Medical experts have urged the federal and Northern Territory governments to invest in saving lives as new research shows the stark health danger facing young Indigenous people in the NT.

The new research – published in Sport Medicine Australia's JSAMS Plus – reveals Indigenous people aged under 40 are at 15 times greater risk of sudden cardiac death than the general population.

"Existing approaches are inadequate for young First Nations Australians, and we advocate for tailored screening to begin at the age of 16," the study authors write in 'Sudden cardiac death in young First Nations Australians in the Northern Territory, Australia: Potential implications for pre-participation screening'.

The researchers reviewed coronial data, including 59 cases of sudden cardiac death between 2019 and 2023. This leads to an estimated incidence of 19.8 per 100,000 Indigenous people, a figure 15 times greater than the annual incidence in the Australian general population from an earlier study.

The authors highlighted three cases where sudden cardiac death had been related to sport or an exercise activity.

"Large numbers of First Nations Australian young people are undertaking sporting and physical activity on a regular or professional basis and should be encouraged to do so," the authors said.

"However, for those with heart disease, avoidance of high intensity and prolonged exercise or competitive sports would be recommended."

They authors noted that awareness of warning symptoms and signs is important so those affected could stop exercising and seek medical help.

The review concluded that current screening approaches were inadequate for young First Nations Australians who face a higher burden of cardiovascular disease than the broader population. 

"There is therefore a case for revising the current guidelines for screening to improve early detection of heart disease and risk factors in the First Nations Australians, at an earlier age of <16 years," they found. 

"There should be ongoing close clinical evaluation for early diagnosis, effective treatment to prevent SCD and guide decisions on their participation in sports." 

The focus needs to be on improving uptake, addressing cultural requirements and geographic barriers.

Territory Sports and Exercise Medicine Doctor Dr Sonali Pande, principal researcher, and first author of the paper said: "Our research from the Northern Territory has brought attention to the serious burden of cardiac diseases in First Nations Australians. This should form the basis of efforts in early screening to identify subjects at risk of sudden cardiac death as a matter of high priority."

Dr Sonali said "culturally safe, well-resourced and co-ordinated strategy is needed for assessing risk factors and diagnosing cardiac disease" in young NT people, including sports participants.

The authors say cardiac screening in First Nations communities must: include electrocardiogram, echocardiogram and assessment of cardiovascular risk factors; have accessible point of care testing for lipids and blood sugar levels; provide a clear pathway to care; and be linked to exercise promotion as an essential part of modifying cardiac risk factors.

Training on recognition and response to sudden cardiac arrest, including CPR, is also critical.

University of Sydney cardiac screening researcher Associate Professor Jessica Orchard, who was not one of the report authors, said the research indicated there is a need for the Federal and Northern Territory governments to invest in new strategies for First Nation Australians, such as comprehensive cardiac screening, including electrocardiogram, echocardiogram and a heart-health assessment.

"There is a critical need to implement novel screening strategies that are community-led. This should be linked to exercise promotion as an essential part of cardiovascular health and risk reduction," Associate Professor Orchard said.

The authors said their recommendations are consistent with a 2020 consensus statement from the Royal Australian College of General Practitioners and the National Aboriginal Community Controlled Health Organisation and 2024 guidelines from the Australasian College of Sport and Exercise Physicians.

Sports Medicine Australia cchief executive Jamie Crain said the research "makes it clear that a segment of our community are dying at a disproportionate rate and something needs to be done urgently".