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 (2019)  management of Indigenous and   single centre; 2010-2015  Indigenous patients   Indigenous patients with stroke were 15.8 years younger   have a higher prevalence of
 non-Indigenous patients with IS   admitted to a single centre  (56.8 years vs. 72.6 years, P < 0.001), and were more likely  preventable disease, including those
 to national stroke standards  with an IS  to have risk factors for stroke, including smoking (51.2% vs.  that confer a higher stroke risk
       15.0 %, P < 0.001), diabetes mellitus (37.2% vs. 16.8%, P =
       0.003) and past history of CVA or TIA (50.2% vs. 31.1%, P
       = 0.032)
 [41]
 Dos Santos et al.    To estimate the difference in   Prospective cohort study;  1843 patients, 2.5%   Indigenous patients were younger (62 years vs. 74 years),  Indigenous Australians with stroke are
 (2020)  stroke recognition, risk factors,   single centre; 2012-2017  Indigenous  and more likely to have diabetes (RD: 22.3% [95%CI: 3%,  a decade younger and have a higher
 treatment rates and outcomes   41.7%]), dyslipidaemia (RD: 19.4% [95%CI: 21.%,   prevalence of important, modifiable
 between Indigenous and non-  36.7%]), and have ever smoked (RD: 24.9% [95%CI:   stroke risk factors
 Indigenous peoples at a single   9.5%, 40.3%])
 centre
 [52]
 He et al.   (2015) Compare stroke recurrence and   Retrospective cohort   2105 patients, 43.9%   In multivariable analyses, adjusting for comorbidities   Some of the excess risk of death
 role of comorbidities in adverse   study; single centre;   Indigenous  Indigenous patients’ excess risk for both case fatality (OR:  following a stroke was attributable to a
 stroke outcomes (recurrence and  1996-2011  1.25, 0.88-1.78) and long-term death (HR: 1.27, 1.01-1.61)   greater prevalence of comorbidities
 death) between Indigenous and   was considerably reduced (when compared to unadjusted
 non-Indigenous Australians  analyses
 [40]
 Kilkenny et al.     Compare guideline-directed care  Australian national stroke  305 patients, 18%   Smoking, diabetes mellitus and excessive alcohol   Indigenous patients with stroke had
 (2013)  and outcomes in Indigenous and   audit, data from 33   Indigenous, age-restricted   consumption were greater in Indigenous patients admitted  worse health outcomes even after
 non-Indigenous patients admitted  hospitals; 2009  from 18-64 years  to hospital with stroke than in non-Indigenous patients  adjusting for hospital site, age, risk
 with acute stroke                                        factors (diabetes mellitus, smoking,
                                                          alcohol), stroke severity variables
                                                          (speech impairment, incontinent
                                                          within 72 h), stroke subtype, and
                                                          access to a stroke unit
 Katzenellenbogen  To determine the prevalence of   State-wide linked hospital  13591 cases, 5% Indigenous Indigenous stroke survivors aged less than 70 years had a   Whilst primary prevention can reduce
 [36]
 et al.   (2014)  hospitalized stroke and coexistent  and mortality data 2007-  greater comorbidity burden than non-Indigenous patients   disparities in incidence and prevalence,
 conditions in Indigenous and non- 2011  of the same age  the wider solutions lie in tackling
 Indigenous people in Western                             environmental, social and economic
 Australia                                                disadvantage

 Canada
 [5]
 Anand et al.    To determine which factors,   Population-based study   1302 participants, all First   More than 85% of individuals had a risk score in the   Communities with greater
 (2019)  account for the variations in   from 8 First Nations   Nations  moderate to high range  socioeconomic advantage (greater
 cardiovascular risk (determined   communities, cross-    employment, higher income and long-
 [53]
 by the INTERHEART   risk   sectional analysis; 2013-     term marital partnerships), greater
 score) in First Nations   2018                           trust between community members,
 communities in Canada                                    higher education levels and supportive
                                                          environments had a lesser burden of
                                                          cardiovascular risk factors
 [26]
 Hu et al.   (2019) To describe the cardiovascular   Two cross-sectional   IHS; 2070 Inuit adults (20-  Inuit females had greater prevalence of heart attack (3.1%  Canadian Inuit, in comparison to the
 health profile of Canadian Inuit, in  surveys (Inuit   79 years). CHMS; 3464   vs. 1.8%), stroke (2.2% vs. 1.0%), diabetes (14.6% vs.   general Canadian population, have
 comparison to the general   communities -HIS; 2007- Canadian adults (20-79   9.0%), obesity (35.8% vs. 24.2%), HTN (7.5% vs. 2.5%)   different health profiles and a greater
 Canadian population  2008) and (general   years). To compare results   than non-Inuit females   burden of cardiovascular diseases
 Canadian population -  between the IHS and   Inuit males had a higher prevalence of stroke (2.1% vs.
 CHMS; 2007-2009 and   CHMS, age-standardized   0.8%) and HTN (12.2% vs. 2.5%) than non-Inuit males
 2012-2013)  estimates were calculated  Inuit males and females had better blood lipid profile than
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