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STATISTICS The Heart and Stroke Foundation plays a leading role in the tracking and development of relevant and current statistics on heart disease and stroke as well as their related risk factors in Canada. Statistics listed on this page are the most current available, and will be updated when new reports are issued. References for statistics may be found at the end of this document. Statistics are available for the following topics. By clicking on the topic, you will be automatically advanced to that section of the document. Heart disease
Decline of cardiovascular disease Cardiovascular diseases are defined as diseases and injuries of the cardiovascular system: the heart, the blood vessels of the heart and the system of blood vessels (veins and arteries) throughout the body and within the brain. Stroke is the result of a blood flow problem in the brain. It is considered a form of cardiovascular disease. Over the past 40 years the rates of heart disease and stroke have steadily declined. The rate has declined:
Every 7 minutes in Canada, someone dies from heart disease or stroke. Cardiovascular disease (heart disease, diseases of the blood vessels and stroke) accounts for the death of more Canadians than any other disease. These statistics are based on 2004 data (the latest year available from Statistics Canada).1 In 2004 cardiovascular disease accounted for:
In 2004, of all cardiovascular deaths:
For provincial and national mortality tables, go to Statistics Canada. Cost of cardiovascular diseases Heart disease and stroke costs the Canadian economy more than $18 billion every year in physician services, hospital costs, lost wages and decreased productivity. 2 Canadian acute care hospitals handled almost three million (2.8 million) hospitalizations in 2004, a slight increase from the previous year and approximately 14% less than in 1995. Between 1994-95 and 2003-04, the rate of hospitalizations for ischemic heart disease has declined 25% and for acute heart attack the rate has declined 9%.3 The leading cause of hospitalization in Canada continues to be circulatory diseases (heart disease and stroke), accounting for 15.4 % of total hospitalizations. The number of Canadians living with some form of heart disease or stroke (based on self report) remains high and increases with age:
There are an estimated 70,000 heart attacks each year in Canada. Approximately 19,000 Canadians die each year as the result of a heart attack. Most of these deaths occur out of hospital. The number of heart attack-related hospitalizations has increased steadily over the past decade (1994-95 to 2003-04).3 The number of Canadians living with some form of heart disease or stroke (based on self report) remains high and increases with age:
About 40,000 Canadians experience cardiac arrest every year. The majority, 70%, of all cardiac arrests occur in homes and public places.4 Less than 5% of those who have a cardiac arrest outside of a hospital survive.5, 6 The Chain of Survival refers to the fact that cardiac arrest care is only as strong as its weakest link among early access, early CPR, early defibrillation and early Advanced Cardiac Life Support (ACLS). Ultimately, survival from cardiac arrest is dependent on the strength of individual links, with each link representing a specific community response to the emergency situation of cardiac arrest. Cardiac arrest incidence rates per 100,000 vary between 53 and 59 across Canada. Most victims are men in their late 60s or early 70s. Their collapse is witnessed 35% to 55% of the time. The majority of cardiac arrests occurred in residential locations, with only 14.6% to 22% occurring in public places (56% in single-family homes, 22% apartments, 6% nursing homes, 3% malls, 2.7% on the road, 2.1% at the gym, 1.2 % at the office). For every 1 minute delay in defibrillation, the survival rate of a cardiac arrest victim decreases by 7% to 10%.7 Defibrillation, when used with CPR, can improve cardiac arrest survival rates to more than 50% if delivered in the first few minutes.8 Eight in 10 Canadians (80%) have at least one risk factor for heart disease or stroke (smoking, alcohol, physical inactivity, obesity, high blood pressure, high blood cholesterol, diabetes). Atrial fibrillation affects approximately 200,000 to 250,000 Canadians. About 6% of people 65 and older have atrial fibrillation. It is estimated that up to 15% of all strokes are due to atrial fibrillation. Heart failure is on the increase as a result of successes in treating heart attacks and other cardiac conditions. As people with damaged hearts are living longer, they become more susceptible to heart failure. It is estimated that there are 400,000 Canadians living with congestive heart failure (CHF).9 The number of Canadians living with some form of heart disease or stroke (based on self report) remains high and increases with age:
Depending on the severity of symptoms, heart dysfunction, age and other factors, congestive heart failure can be associated with an annual mortality of between 5% and 50%.9 The average annual mortality rate for congestive heart failure is 10% per year with a 50% five-year survival rate.10 Up to 40% to 50% of people with congestive heart failure die within five years of diagnosis.10 The study, which examined hospital discharges for fiscal 2000, found that a total of 1.38 million hospital days were associated with congestive heart failure. 15.8% of patients died while in hospital, and the average hospital stay was slightly less than 13 days. Re-admission to hospital was also examined in the study. There were a total of 106,130 discharges for congestive heart failure in 85,679 patients – suggesting that there were 20,451 re-admissions among these patients. It’s a re-admission rate that Dr. Ross T. Tsuyuki, associate professor, division of cardiology at the University of Alberta, sees as a call to action for healthcare professionals. “We must adopt more effective therapies, better apply already-proven therapies and undertake better patient education on congestive heart failure.” Data for the study was obtained from the Canadian Institute of Health Information Discharge Abstract Database, which covers about 85% of Canadian hospitals. The researchers analyzed data on patients who had been hospitalized with congestive heart failure as a “most responsible,” primary or complicating diagnosis. About 1 of every 100 babies born has some form of heart defect, representing 1% of births. These heart defects range from a tiny hole that will never require treatment, to a life-threatening heart defect in which blood carrying oxygen and nutrients is pumped throughout the body. In 2004, there were about 339,000 babies born in Canada.11 In Canada, there are about 100,000 adults who, as children, had surgery to correct congenital heart defects. In 2003, heart transplants were performed in 12 Canadian hospitals. These hospitals were located in five provinces: British Columbia, Alberta, Ontario, Quebec and Nova Scotia. In 2003, there were 157 heart transplants in Canada. This number reflects the number of transplants that occurred, not the number of recipients – some recipients may have received more than one transplant.
On December 31, 2003, there were 131 people on the waiting list for a heart transplant. From 1993 to 2003, 375 Canadians died while waiting for a heart transplant. 12 In 2001-02, there were 36,726 coronary angioplasties performed in Canada. About 80% of strokes are ischemic caused by the interruption of blood flow to the brain due to a blood clot. About 20% of strokes are hemorrhagic caused by uncontrolled bleeding in the brain. Stroke is the third leading cause of death in Canada. Seven percent of all deaths in Canada are due to stroke. Each year, more than 14,000 Canadians die from stroke. Each year, more women than men die from stroke. More than 50,000 strokes occur in Canada each year. That’s one stroke every 10 minutes. For every 100,000 Canadian children under the age of 19, there are 6.7 strokes. About 300,000 Canadians are living with the effects of stroke. After age 55, the risk of stroke doubles every 10 years. A stroke survivor has a 20% chance of having another stroke within 2 years. The number of Canadians living with the effects of stroke (based on self report) remains high and increases with age:
Of every 100 people who have a stroke
Stroke costs the Canadian economy $2.7 billion a year in physician services, hospital costs, lost wages, and decreased productivity (1993 statistic). 3 The average acute care costs is about $27,500 per stroke Canadians spend a total of 3 million days in hospital because of stroke. Transient Ischemic Attacks (TIAs) Each year, about 15,000 people in Canada experience a TIA. Many more go unreported. 14 People who have had a TIA are five times more likely to have a stroke over the next two years than the general population. Many people who have a stroke had one or more TIAs before their stroke. According to the Canadian Community Health Survey (2004), about 1.3 million Canadians aged 12 and over, or 5% of the population, report that they have been diagnosed with diabetes. The Canadian Diabetes Association estimates that approximately 90% of people with diabetes have type 2 diabetes. Gestational diabetes occurs in 2% to 4% of women during pregnancy and usually disappears after the birth of the baby. It can increase the risk of the mother and the baby developing diabetes later in life. In 2002, diabetes and its complications cost the Canadian society an estimated $13.2 billion. 15 Women and diabetes 6% of Canadian women aged 46 to 64 years have been diagnosed with diabetes, climbing to 13% among those 65 and over (Statistics Canada, Health Indicators). A woman with type 2 diabetes has an 8-fold greater risk of heart disease than a woman without diabetes. 16 In 2006: 17
SMOKING RATE (%) BY PROVINCE: 2006, 2005, 2004, 2003
In 1965, when monitoring began, an estimated 50% of the population smoked. Chart of national smoking rates from 1999 to 2006 Based on trends to date, the rates of smoking among men and women are projected to continue to decline between now and 2015.3 Teens and smoking
Teens between the ages of 15 and 19 who smoke consume an average of 12.3 cigarettes a day, down from 13 a day in 1999. 17 More than 90% of teenagers who smoke as few as 3 to 4 cigarettes a day may be trapped into a lifelong habit of regular smoking, which typically lasts some 35 to 40 years. Canadians under the age of 19 consume about 1.7 billion cigarettes every year. Young adults and smoking The highest smoking rates are for young adults ages 20 to 24 years at 27%, although greatly reduced from 35% in 1999.
Women and smoking Among young women who smoke:
Deaths from smoking and second-hand smoke Smoking contributes to more than 37,000 deaths a year in Canada, of which almost 11,000 are heart disease and stroke-related (29% of all smoking-related deaths are heart disease and stroke-related). 18 Almost 6,300 non-smokers die each year from exposure to second-hand smoke. Smoking is responsible for 14.54% of all heart disease and stroke deaths. If current rates of tobacco use continue, approximately 1 million Canadians will die over the next 20 years as a direct result of smoking and second-hand smoke.19 Becoming smoke-free As soon as an individual quits smoking, the risk of heart disease and stroke begins to decrease. 20
More than 50% of former smokers report they are able to become smoke-free after one or two serious attempts.21 The percentage of people who remain smoke-free after one year of quitting ranges from 5% to 18%. 22 About 40% of Canadians have high blood cholesterol. It is estimated that as many as 10 million Canadian adults have a cholesterol level higher than the recommended target.* *Healthy cholesterol levels are dependent upon your risk of developing heart disease or stroke. Your doctor will take into account factors that increase your risk of heart disease and stroke such as your age, sex, blood pressure, and whether you have diabetes or smoke. The higher your risk, the lower your target levels should be. Your doctor will determine the target level that is right for you. Canadians of all ages get more than one-fifth of their calories from "other foods," which are food and beverages that are not part of the Four Food groups. Snacks, that is, food and drink consumed between meals, accounted for more calories than breakfast, and about the same number of calories as lunch. Food consumption among adults is linked to their household income, but not so much among children. 23 Fat More than one-quarter of Canadians ages 31 to 50 get more than 35% of their total calories from fat, the threshold beyond which health risks increase.23 Milk and alternatives More than one-third of children ages 4 to 9 do not have the recommended two servings of milk products a day. By age 30, more than two-thirds of Canadians do not attain the recommended minimums. 23, 24 Vegetables and fruit Seven out of 10 children ages 4 to 8, and half of adults, do not eat the recommended daily minimum of five servings of vegetables and fruit.23 64% of Canadian adults (age 20+) consume fewer than five servings of vegetables and fruit per day.3 Eating out According to Statistics Canada, almost 25% of Canadian household food dollars are spent in restaurants. In 2005, Canadian households visited a restaurant for a meal or snack an average of 11 times every two weeks. Total foodservice sales in Canada in 2006 is projected to be $50.6 billion. Of all the money spent on food in Canada, 40% is spent in foodservice outlets. There are 62,629 foodservice outlets in Canada.25 Statistics show that on any given day, 30% of kids living in North America visit a fast food restaurant. 26 Almost 60% of adults ages 18 and over, or 14.1 million Canadians, are overweight or obese. Almost one quarter of Canadian adults ages 18 and over (23% or 5.5 million) are obese. 26 Almost one quarter of Canadian adults ages 18 and over (23% or 5.5 million) are obese, and an additional 36% are overweight. 27 53% of Canadian women ages 18 and over are overweight or obese. 26 A greater proportion of sedentary adults, especially women, are overweight or obese, compared to active adults. Children and obesity In 1981, about 14% of girls and 18% of boys were obese. By 1991, 24% of girls and 26% of boys were considered overweight or obese. In 1978/79, 3% of Canadian children and youth were obese. By 2004, 8% or an estimated 500,000 were obese. Overall, 26% of Canadian children ages 2 to 17 years are overweight or obese, with the percent increasing with age from 21% among those 2 to 5 years to 29% among those 12 to 17 years. 28 Children who are obese are at increased risk of remaining overweight or obese as adults. Children who report higher levels of watching TV or videos, or playing on the computer are more likely to be overweight or obese than those who report less time in front of the TV or computer. Costs of obesity In 2002 Canada spent $2 billion treating illnesses attributable to overweight and obesity. Deaths due to obesity From 1985 to 2000, 57,000 deaths in Canada were associated with overweight and obesity.28 Five million Canadian adults have high blood pressure, representing 22% of the adult population. Of Canadians with high blood pressure:
Women and blood pressure In 200529:
Women with high blood pressure have a 3.5-times greater risk of developing heart disease than women with normal blood pressure. 30 Nearly half (48%) of Canadians ages 12 and over report being physically inactive. Among Canadian women ages 12 and over, 50% are physically inactive 45% of Canadian men are physically inactive.31 Only 43% of people over the age of 65 are active; the fewest in any age group.32 It’s estimated that if you are inactive and become physically active, you can reduce heart attack risk by 35% to 55%. 33 Children and physical activity Over half of young people ages 5 to 17 years are not active enough for optimal growth and development. 31 82% of Canadian teenagers may not be active enough to meet international guidelines for optimal growth and development 34 Girls are significantly less active than boys with 64% of girls and 48% of boys being physically inactive. 34 Only 38% of children in families with annual incomes below $25,000 participate in organized sport compared to 44% amongst middle income children and 50% of children in families of incomes of $80,000 or more per year.35 Only 20% of Canadian children receive daily physical education in school, 41% receive one to two days per week, while 10% receive no physical education at all. These numbers get worse as children move through high school. 36 Physical education classes averaging 18 or more minutes a day can more than double the odds that an overweight or obese child becomes and remains physically active. 37 Costs of inactivity In 1999, the direct healthcare costs in Canada of physical inactivity totalled $2.1 billion, representing approximately 21% of the healthcare costs of coronary artery disease, stroke, high blood pressure, colon cancer, breast cancer and diabetes. 15 More than a quarter (26%) of Canadian women ages 45 to 64 report a high degree of life stress. 38 Research shows an association between psychosocial and marital stress and heart disease in women.39 22% of Canadian women ages 20 to 34 years drink 5 or more drinks on one occasion, 12 or more times a year. The rate decreases with age, however, dropping to 11% among those 35 to 44, 8% among those 45 to 64 and 2% of those 65 and older. 40 Excessive alcohol consumption can increase blood pressure and increase the risk of obesity, some forms of heart disease and stroke. Circulatory diseases are the leading cause of death among First Nations people. Smoking In the First Nations communities, up to 46% of adults 18 years of age and older report smoking daily.3 Physical activity In the First Nations Regional Longitudinal Health Survey41, 79% of First Nations adults are not sufficiently active, whereas 49% of First Nations adolescent males and 61% of First Nations adolescent females are not sufficiently active. Obesity Obesity is more prevalent among off-reserve (38%) and on-reserve (35%) Aboriginal peoples than among the general population (23%). More than 40% of First Nations youth are either overweight or obese. About 60% of First Nations children are either overweight or obese. Eight percent of First Nations people with acceptable weight report having cardiovascular disease, compared to 16% who are overweight and 27% who are obese. Diabetes One in five (19.7%, age standardized) of First Nations adults age 18+ has been diagnosed with diabetes compared to one in 19 (5.2%) in the general Canadian population age 20+. 3 Heart disease is about four times more prevalent among First Nations adults with diabetes as among those without diabetes (14.9% versus 3.3%). High blood pressure is about four times more prevalent among First Nations adults with diabetes as among those without diabetes (42% versus 10.3%). High blood pressure High blood pressure is more prevalent among First Nations adults than the general population of Canada (20.4% versus 16.4%).
Reference Notes: 1 Statistics Canada, Causes of Death 2004. Released 2006. 2 Public Health Agency of Canada, Economic Burden of Illness in Canada, 1998. Released 2002 3 Heart and Stroke Foundation of Canada. (Tipping the Scales of Progress: Heart Disease and Stroke in Canada. 2006. 4 Vaillancourt, C. et al. (Cardiac Arrest care and emergency medical services in Canada. Canadian Journal of Cardiology, Vol 20 No x 2004. 5 Robertson, RM (Editorial). ;(Sudden Death from Cardiac Arrest - Improving the Odds, New England Journal of Medicine. October 26, 2000, 343(17): 1259-60. 6 Culley, L et al. Public Acess Defibrillation in Out-of-Hospital Cardiac Arrest – A Community Based Study. Circulation. Vol: 109, 1859-1863, 2004. 7 Larsen MP et al. Predicting survival from out-of-hospital cardiac arrest: a graphic model. Annals of Emergency Medicine. 1993; 22: 1652-1658. 8 Valenzuela et al. NEJM 2000. 343;17 : 1206-1209. 9 Canadian Cardiovascular Society. CCS Consensus Document on congestive heart failure 2006 10 Canadian Cardiovascular Society. CCS Consensus Document on congestive heart failure 2001 11 Statistics Canada, Births: stillbirths 2004. Ottawa, 2006. 12 Canadian Institute for Health Information. Canada's Heart Transplantation Rate Down; Survival Rates Up, Reports CIHI. 2004. 13 Statistics Canada. Causes of Death. 2007. 14 Field TS, Green TL, Roy K, Pedersen J, Hill MD. Trends in stroke occurrence in Calgary Can J Neurol Sci 2004;31:387-393. 15 Chronic Disease Prevention Alliance of Canada. CDPAC Fact sheet. 16 Laakso M et al. Does NIDDM increase the risk for coronary heart disease similarly in both low and high risk population? Diabetologia 1995;39:487-93. 17 Health Canada. Canadian Tobacco Use Monitoring Survey 2006. Ottawa, 2007 18 Canadian Centre on Substance Abuse. The Costs of Substance Abuse in Canada. Ottawa, 2002 19 Makomaski Illing EM, Kaiserman MG. Mortality attributable to tobacco use in Canada and its regions 1998. Canadian Journal of Public Health 2004;95(1):38-44. 20 Health Canada, Rewards of Quitting. 21 Health Canada. Canadian Tobacco Use Monitoring Survey 2003. 22 Reid R, Coyle D, Papadakis S, Boucher K. Nicotine replacement therapies in smoking cessation: A review of evidence and policy issues. Ottawa, 2001. Canadian Council for Tobacco Control. 23 Statistics Canada. The Daily – July 6, 2006 (Canadian Community Health Survey 2004). 24 Canadian Council of Food and Nutrition. Tracking Nutrition Trends 2006. 25 Canadian Restaurant and Foodservice Association. Foodservice Facts 2006 Market Review and Forecast. 26 Heart and Stroke Foundation of Canada. Report Card 2004 – Fat is the New Tobacco. 27 Tjepkema M, Sheilds M. Nutrition Findings from the Canadian Community Health Survey – Overweight Canadian children and adolescents. Statistics Canada 2005. 28 Katzmarzyk PT, Ardern CI. Overweight and obesity mortality trends in Canada 1985-2000. Canadian Journal of Public Health 2004;95(1):16-20. 29 Statistics Canada, Canadian Community Health Survey, 2007. 30 Corrao JM et al. Coronary heart disease risk factors in women. Cardiology 1990;77:8-12. 31 Heart and Stroke Foundation of Canada. Getting Active for Life. 2007. 32 Statistics Canada. Health Reports, Vol 18, No.3, August 2007 33 Heart and Stroke Foundation of Canada. Living with Cholesterol. 2006. 34 Canadian Fitness and Lifestyle Research Institute. 2002 Physical Activity Monitor. 35 Active Healthy Kids Canada Report Card 2006. 36 Canadian Association of Physical Health Education, Recreation and Dance. Time to move, 2005. 37 Sallis J and MacKenzie T. 1991 in MacKenzie, Feidman, Woods, Romero Dahstrom, Stone et al. 1995. 38 Statistics Canada, Health Indicators 2005 39 Orth-Gomer K et al. The Stockholm Female Coronary Risk Study. JAMA 2000;284:2008-14 and abstract 40 Statistics Canada, Health Indicators, 2005. 41 First Nations Regional Longitudinal Health Survey 2002-03 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
