Rural Australians have more heart disease and worse outcomes than people in metropolitan areas. Better prevention, telehealth, and regional cardiac care may help reduce this gap, but the available evidence is still insufficient.
Additional notes
- revised title
- rebuilt Study-Level Evidence Map
Abstract: The aim of this paper is to synthesize the available evidence on the prevalence of heart disease and associated outcomes, risk factors, and healthcare disparities between rural and metropolitan populations in Australia. The review utilises 5 original studies with 74385 total participants (topic deduplicated ΣN). Across the mapped evidence, rural and regional Australians show a consistent signal of higher cardiovascular burden and worse outcomes than metropolitan populations, with modelling suggesting that about 1461 CVD deaths per year could be delayed if rural risk-factor profiles matched metropolitan levels. Outcome disparities were also evident in linked administrative data for heart failure, where rural residence was associated with higher 30-day mortality (OR 1.25, 95% CI 1.06 to 1.48) and higher 1-year mortality (HR 1.13, 95% CI 1.02 to 1.27). Mechanistically relevant correlates were highlighted by distinct rural dietary patterns and strong associations between a dietary pattern and ischaemic heart disease risk (OR 13.90, 95% CI 2.29 to 84.3), alongside practice-focused signals emphasizing access gaps and the potential role of telehealth and regional cardiac care models for acute presentations. Taken together, the evidence map indicates that addressing modifiable risk factors and improving timely access to specialist cardiac assessment are practical levers to reduce rural–metropolitan inequities, while acknowledging that heterogeneity in definitions and limited study breadth temper certainty. Future research should prioritize standardized rurality classifications and prospective evaluations of regionally tailored prevention and care-delivery models (including telehealth) to determine which interventions most effectively narrow outcome gaps.
Final search date and database lock: 2026-03-16 17:07:11 CET
Plan: Pro (expanded craft tokens; source: Semantic Scholar)
Source: Semantic Scholar
Total Abstracts/Papers: 209
Downloaded Abstracts/Papers: 209
Included original and non-original Abstracts/Papers (all): 6
Included original Abstracts/Papers (OSMA vote counting by direction of effect): 5
Reference Index (links used in paper): 4
Total participants (topic deduplicated ΣN): 74385
Get access to the full paper
temporary link or permanent access.
The remaining part of the paper opens after purchase or unlock.
Reference Index (4)
[1] Quantifying the role of modifiable risk factors in the differences in cardiovascular disease mortality rates between metropolitan and rural populations in Australia: a macrosimulation modelling study — https://doi.org/10.1136/bmjopen-2017-018307
[2] Rural and Remote Cardiology During the COVID-19 Pandemic: Cardiac Society of Australia and New Zealand (CSANZ) Consensus Statement — https://doi.org/10.1016/j.hlc.2020.05.001
[3] Dietary patterns in rural and metropolitan Australia: a cross-sectional study exploring dietary patterns, inflammation and association with cardiovascular disease risk factors — https://doi.org/10.1136/bmjopen-2022-069475
[4] Rural–urban differentials in 30-day and 1-year mortality following first-ever heart failure hospitalisation in Western Australia: a population-based study using data linkage — https://doi.org/10.1136/bmjopen-2013-004724
