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More women than men are dying of cardiovascular disease

June 23, 2009 Toronto

For the first time in Canada, more women than men died from cardiovascular disease in 2000. By 2004, 50.5 per cent of all cardiovascular deaths occurred in women, according to a new study led by researchers at the Institute for Clinical Evaluative Sciences (ICES), conducted in collaboration with members of the Canadian Cardiovascular Outcomes Research Team (CCORT).

While men were more likely to die from heart attack (56 per cent of all heart attack deaths), women were more likely to die from heart failure (60 per cent of all heart failure deaths) or stroke (59 per cent of all stroke deaths). The dramatic decrease in death rates from heart attack has meant an increase in the number of deaths due to heart failure and stroke and more frequent deaths in women.

The study looked at national trends between 1994 and 2004 in the death rates and hospital admission rates for cardiovascular disease in Canada with a particular focus on heart attacks, heart failure and stroke.

A major finding was the rapid decline in death rates from heart attacks, with 4,000 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, along with better acute treatment for those heart attack patients treated in-hospital.

However, the study also showed trends towards 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,” says Dr. Jack Tu from the Institute for Clinical Evaluative Sciences (ICES). “Heart disease is becoming an increasing problem affecting elderly women, in part because of previous successful efforts to prevent and treat heart disease among younger men.”

The authors caution that despite the 30 per cent 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.”

Rates of death and hospital admissions for cardiovascular disease declined 30 per cent over a 10-year period in Canada, pointing to successful efforts to prevent and treat heart disease, the leading cause of death globally. However, for the first time, more women than men are dying of cardiovascular causes.

The study was funded a Canadian Institutes for Health Research (CIHR) Team Grant in Cardiovascular Outcomes Research to the Canadian Cardiovascular Outcomes Research Team (CCORT).

Author affiliations: ICES (Tu, Nardi, Fang, Liu, Khalid); Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto (Tu) and Health Information and Research Division (Johansen), Statistics Canada, Ottawa, Ont.

The study “National trends in rates of death and hospital admissions related to acute myocardial infarction, heart failure and stroke, 1994-2004” is in the June 23, 2009 issue of CMAJ.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

The Canadian Cardiovascular Outcomes Research Team (CCORT) is a national team of over 30 cardiovascular outcomes researchers from across Canada who are funded by a Canadian Institutes of Health Research Team Grant. The CCORT researchers are conducting a series of projects to measure and improving access to quality cardiac care in Canada, including the production of a series of articles on national trends in cardiovascular care, being published in the Canadian Medical Association Journal. ICES serves as the national coordinating centre for the CCORT initiative.

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