A new study in CMAJ (Canadian Medical Association Journal) reports that the rates of death and hospital admissions for cardiovascular disease declined thirty percent over a ten year period in Canada. The findings draw attention to successful efforts to prevent heart disease, the leading cause of death globally. But, for the first time, there is indication that more women than men are dying of cardiovascular causes.

Data from the Canadian Mortality Database, Statistics Canada’s national death registry which contains information on the cause of all deaths in the country were evaluated. The study was the first of its kind in Canada. It also analyzed hospital admissions for heart attacks, heart failure and stroke.

The main finding was the rapid drop in death rates from heart attacks. There were 4,000 fewer deaths from acute myocardial infarction in 2004 than in 1994 in Canada. This could be the result of the declines in risk factors, such as smoking and increased use of statins to control cholesterol.

On the other hand, the research shows that there were high rates of death and hospital admission associated to cardiovascular disease in elderly women. Dr. Jack Tu from the Institute for Clinical Evaluative Sciences (ICES) and coauthors write: “This highlights the need for increased investment in education and research on cardiovascular health and disease in women.”

Even though there was a thirty percent decrease, the authors warn that, “these findings are not grounds for complacency. They suggest that previous efforts to prevent cardiovascular events have been successful, but in many cases they may have delayed the occurrence of such events until people are older and potentially more difficult to treat.”

In a supplementary note, Dr. Simon Capewell and Dr. Martin O’Flaherty from the University of Liverpool, United Kingdom, write that overall reductions in cardiovascular disease are due to success in reducing risk factors as well as thriving treatment of heart disease. They warn that in the future, patients with cardiovascular disease will be older and more challenging to treat.

The authors explain: “Prevention, therefore, becomes vital because over 80% of premature cardiovascular disease is avoidable.” Encouraging quitting smoking, promoting healthier diets and physical activity are crucial in addition to medications that control blood pressure and cholesterol.

“National trends in rates of death and hospital admissions related to acute myocardial infarction, heart failure and stroke, 1994-2004”
Jack V. Tu MD PhD, Lorelei Nardi MSc, Jiming Fang PhD, Juan Liu MD, Laila Khalid MD, Helen Johansen PhD, for the Canadian Cardiovascular Outcomes Research Team

“Trends in cardiovascular disease: Are we winning the war?”
Simon Capewell DSc, Martin O’Flaherty MD

Written by Stephanie Brunner (B.A.)