Cardiovascular diseases (CVD) affect the circulatory system including the heart and blood vessels. There are six types of CVD. While they are one of the leading causes of death for men and women in Canada, in many cases they are preventable.
Funded projects
Public Health Agency of Canada projects
Cardiovascular Funded Programs at the Public Health Agency of Canada:
- Funded projects from the Canadian Institutes of Health Research, Institute of Circulatory and Respiratory Health
- Healthy Living and Chronic Disease Funding Program (HLCD) – List of funded projects 2010-2013
Facts and figures
The following information is taken from Public Health Agency of Canada (PHAC) reports and Statistics Canada:
Prevalence
- In 2007, 1.3 million Canadians (4.8%) reported having heart disease diagnosed by a health professional.
- Men are more likely to report having a heart disease than women – 5.3% of men and 4.2% of women.
- A further 315,000 Canadians reported living with the effects of a stroke in 2009.
- Since the prevalence rates of heart disease and stroke were obtained from self-reports, the true number of people with these conditions is likely underestimated.
- Nearly 6 million Canadians aged 20 years and older (22%) were living with diagnosed hypertension in from 2007 to 2009.
Mortality
- In 2009, cardiovascular diseases were the second leading cause of death for Canadians, representing 22.7% of all deaths.
- Men were more likely to die of CVD than women – almost three times higher for those under 65 years of age.
- Mortality rates for CVD increase dramatically among men at age 45 and among women at age 55.
- On the other hand, between 1969 and 2004, mortality rates for ischemic heart disease, heart attack and stroke all decreased significantly and combined, major cardiovascular diseases continued this trend through 2009.
- While the reason for this decrease is not known, it was likely the result of a combination of lower rates of people developing CVD due to a reduction in risk factors and better management of CVD leading to longer survival rates.
Economic burden
- CVD has a major economic impact in Canada on individuals, their families, communities and the health care system. In 2000, the direct and indirect costs of CVD in Canada were estimated to be $22.2 billion. This was the second highest total cost among all diagnostic categories and only slightly less than musculoskeletal diseases which were the most costly.
- 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.
For more facts and figures on CVD
- The Public Health Agency of Canada provides Chronic disease data cubes which are interactive databases that allow users to create tables and graphs using their web browser and interactive maps providing current statistics on priority chronic disease and risk factor prevalence in Canada as well as for other non-communicable diseases.
- Maternal Hypertension in Canada Fact Sheet Public Health Agency of Canada (2014).
- Tracking Heart Disease and Stroke in Canada – Stroke Highlights 2011
- Report from the Canadian Chronic Disease Surveillance System: Hypertension in Canada, 2010
- Tracking heart disease and stroke in Canada-2009 (PDF document)
Risk factors
- Risk factors for cardiovascular diseases (CVD) include: smoking, unhealthy eating, physical inactivity and high levels of stress.
- People who are overweight or obese, who have hypertension, high cholesterol and/or diabetes are also at higher risk of developing CVD.
- As the number of risk factors present in an individual increases, so does their risk of developing CVD.
- Many factors likely contribute to the higher prevalence of CVD risk factors among individuals with low income and/or low education, such as lack of access to healthy foods, which are more costly, and stressful lives, which may lead to unhealthy coping behaviours.
For more information on risk factors:
- Tracking Heart Disease and Stroke in Canada – Stroke Highlights 2011
- 2009 Tracking Heart Disease and Stroke in Canada
- The Risk factor atlas from the Public Health Agency of Canada shows major chronic disease risk factors (with national trends over time, age-specific prevalence estimates, and maps of the prevalence of risk factors in health regions across the country) using data from the Statistics Canada Canadian Community Health Surveys (2005 and 2003).
Prevention
Many cardiovascular diseases (CVD) can be prevented. Primary prevention activities focus on preventing CVD before it occurs by: stress management, healthy diet, regular physical activity and maintaining a healthy weight, as well as by not smoking and avoiding alcohol abuse. Controlling diabetes, hypertension and high cholesterol are also important in preventing CVD.
For more information on primary prevention:
- Public Health Agency of Canada information on prevention of CVD.
- The Heart and Stroke Foundation web site provides information prevention of CVD.
- Hypertension Canada provides information on prevention and treatment of hypertension for health professionals and the public.
- U.S. Centers for Disease Prevention and Control prevention information.
- The World Health Organisation’s prevention of CVD: pocket guidelines for assessment and management of CVD risk.
- U.K. Prevention of cardiovascular disease, National Institute for Health and Clinical Excellence (2010).
Strategies
A number of strategies have been developed to prevent cardiovascular diseases by addressing modifiable risk factors.
Canada
- The Pan Canadian Framework on the prevention and control of hypertension : A discussion paper on the way forward (PDF document) by the Healthy Blood Pressure Framework Steering and Drafting Committee (2012) provides a long-term plan on the successful prevention, reduction and management of hypertension in Canada.
- The Canadian heart health strategy and action plan (PDF document) contains six major recommendations that focus on the potential to create significant impact through prevention across the continuum of the health system and includes a recommendation specific to Aboriginal populations (2009).
International
Finland
The North Karelia project in Finland: A societal shift favouring healthy lifestyles serves as a model in promoting healthy lifestyles as the outcomes of the initiative dropped the mortality rate of coronary heart disease in the region by 85% in 35 years. Institut national de santé publique du Québec (2013).
United Kingdom
The Cardiovascular disease outcomes strategy: Improving outcomes for people with or at risk of cardiovascular disease (PDF document) by the U.K. Department of Health (2013) identifies ten key actions which can deliver the most impact to improve mortality rates and reduce health inequalities of those with, or at risk of cardiovascular disease.
United States
The Public Health action plan to prevent heart disease and stroke is a comprehensive public health strategy based on five components namely: action, capacity building, evaluation, policy, and multi-level partnerships. Centers for Disease Control and Prevention (2013).
World Health Organization
The Population sodium reduction strategies are designed to help achieve the voluntary global NCD target for a 30% relative reduction in mean population intake of salt, with the aim of achieving a target of less than 5 grams per day (approximately 2g sodium) by 2025.
Guidance
Guidelines on promoting healthy eating, physical activity, tobacco control and preventing alcohol misuse as well as integrated approaches to preventing chronic diseases can be found at the relevant topic pages on this site.
The Canadian Cardiovascular Society’s data definitions and quality indicators project contains data element definitions that reflect national consensus on definitions in multiple areas of cardiovascular disease, treatment and subspecialty expertise.
The Canadian Task on Preventative Health Care’s Screening for hypertension guidelines (2012) provides recommendations for health professionals on screening for hypertension in adults over 18 years old without known hypertension.
The guidelines below are specifically on the primary prevention of cardiovascular diseases (CVD) within public health settings:
British Columbia
In the guidelines, Cardiovascular disease – Primary prevention, the BC Ministry of Health provides recommendations directed at physicians on the primary prevention of cardiovascular disease (CVD) in adults who do not have CVD (2014).
Core Public Health Functions for BC: Evidence Review, Chronic Disease (PDF document), Chapter 8, p. 86 describes the evidence for primary prevention of CVD (2010).
Ontario
Healthy Eating, Physical Activity and Health Weights (PDF document), Ministry of Health Promotion, Government of Ontario (2010).
International
Risk estimation and the prevention of cardiovascular disease, a national clinical guideline (PDF document) Scottish Intercollegiate Guidelines Network (2007).
U.K. Prevention of cardiovascular disease, guidance from the National Institute for Health and Clinical Excellence (2010).
Surveillance
Surveillance refers to the systematic, regular collection, analysis and interpretation of data for a given population, to detect changes in patterns of disease or determinants of disease, with action taken if predefined criteria or thresholds are met.
Canada
- Health fact sheets, including blood pressure for children, youth and adults. Statistics Canada. Features short, informative articles on interesting health topics from various health data sources.
- The Public Health Agency of Canada provides Chronic Disease Infobase Data Cubes which are interactive databases that allow users to create tables and graphs using their web browser and interactive maps providing current statistics on priority chronic disease and risk factor prevalence in Canada as well as for other non-communicable diseases.
- Data tables from Statistics Canada by subject: Diseases and health conditions, including CVD.
- Statistics Canada database of surveillance information on CVD.
Provincial/Territorial Data
New Brunswick
- The state of public health in New Brunswick 2013: Heart health – A report from the Chief Medical Officer of Health (PDF document) provides an understanding of the extent of burden, trends and risk factors of cardiovascular disease with the aim of shifting the focus of care from treatment to prevention. Government of New Brunswick.
Ontario
- The annual Ontario stroke evaluation report 2014: On target for stroke prevention and care by the Institute of Clinical Evaluative Sciences (ICES) (2014), documents progress made by the Ontario Stroke Network in the provision of best practice stroke prevention and care from 2003/04 to 2012/13 through 43 core performance indicators.
Saskatchewan
- Prevalence and incidence of ischemic heart disease and heart failure in Saskatchewan Government of Saskatchewan (2015).
- Prevalence of asthma, COPD, diabetes and hypertension in Saskatchewan, 2010-11 Government of Saskatchewan (2013).
International Data
Organisation for Economic Cooperation and Development (OECD)
- Cardiovascular Disease and Diabetes – Policies for better health and quality of care, OECD Health Policies Studies (2015). Examines how countries perform in their ability to prevent, manage and treat cardiovascular disease (CVD) and diabetes.
United Kingdom
- Coordinated by Public Health England, the National Cardiovascular Health Intelligence Network (NCVIN) analyses surveillance data and translates it into user-friendly information for by commissioners, policy makers, clinicians and health professionals to improve services and outcomes.
World Health Organisation
- The Global atlas on cardiovascular disease prevention and control from the World Health Organization documents the magnitude of the problem, using global cardiovascular mortality and morbidity data (2011).
Publications
Canadian
- Public Health Agency of Canada‘s website on CVD provides a series of reports and publications on CVD topics.
- Statistics Canada’s health reports on cardiovascular disease
- Canadian Institutes of Health Research, Institute of Circulatory and Respiratory Health publications and resources.
- Heart and Stroke Foundation database of reports on Canadian heart health.
International
- The U.S. Centres for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention provides a database of publications on CVD.
- The World Health Organisation‘s site on CVD provides key publications.
Provincial/territorial cardiovascular disease prevention sites
Manitoba
- Healthy living: chronic disease prevention site with information on preventing a range of chronic diseases.
Newfoundland and Labrador
- Chronic Disease provides provincial Chronic Disease Policy Framework, self-management and links for community action.
Nova Scotia
- Cardiovascular Health Nova Scotia aims to improve the cardiovascular health of Nova Scotians. Encompasses cardiac disease and stroke.
Prince Edward Island
- Chronic disease prevention and management section of Health PEI PEI provides provincial leadership, management, policy and program development for chronic disease prevention and management including tips and tools for healthy living aimed at the general public.
Tools and resources
- Public Health Agency of Canada‘s cardiovascular disease (CVD) web site has information on risk factors, managing cardiovascular disease, initiatives, strategies and programs
- Heart and Stroke Foundation of Canada site provides information for health professionals and Canadians.
- Hypertension Canada provides information, education and recommendations for health care professionals and the public in a variety of multimedia formats.
Systematic Reviews of the Literature
Selected reviews from HealthEvidence.org on the prevention of cardiovascular disease:
- Reduced dietary salt for the prevention of cardiovascular disease (2014).
- Exercise for people with high cardiovascular risk (2014).
- Increased consumption of fruit and vegetables for the primary prevention of cardiovascular disease (2013).
- Reduced or modified dietary fat for preventing cardiovascular disease (2012).
- Lifestyle-focused interventions at the workplace to reduce the risk of cardiovascular disease: A systematic review (2010).