June 22, 2009 Rates of death and hospital admissions for cardiovascular disease declined 30% over a 10-year period in Canada, according to a new study in CMAJ (Canadian Medical Association Journal), pointing to successful efforts to prevent heart disease, the leading cause of death globally. However, for the first time, more women than men are dying of cardiovascular causes.
The study, the first of its kind in Canada, looked at data from the Canadian Mortality Database, Statistics Canada's national death registry which contains information on the cause of all deaths in the country. It also looked at hospital admissions for heart attacks, heart failure and stroke.
A major finding was the rapid decline in death rates from heart attacks, with 4000 fewer Canadians dying from acute myocardial infarction in 2004 than in 1994. This could reflect declines in risk factors such as smoking and increased use of statins to control cholesterol.
However, the study showed high rates of death and hospital admission related to cardiovascular disease in elderly women. "This highlights the need for increased investment in education and research on cardiovascular health and disease in women," write Dr. Jack Tu from the Institute for Clinical Evaluative Sciences (ICES) and coauthors.
The authors caution that despite the 30% decrease, "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 related commentary, Dr. Simon Capewell and Dr. Martin O'Flaherty from the University of Liverpool, United Kingdom, write that global reductions in cardiovascular disease are due to success in reducing risk factors as well as treatment of heart disease. They caution that patients with cardiovascular disease in the future will be older and more challenging to treat.
"Prevention, therefore, becomes vital because over 80% of premature cardiovascular disease is avoidable," state the authors. Promotion of smoking cessation, healthier diets and physical activity is crucial in addition to medications that control blood pressure and cholesterol.
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