MONITORING THE BURDEN OF HEART DISEASE WITH THE CANADIAN CHRONIC DISEASE SURVEILLANCE SYSTEM

Abstract

Heart disease remains the second leading cause of death in Canada despite major declines in heart disease mortality over the last few decades. Heart disease surveillance used to rely on self-reported or hospitalization data. This study explores estimates of incidence, prevalence and all-cause mortality of Canadians with heart disease using population-based data. Aggregated administrative health data contributed by the provinces and territories to the Public Health Agency of Canada’s Canadian Chronic Disease Surveillance System (CCDSS) were used to identify ischemic heart disease (IHD) cases, including acute myocardial infarction (AMI), in adults aged 20 years and older from 2000/01 to 2012/13. Those with at least one hospitalization or procedure for IHD or two or more physician claims within one year with relevant IHD codes selected from the International Classification of Diseases and Related Health Problems, 9th and 10th Revisions, were included. Those with at least one hospitalization for an AMI were also included. Only those individuals with a first hospitalization for AMI during all the years of the study were included to estimate the rate of first AMI (a proxy for incidence). Yukon data were not available. About 2.4 million (8.4%, crude) Canadian adults were living with heart disease in 2012/13, including about 578,000 (2.1%, crude) with a history of a heart attack. Approximately 158,700 (6.1 per 1,000, crude) individuals were newly diagnosed with heart disease that year alone. The age-standardized prevalence of heart disease increased less than one percent between 2000/01 and 2012/13 while the proportion of adults aged 20+ who survived a heart attack increased from 1.2% to 2.0% (Table). Age-standardized incidence and all-cause mortality rates per 1,000 decreased between 2000/01 and 2012/13 in those with a heart disease, from 12.3 to 6.8 and from 22.5 to 17.1, respectively (Table). Age-standardized heart disease prevalence and incidence rates were about 1.5 times higher in men than women between 2000/01 and 2012/13. Women aged 45 to 74 years who experienced a heart attack were about 1.5 times more likely to die than men of the same age who also had a heart attack (Figure). Important declines in heart disease incidence and all-cause mortality rates were observed over the 13-year period. Men were more likely to live with or be newly diagnosed with heart disease than women. However, middle-aged women who experienced a heart attack were more likely to die than men of the same age.View Large Image Figure ViewerDownload Hi-res image Download (PPT)