CMAJ: Canada CV deaths, admissions drop 30% over 10 years

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Rates of death and hospital admissions for cardiovascular (CV) disease declined 30 percent over a 10-year period in Canada, according to a study published online June 22 in Canadian Medical Association Journal, pointing to efforts to prevent heart disease. However, for the first time, more women than men are dying of CV causes.

The study looked at data from 1994 to 2004 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 4,000 fewer Canadians dying from acute MI in 2004 than in 1994, which 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 CV disease in elderly women. "This highlights the need for increased investment in education and research on cardiovascular health and disease in women," wrote Jack Tu, MD, from the Institute for Clinical Evaluative Sciences, and colleagues.

The authors cautioned that despite the 30 percent decrease, the "findings are not grounds for complacency. They suggested 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 an accompanying commentary, Simon Capewell, MD, and Martin O'Flaherty, MD, from the University of Liverpool in England, wrote that the global reductions in CV disease are due to success in reducing risk factors as well as treatment of heart disease. They caution that patients with CV disease in the future will be older and more challenging to treat.

"Prevention, therefore, becomes vital because over 80 percent of premature CV disease is avoidable," the authors stated. Promotion of smoking cessation, healthier diets and physical activity is crucial in addition to medications that control blood pressure and cholesterol, they noted.