2022–23 National Aboriginal and Torres Strait Islander Health Survey (AIHW analysis of ABS 2025a).

Incidence

First Nations people aged 25 and over experienced an estimated 2,700 acute coronary events in 2023, corresponding to a rate of 561 per 100,000 population.

Hospitalisations

In 2023–24, there were around 5,900 hospitalisations with a principal diagnosis of CHD among First Nations people, corresponding to a rate of 574 per 100,000 population.

Males had a higher rate of hospitalisations than females across all age groups (Figure 2). The rate of CHD hospitalisations was 1.3 times as high among males than females (657 and 489 per 100,000 population, respectively). 

Deaths

In 2024, CHD was the underlying cause of death for 539 First Nations people. In jurisdictions with adequate First Nations identification, the CHD death rate was 52 per 100,000 population.

The rate of CHD deaths was 1.9 times as high among males as females (69 and 35 per 100,000 population, respectively).

Stroke

Incidence

Limited national information on the occurrence of stroke is available for the First Nations population, with under-identification in hospital and death data and small case numbers often hampering accurate estimates (Katzenellenbogen et al. 2011). However, some studies provide state-level estimates: 

• first-ever stroke incidence rate of 116 per 100,000 population in South Australia in 2009–2011 (Balabanski et al. 2018)
• first-ever stroke incidence rate of 307 per 100,000 population in the Northern Territory in 1999–2011 (You et al. 2015)
• stroke incidence rates of 377 for First Nations males and 341 for First Nations females in Western Australia in 1997–2002 (Katzenellenbogen et al. 2011).

Hospitalisations

In 2023–24, there were around 2,200 hospitalisations with a principal diagnosis of stroke among First Nations people, corresponding to a rate of 209 per 100,000 population.

Rates were higher among males than females, with the exception of those 85 years and older (2,000 and 2,200 per 100,000 population, respectively). Among those aged 45–54 years, the rate was 2.1 times as high among males as females (859 and 416 per 100,000 population, respectively) (Figure 3).

Deaths

In 2024, there were 159 deaths with an underlying cause of stroke among First Nations people, corresponding to a rate of 16 per 100,000 population in jurisdictions with adequate Indigenous status identification.

The rate of stroke deaths among males and females was similar (15 and 16 per 100,000 population, respectively).

Heart failure and cardiomyopathy

Hospitalisations

In 2023–24, there were around 7,700 hospitalisations with a principal and/or additional diagnosis of heart failure or cardiomyopathy among First Nations people, corresponding to a rate of 751 per 100,000 population.

The rate of heart failure or cardiomyopathy hospitalisations was 1.1 times higher among females as males (772 and 730 per 100,000 population, respectively).

Deaths

In 2024, heart failure or cardiomyopathy was an underlying and/or associated cause of death for 683 First Nations people (66 per 100,000 population in jurisdictions with adequate Indigenous status identification).

The rate was similar among males and females (67 and 65 per 100,000 population, respectively).

Atrial fibrillation

Hospitalisations

In 2023–24, there were around 5,500 hospitalisations with a principal and/or additional diagnosis of atrial fibrillation (AF) among First Nations people, corresponding to a rate of 534 per 100,000 population.

The rate of AF hospitalisations was 1.2 times higher among males than females (578 and 490 per 100,000 population, respectively).

Deaths

In 2024, AF was the underlying and/or associated cause of death for 272 First Nations people, equivalent to a rate of 26 per 100,000 population in jurisdictions with adequate First Nations identification.

The rate of AF deaths was the same among males as females (26 per 100,000 population).

Peripheral arterial disease

Hospitalisations

In 2023–24, there were 1,900 hospitalisations with a principal and/or additional diagnosis of peripheral arterial disease (PAD) among First Nations people, corresponding to a rate of 183 per 100,000 population. The rate of PAD hospitalisations were 1.3 times higher among males than females (207 and 160 per 100,000 population, respectively).

Rates were higher among females than males aged under 45 years. Among those aged 65–74 years, the rate of PAD hospitalisations was 2 times as high among males as females (1,300 and 653 per 100,000 population).

Deaths

In 2024, there were 37 deaths from PAD as an underlying cause among First Nations people, a rate of 3.3 per 100,000 population in jurisdictions with adequate First Nations identification.

Acute rheumatic fever and rheumatic heart disease

As at 31 December 2024, there were around 9,500 First Nations people living with rheumatic heart disease (RHD) recorded on registers in New South Wales, Queensland, Western Australia, South Australia and the Northern Territory, or notified in Victoria (AIHW 2025a).

Hospitalisations 

In 2023–24, there were 780 hospitalisations with a principal diagnosis of acute rheumatic fever (ARF) or RHD among First Nations people, corresponding to a rate of 76 per 100,000 population.

Hospitalisation rates were higher among females than males among those aged under 65 years (Figure 4). Among those aged 35–44 year, the rate was times 4.2 times as high among females compared with males (128 and 30 per 100,000 population, respectively).

Deaths

In 2024, there were 32 deaths from ARF or RHD among First Nations people, equivalent to a rate of 3.2 per 100,000 population in jurisdictions with adequate identification of Indigenous status. The rate was 2.6 times as high among females compared with males (4.6 and 1.8 per 100,000 population, respectively).

Congenital heart disease

Hospitalisations

In 2023–24, there were 370 hospitalisations with a principal diagnosis of congenital heart disease among First Nations people, a rate of 36 per 100,000 population. The rates were 1.2 times as high among males compared with females (39 and 33 per 100,000 population, respectively).

Deaths

In 2024, there were 13 deaths from congenital heart disease among First Nations people, a rate of 1.3 per 100,000 population in jurisdictions with adequate identification of Indigenous status.

Comorbidity 

In 2022–24, an estimated 162,000 First Nations adults (30%) had HSVD, diabetes and/or chronic kidney disease (CKD). Around 1 in 5 (19%, 104,000 adults) had only one of HSVD, diabetes or CKD (AIHW analysis of ABS 2025).

Around 11% (58,600 adults) had at least 2 of HSVD, diabetes or CKD:

• 6,700 (1.2%) had HSVD and CKD only
• 4,900 (0.9%) had HSVD and diabetes only
• 39,300 (7.2%) had diabetes and CKD only
• 7,600 (1.4%) had all 3 conditions (Figure 5).

 Treatment and management 

Primary health care

General practice 

In 2020–21, cardiovascular disease was recorded in 3 out of every 100 General Practice clinical encounters with First Nations patients. Conditions included coronary artery disease, peripheral vascular disease, atrial fibrillation, heart failure, stroke, and transient ischaemic attack. These encounters generated around 41,700 issued prescriptions and a total of around 222,000 prescriptions (including issued prescriptions and repeats) for First Nations patients with CVD. Overall, these accounted for 13% of all issued prescriptions and 23% of total prescriptions for First Nations patients (NPS MedicineWise 2022).

Absolute CVD risk

A person’s risk of developing CVD depends on the combined effect of multiple risk factors. The Australian CVD Risk Calculator is used to estimate the probability of an individual developing a cardiovascular event or other vascular disease within a specified time frame (ACDPA 2023).

As at June 2025, 55% of regular clients of First Nations primary health care who were aged 35–74 with no known CVD had the necessary risk factors recorded within the previous 2 years to assess their absolute CVD risk (AIHW 2025).

Better Cardiac Care measures for Aboriginal and Torres Strait Islander people

The Better Cardiac Care for Aboriginal and Torres Strait Islander People project is an initiative of the former Australian Health Ministers’ Advisory Council. It aims to reduce deaths and ill health from cardiac conditions among First Nations people.

Five priority areas consisting of 21 measures were developed to monitor the progress of the project. The eighth national report in 2023 noted improvements in access to cardiac-related health services, declines in mortality rates from cardiac conditions and increases over time in the proportion of First Nations people who received the recommended intervention and ongoing preventive care following hospitalisation for a severe heart attack. However, challenges remain, with First Nations people less likely to receive the recommended intervention after hospitalisation for a severe heart attack, and a significant gap persisting in CVD mortality rates between First Nations and non-Indigenous Australians (AIHW 2024).

Medicine supply to Australians in remote communities

Under the Remote Area Aboriginal Health Services (RAAHS) program, established under section 100 of the National Health Act 1953, any person attending an approved RAAHS can receive eligible PBS medicines without the need for a PBS prescription and without cost.

These arrangements seek to address barriers experienced by people living in remote areas of Australia, who may have limited access to a GP or a community pharmacy, in accessing essential medicines through the PBS. In 2024–25, around 2.7 million PBS items at a cost of $70.5 million were supplied to participating Aboriginal Health Services (Department of Health, Disability and Ageing 2026).

Emergency department presentations

Emergency departments (ED) are an essential component of Australia’s health care system, and provide care for patients who require urgent medical, surgical or other attention.

In 2024–25, among First Nations people, there were 17,700 ED presentations with a principal diagnosis of CVD (1,700 per 100,000 population). The rate was the same among males and females (1,700 per 100,000 population).

CVD ED presentations included:

• 1,700 presentations with a principal diagnosis of stroke (160 per 100,000 population)
• 1,900 presentations with a principal diagnosis of heart failure (187 per 100,000 population)
• 1,700 presentations with a principal diagnosis of atrial fibrillation (159 per 100,000 population).

Impact 

Burden of cardiovascular disease

Burden of disease estimates are available for First Nations people for the year 2022 (AIHW 2026). Based on these data: 

• CVD accounted for 11% (around 35,000 DALY) of total burden in First Nations people (12% for males, 9.8% for females), making it the disease group with the third-greatest contribution, behind mental and substance use disorders (20%) and injuries (13%).
• Coronary heart disease caused the greatest burden of any disease or injury (6.0% of total DALY) and stroke ranked 18th (1.6% of total DALY).
• 85% of the burden from CVD among First Nations people was fatal, and 15% was non-fatal. 

For more information see First Nations Burden of Disease Study 2022.

Expenditure on cardiovascular disease

In 2022–23, expenditure on hospitalisations for First Nations people living with CVD was $493 million – equivalent to 4.5% of total expenditure on hospitalisations for people with CVD. This equated to $487 per First Nations person, compared with $413 for non-Indigenous persons.

Hospitalisation for RHD among First Nations people accounted for 4.9% of total First Nations hospital expenditure on CVD. The per person expenditure on RHD hospitalisation for the First Nations population was 3.5 times the per person expenditure for the non-Indigenous population, which reflects the higher burden in the First Nations population (AIHW & NIAA 2025).

Comparisons with non-Indigenous Australians 

After age‑standardisation, First Nations people experience a consistently higher burden of cardiovascular disease (CVD) than non‑Indigenous Australians. This was consistent across most CVD subtypes. 

Overall, the prevalence of heart, stroke and vascular disease was 1.4 times as high, and hospitalisation and death rates were around twice as high in 2023–24 and 2024, among First Nations people compared with non-Indigenous Australians. The disparity typically was greater for females than males. Similar patterns were seen across major CVD subtypes, including CHD, stroke, heart failure and atrial fibrillation, with age‑standardised hospitalisation and death rates 1.6 to 2.6 times as high as those for non‑Indigenous Australians.

The largest disparities were observed for ARF and RHD, where hospitalisation rates were 6.2 times as high among First Nations females and 3.2 times as high among First Nations males when compared with non-Indigenous Australians in 2023–24. ARF and RHD death rates were 5.1 times as high among First Nations people when compared with non-Indigenous Australians, with First Nations Australians accounting for 8.5% of all deaths due to ARF and RHD in 2024. In contrast, congenital heart disease was the only condition for which hospitalisation rates were similar between First Nations and non‑Indigenous Australians in 2023–24.

See the supplementary data tables for age-standardised rates for CVD subtypes by Indigenous status.