Paul Davis has never smoked or had high blood pressure and has tried to stay healthy, with his fitness peaking in the '90s while playing five-eighth for the Balmain Tigers.
But the 47-year-old now suffers from coronary heart disease as well as kidney disease - a stark reminder that even if all the traditional risk factors are controlled, heart disease rates are alarmingly high in Australia's Indigenous communities.
"I was devastated when I was diagnosed because I've lost a lot of family members to heart failures and heart attacks," he said while undergoing dialysis at Royal Prince Alfred hospital.
"I lost my aunty only three weeks ago and I'm burying my cousin on Friday; he was 45 and he had heart problems."
New data from the Heart Foundation shows Indigenous people are dying from heart disease at double the rate of non-Indigenous Australians. In WA, that rate is triple.
The data also shows Indigenous people are being hospitalised for a heart condition 2.6 times more often than other Australians.
The ratio gap in NSW is 2.1, which is lower than the national average but higher than in Victoria, where it is 1.6.
Two NSW regions - "Southern Highlands and Shoalhaven" and "Mid North Coast" - feature in the top 20 regions in Australia with the largest ratio gaps when it comes to hospitalisations for heart conditions.
At the top is the "Wheat Belt", "northern outback" and "north-east Perth", all in WA.
The foundation's health equity manager Jane Potter warned against complacency, pointing to the fact that heart disease was responsible for about one quarter of the gap in life expectancy.
She said Indigenous women were suffering the most. Indigenous women in the Northern Territory were admitted to hospital with heart failure at six times the rate of non-Indigenous women.
"If people are living in the same region, with the same level of access to services, then we’ve got to ask the question - why are the health outcomes so different?" she said.
The foundation’s Aboriginal engagement manager Corey Turner said there was a historical distrust of mainstream health services.
“Many will delay seeking medical help ... in time to prevent being hospitalised and they can also discharge themselves early against medical advice because they are so anxious about being in hospital," he said.
It's well known that heart health improves with a good education, secure employment, adequate housing and access to healthy food.
"We know that 24 per cent of Aboriginal and Torres Strait Islander people aged over 15 reported having run out of food in the previous 12 months – in remote areas, as many as 36 per cent," he said.
"It’s hard to prioritise your health when there are so many other hardships. These areas have entrenched social and economic challenges and many also have higher rates of smoking and obesity."
Mr Davis' cardiologist, Dr Raj Puranik from RPA, said his case of not having the major risk factors but still being sick was consistent with the fact Indigenous people experienced very high rates of heart disease.
"Paul's been an extremely motivated football player and so when you’re looking at traditional risk factors, it’s not about that," he said.
"It’s more about the predisposition that comes from being Aboriginal ... and that still remains something we haven’t solved, we haven’t put enough resources into."
NSW Health said heart disease deaths, as well as smoking, were steadily decreasing in Aboriginal communities.
"NSW Health has allocated $25.5 million in 2018-19 to fund and support more than 40 Aboriginal Community Controlled Health Services to provide evidence-based comprehensive primary health care," a spokesman said.
It has also developed videos to boost awareness of heart disease, funded "healthy eating and active living" programs targeting Aboriginal people, and undertaken a data linkage project to explore Aboriginal peoples’ access to cardiac procedures.
The figures will be released on Thursday at the National Aboriginal Community Controlled Health Organisation's annual conference in Brisbane.
Esther Han is a health reporter at The Sydney Morning Herald. She has previously been consumer affairs editor and also covered food and wine.