Auckland District Health Board

Heart disease and stroke

During 2011–2013, there were 413 hospital admissions per year among Māori for diseases of the circulatory system (including heart disease and stroke), at a rate 69% higher than non-Māori, or 734 more admissions per 100,000.

Table : Ischaemic heart disease indicators, 25 years and over, Auckland DHB, 2011–2013

Gender	Māori				Non-Māori				Māori/non-Māori ratio (95% CI)			Rate difference
	Ave. no. per year	Age-standardised rate per 100,000 (95% CI)			Ave. no. per year	Age-standardised rate per 100,000 (95% CI)
Ischaemic heart disease admissions
Female	30	224.5	(182.2,	276.7)	427	126.4	(118.3,	135.1)	1.78	(1.43,	2.21)	98.1
Male	44	397.9	(335.0,	472.5)	782	357.8	(342.5,	373.8)	1.11	(0.93,	1.33)	40.1
Total	74	311.2	(272.4,	355.6)	1210	242.1	(233.4,	251.1)	1.29	(1.12,	1.48)	69.1
Angiography procedures
Female	34	260.9	(214.2,	317.8)	370	149.9	(140.6,	160.0)	1.74	(1.41,	2.14)	111.0
Male	46	415.6	(350.9,	492.1)	772	384.8	(368.5,	401.8)	1.08	(0.91,	1.29)	30.8
Total	79	338.2	(297.4,	384.7)	1142	267.4	(257.9,	277.2)	1.27	(1.11,	1.45)	70.9
Angioplasty procedures
Female	10	79.0	(55.4,	112.7)	101	37.0	(32.6,	42.0)	2.14	(1.47,	3.11)	42.0
Male	16	151.7	(114.3,	201.4)	323	163.5	(152.9,	174.8)	0.93	(0.69,	1.24)	-11.8
Total	27	115.4	(92.4,	144.1)	424	100.3	(94.5,	106.4)	1.15	(0.91,	1.45)	15.1
Coronary Artery Bypass Graft (CABG)
Female	3	20.8	(10.4,	41.7)	23	9.4	(7.3,	12.2)	2.21	(1.05,	4.63)	11.4
Male	7	59.7	(38.5,	92.8)	106	51.3	(45.7,	57.5)	1.17	(0.74,	1.84)	8.5
Total	9	40.3	(27.7,	58.5)	129	30.4	(27.3,	33.7)	1.33	(0.90,	1.95)	9.9
Acute coronary syndrome admissions
Female	20	148.4	(114.7,	192.1)	266	72.2	(66.2,	78.7)	2.06	(1.57,	2.70)	76.2
Male	28	251.7	(202.6,	312.6)	466	212.7	(200.9,	225.3)	1.18	(0.95,	1.48)	38.9
Total	47	200.0	(169.3,	236.3)	732	142.5	(135.8,	149.5)	1.40	(1.18,	1.67)	57.6

Source: NMDS.
Note: Ratios in bold show that Māori rates were significantly different from non-Māori rates in the DHB.

On average, 74 Māori per year were admitted to hospital for ischaemic heart disease (IHD), at a rate 29% higher than non-Māori. Of those admitted for IHD, 47 Māori admissions per year were for acute coronary syndrome (ACS). Māori women had twice the risk of admission for ACS of non-Māori women (76 more admissions per 100,000). However, for both IHD and ACS admission rates were higher for men than for women.

There were 79 angiography procedures conducted for Māori patients per year on average, at a rate 27% higher than the non-Māori rate. On average, 27 Māori per year had angioplasty procedures, with the rate for Māori women more than twice the non-Māori rate. Nine Māori per year had a CABG, with the rate for males more than double that of females. Māori women had twice the rate of CABG of non-Māori women.

Table : Hospitalisations for heart failure, stroke, and hypertensive disease, 25 years and over, Auckland DHB, 2011–2013

There were 72 admissions per year on average among Māori with heart failure, at 4 times the rate of non-Māori, or 234 more admissions per 100,000. Men were more likely to be admitted than women.

On average, 40 Māori per year were admitted for stroke. Māori women had nearly twice the risk of non-Māori women, or 87 more admissions per 100,000.

There were 11 Māori admissions per year on average for hypertensive disease, at a rate twice that of non-Māori, or 28 more admissions per 100,000.

Table : Hospitalisations for chronic rheumatic heart disease and heart valve replacements, 25 years and over, Auckland DHB, 2011–2013

Gender	Māori				Non-Māori				Māori/non-Māori ratio (95% CI)			Rate difference
	Ave. no. per year	Age-standardised rate per 100,000 (95% CI)			Ave. no. per year	Age-standardised rate per 100,000 (95% CI)
Chronic rheumatic heart disease
Female	2	18.7	(8.3,	42.1)	19	9.0	(6.8,	12.0)	2.07	(0.87,	4.90)	9.6
Male	2	20.4	(9.7,	42.8)	11	5.4	(3.7,	7.8)	3.78	(1.65,	8.66)	15.0
Total	4	19.5	(11.3,	33.8)	30	7.2	(5.7,	9.0)	2.71	(1.49,	4.91)	12.3
Heart valve replacements
Female	1	11.9	(4.4,	32.2)	21	8.6	(6.5,	11.4)	1.39	(0.50,	3.90)	3.3
Male	2	15.3	(6.3,	37.1)	41	18.3	(15.1,	22.2)	0.84	(0.34,	2.07)	-3.0
Total	3	13.6	(7.0,	26.4)	62	13.5	(11.5,	15.8)	1.01	(0.51,	2.00)	0.2

Source: NMDS.
Note: Ratios in bold show that Māori rates were significantly different from non-Māori rates in the DHB.

Māori had 2.7 times the non-Māori rate of admission for chronic rheumatic heart disease (CRHD) but similar rates of heart valve replacement. On average, four Māori per year were admitted for CRHD and three had heart valves replaced.

Table : Early deaths from circulatory system disease, Auckland DHB, 2007–2011

Gender	Māori				Non-Māori				Māori/non-Māori ratio (95% CI)			Rate difference
	Ave. no. per year	Age-standardised rate per 100,000 (95% CI)			Ave. no. per year	Age-standardised rate per 100,000 (95% CI)
Female	10	42.5	(32.3,	55.9)	48	12.2	(10.6,	14.0)	3.49	(2.56,	4.74)	30.3
Male	15	71.1	(56.6,	89.4)	123	33.1	(30.5,	35.9)	2.15	(1.69,	2.74)	38.1
Total	25	56.8	(47.6,	67.8)	171	22.6	(21.1,	24.3)	2.51	(2.08,	3.04)	34.2

Source: Mortality data, Ministry of Health
Notes: “Early deaths” are defined as those occurring under 75 years of age.
Ratios in bold show that Māori rates were significantly different from non-Māori rates in the DHB.

On average 25 Auckland Māori per year died early from circulatory system disease (including heart disease and stroke), at 2.5 times the rate of non-Māori, or 34 more deaths per 100,000. Males had higher mortality rates than females.