Did you know that heart disease impacts 1 in 2 of us Canadians? The Heart and Stroke Foundation Report on the Health of Canadians released looks back on 60 years of history. As we have made progress, it is important to note that our population is changing and with it some real risks that we must take note of.
60 years ago, a heart attack meant that 30 - 35 per cent did not survive. Today that number is down to five per cent. Or as the report points out 95% of Canadians who have a heart attack will now survive .
The greatest success has been survival rates. In 1952, heart disease and stroke was responsible for 46% of all deaths in Canada. Today it accounts for 27% of all deaths. To quote the report-60 years ago, fewer than 20% of infants born with complex heart defects reached adulthood, but today, more than 90% do.
What has been learnt?
- Identifying, treating and managing risk factors such as high blood pressure and cholesterol.
- Cutting smoking rates by much more than half to 16% today from about 50% in the 1950s.
- Understanding the physical causation of the disease; for example, identifying the role that clots play in acute myocardial infarctions (heart attacks) led to effective clot-busting drugs.
- Developing and continually improving medications to manage risk factors and heart disease such as:
- Beta blockers, which protect the heart from subsequent attacks.
- ACE inhibitors, which cause blood vessels to relax, leading to lower blood pressure.
- Statins, which are used to lower cholesterol and are effective at preventing cardiovascular disease as well as treating those who have it.
- Anticoagulants and anti-platelets such as acetylsalicylic acid (ASA, commonly referred to as Aspirin), which can be used to prevent dangerous blood clots from forming.
- Producing sophisticated imaging equipment, such as magnetic resonance imaging (MRI) scanners and CT (X-ray) scanners, has made diagnosis faster and more precise.
- Discovering and improving new procedures; for example, open-heart surgery has more and more been replaced by less invasive procedures such as angioplasty, a non-surgical technique.
- Improving recovery time and quality of life for the 1.6 million Canadians living with the effects of cardiovascular disease.
- Collecting and analysing data to measure practices and improve treatments and outcomes for patients.
- Translating knowledge to make the most effective use of evidence collected, by sharing it with the right players, and putting it into action. For example, sharing evidence about the harms of second-hand smoke with policy-makers resulted in smoke-free policies.
New challenges however can threaten advances.
Heart disease and stroke continue to be the second leading cause of death in Canada and a leading cause of disability, responsible for 66,000 deaths each year.
What are the concerns?
- Diabetes rates in heart attack patients have skyrocketed to 31% from 17% in a matter of decades.
- 60% of adult Canadians are overweight or obese and obesity rates in children have tripled over 30 years.
- The population is aging and as people get older, their chances of developing cardiovascular disease increases.
- Poor diets and lack of physical activity are leading risk factors.
- Nine out of 10 Canadians have at least one risk factor for cardiovascular disease, but according to the poll only 12% of Canadians are aware of this fact.
- Smoking rates have decreased but 16% of adult Canadians still engage in this behaviour that is the leading cause of preventable disease, disability and death, and the proliferation of e-cigarettes poses new challenges.
The report also states that the portrait of the typical heart patient has changed dramatically. Years ago, 75% of patients were male. The average age was 55. Today the average patient is substantially older, and still likely to be male - although the numbers of women with heart disease has risen. Patients still tend to be overweight, and while many have high blood pressure and elevated cholesterol, these are most likely diagnosed and well managed. Fewer are smokers, but if anything heart disease patients are even more sedentary than in the past.
Canadians identified the top priorities for heart health research as:
- Better individualized assessment and treatment plans based on someone's medical history, lifestyle and genetics.
- Better tools and support to help people make healthy lifestyle choices.
- Better understanding of the genetic causes of heart disease and how to address them.
- New tests to diagnose heart disease.
What the experts say: We need a better understanding around how to change behaviour across the population. Many of the diseases we treat are in theory preventable and by activities that do not require a doctor where the research is going -- according to the newly released report -- Restoring function to damaged hearts. Heart failure is on the rise as more people survive heart attacks and other acute heart conditions. As people with damaged hearts are living longer, they become more susceptible to heart failure. Work continues into finding new ways to repair damaged hearts by repairing muscle using stem cells, and other therapies to stop cells from dying or to regenerate new cells.
Work is being done to identify genetic markers that will reveal which genes predispose a person to cardiovascular disease - information that could help stop the disease before onset or halt its progression. Breaking down the DNA code could help explain why heart disease runs in families, and will help develop the individualized drug treatments of tomorrow.
Quick stats - Canada
- Every seven minutes in Canada, someone dies from heart disease or stroke.
- 1.6 million Canadians live with the effects of cardiovascular disease.
- Heart disease and stroke are two of the leading causes of death in Canada.
- Heart disease and stroke cost the Canadian economy $20.9 billion every year, and are the biggest driver of prescription drug use.
- 500,000 Canadians live with heart failure.
- One in 100 babies is born with a congenital heart defect.
- More women are dying from cardiovascular disease than men.
You can read the the full report at .
