2009 Tracking Heart Disease and Stroke in Canada

Report Highlights

Cardiovascular diseases (CVD), including heart disease and stroke, are lifelong diseases caused by the interaction of genetic predisposition, health behaviours, and the environment.

• The risk for developing CVD can be reduced by stress management, healthy nutrition, regular physical activity and maintaining a healthy weight, and by not smoking, avoiding alcohol abuse, and controlling diabetes, hypertension, and high cholesterol.
• Nine in ten individuals over the age of 20 years have at least one risk factor for CVD. Four in ten have three or more of these risk factors. As the number of risk factors increases, so does the risk of CVD.

A conservative estimate: 1.6 million Canadians have heart disease or are living with the effects of a stroke.

• 1.3 million Canadians reported having heart disease diagnosed by a health professional - 5% ages 12+ years and 23% of Canadians age 75 years and older.
• About 300,000 Canadians reported living with the effects of a stroke - 1% of Canadians ages 12+ years and 7% of Canadians age 75 and older.

CVD have a major impact on individuals and families.

• Twice as many people with heart disease or living with the effects of a stroke rated their health as being fair or poor compared to people without any chronic condition.
• About two thirds of people living with the effects of a stroke and one third of those with heart disease need help with the activities of daily living like personal care, and most report feeling limited in carrying out activities that they previously enjoyed (four in five for stroke and two in three for heart disease).
• One in five people with ischemic heart disease or with stroke, up to two in five people with congestive heart failure, and one in three people following a heart attack develop clinical depression. Individuals with both CVD and depression have an impaired quality of life, and increased health problems and risk of death.
• In Canada in 2004, CVD was the leading cause of death for Canadians - 72,743 deaths, representing 32% of all deaths.
• In 2004, CVD was responsible for an estimated 246,287 potential years of life lost (the number of years not lived, owing to premature death before age 75).

CVD affects men earlier than women.

• Hospitalization and death rates for CVD increase dramatically among men at age 45 and among women at age 55. Women’s hormones offer some protection until menopause.
• While men have higher CVD hospitalization and death rates than women in all age groups, the difference lessens with age. However because women live longer than men, there were a similar number of deaths for women and men from CVD.

Some progress has been made in reducing the risk of developing CVD, and improving survival through effective management.

• The age-standardized death rate for CVD has decreased dramatically from the late 1960’s to 2004. While the full reason for this decrease is not known, it was likely the result of a combination of factors, including a reduction in the risk of developing CVD (lower rates of smoking and physical inactivity, increased consumption of vegetables and fruit, better diagnosis and treatment of high blood pressure and high cholesterol), and also better management of individuals with CVD resulting in longer survival.

The number of people with CVD will likely increase in the future.

• The increased rate of obesity and of diabetes combined with further aging of the population will likely lead to an increase in the number of people with CVD in the future. This will compromise the health of Canadians, put a strain on the health care system, and have a major economic impact on Canada.

CVD have a major economic impact in Canada.

• In 2000, CVD costs in Canada amounted to $22.2 billion - the second highest total cost among all diagnostic categories only slightly less than musculoskeletal diseases at number one.
• The total costs for CVD included $7.6 billion for health care costs (direct costs), and $14.6 billion for indirect costs resulting from lost economic productivity due to disability or death.
• An estimated 65.7 million prescriptions were dispensed for the treatment of CVD - a substantial increase over the 57.4 million prescriptions dispensed in 2005, and 52.5 million prescriptions dispensed in 2003.
• In 2007, 34.6 million visits (10% of all visits) made by Canadians to community physicians were for the management of CVD.
• In 2005/06, cardiovascular diseases were the primary reasons for hospitalization for 17% of all hospitalizations - 20% for men and 14% for women. The proportion doubled when hospitalizations with CVD as a related condition were included.
• CVD also accounted for the highest proportion of days in hospital compared to other health problems (17% of all days - 19% for men and 15% for women).