The Centre of Research Excellence (CRE) to Reduce Inequality in Heart Disease focuses on improving the heart health and outcomes of groups and communities i.e. Regional Australians, Indigenous Australians and International Health

Older individuals with chronic heart disease

Theme Leader

Professor Simon Stewart


Olderindividualswith1.jpg - largeCardiovascular disease (CVD) and its most common manifestation, heart disease, affect more Australian adults than any other disease type. Indeed, non-communicable (atherosclerotic) manifestations of heart disease represents Australia’s [1] and the world’s [2-5] single largest cause of death and disability. In 2004–05, management of CVD was estimated to cost $5.94 billion (11% of total allocated health care expenditure) [1]. A major portion of this expenditure can be attributed to the combination of a growing number of older individuals with chronic heart disease and higher rates of disease (often premature) in disadvantaged individuals and communities. Fortunately, survival from acute myocardial infarction (AMI) is improving when an affected individual reaches hospital for treatment [3]. However, ageing of the Australian population and increased development of factors such as hypertension, lipid disorders, obesity and diabetes,[6-10] coupled with survival from previously fatal AMI [3], has led to an increase in chronic forms of heart disease – including CHF [11]. Consequently, the true impact of heart disease (particularly in women) is often under-appreciated by the public, policy makers and health professionals alike.  This represents a critical issue when considering our (collective) social responsibility to ensure we apply sustainable programs that ensure those most affected by CVD have access to cost-effective programs of care [12].


Building on a rich tradition of developing innovative health services for individuals with chronic heart disease, the Centre of Research Excellence to Reduce Inequality in Heart Disease will undertake the following research activities:

  1. Coordinate a series of trials designed to improve health outcomes in older individuals with heart disease in whom treatment options are often limited and/or difficult to apply.
  2. Undertake parallel research focusing on patient preferences for health service delivery.
  3. Complete embedded health economic analyses to determine the cost dynamics of future health care programs based on the trials.
  4. Develop better measures to understand individual health journeys and their impact on quality of life and health outcomes.
  5. Develop and apply innovative risk (computer-based) tools.
  6. Translate these (and other) innovative strategies into sustainable health services to meet the complex needs of those unfortunate enough to develop chronic heart disease.

List of Projects


WHICH? Trial



  1. Australian Institute of Health and Welfare. Australia's health 2010. Canberra, ACT, Australia: AIHW cat. no. AUS 122;2010.
  2. Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007;370(9603):1929-1938.
  3. Dudas K, Lappas G, Stewart S, Rosengren A. Trends in out-of-hospital deaths due to coronary heart disease in Sweden (1991 to 2006). Circulation. 2011;123(1):46-52.
  4. Gersh BJ, Sliwa K, Mayosi BM, Yusuf S. Novel therapeutic concepts: the epidemic of cardiovascular disease in the developing world: global implications. Eur Heart J. 2010;31(6):642-648.
  5. Sliwa K, Stewart S, Gersh BJ. Hypertension: a global perspective. Circulation. 2011;123(24):2892-2896.
  6. World Health Organization. 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases. Geneva, Switzerland 2008.
  7. Carrington M, Stewart S. Australia's cholesterol crossroads: An analysis of 199,331 GP patient records. Melbourne, Australia: Baker IDI Heart and Diabetes Institute; January 2011.
  8. Carrington MJ, Jennings GL, Stewart S. Pattern of blood pressure in Australian adults: results from a national blood pressure screening day of 13,825 adults. Int J Cardiol. 2010;145(3):461-467.
  9. Dalton M, Cameron AJ, Zimmet PZ, et al. Waist circumference, waist-hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults. J Intern Med. 2003;254(6):555-563.
  10. Dunstan DW, Zimmet PZ, Welborn TA, et al. The rising prevalence of diabetes and impaired glucose tolerance: the Australian Diabetes, Obesity and Lifestyle Study. Diabetes Care. 2002;25(5):829-834.
  11. Stewart S, Ekman I, Ekman T, Oden A, Rosengren A. Population impact of heart failure and the most common forms of cancer: a study of 1 162 309 hospital cases in Sweden (1988 to 2004). Circ Cardiovasc Qual Outcomes. 2010;3(6):573-580.
  12. Global health in 2012: Development to sustainability. Lancet. 2012;379(9812):193.