Health

Circulatory system disease accounted for one-third of all deaths in Canada (72,743 deaths) in 2004—the last year of published data. It remains the leading cause of hospitalization in the country, accounting for 18 per cent of the total.

There are many types of circulatory diseases. About half of deaths are due to ischemic heart disease, also known as coronary artery disease, which is a condition that affects the supply of blood to the heart. The blood vessels are narrowed, reducing the supply of oxygen and nutrients to the heart, which can eventually result in a heart attack. Deaths due to cerebrovascular diseases (known as strokes) account for about 20 per cent of all circulatory disease deaths.

Canada ranks 4th out of the 16 peer countries, and earns a “B” grade. The most recent year of published data on circulatory disease mortality rates for Canada is 2004, with 161 deaths per 100,000 population. The estimated mortality rate for 2006 was 149 deaths per 100,000 population.¹

Both Japan and France have a mortality rate due to circulatory diseases that is less than 130 per 100,000 population, earning them “A”s. Germany is the worst-performing country on this indicator, with 224 deaths per 100,000 people.

Canada reduced deaths due to circulatory diseases from 584 per 100,000 population in 1960 to an estimated 149 in 2006—an average decline of 2.9 per cent per year. Only Australia and Japan managed a larger cut in their mortality rates—by 3 per cent, on average, per year.

The decline in the Canadian mortality rate is attributed to medical advances, new pharmaceuticals, and reductions in major risk factors, such as a decline in tobacco use.

Use the pull-down menu to compare the change in Canada’s mortality rate due to circulatory diseases with that of its peers.

Circulatory system disease encompasses abnormalities of the heart and vessel system. According to the International Classification of Diseases system, there are 10 kinds of circulatory system diseases.

Circulatory system disease can be genetic or acquired. Lifestyle factors, such as diet and smoking, are hugely influential on the likelihood of developing a circulatory disease. Circulatory system disease is also largely age-related.

The three leading conditions contributing to circulatory system disease burden and mortality are stroke, high blood pressure, and ischemic heart disease (coronary heart disease), with the latter being the most prevalent.

Risk factors vary by sex. In Canada, for example, men smoke more and have higher historical smoking rates. Men are also less likely to eat recommended amounts of fruit and vegetables and more likely to be overweight. Women, on the other hand, tend to exercise less and have a greater tendency to high blood pressure.

Doctors believe that circulatory system diseases are mostly preventable. The renowned Mayo Clinic in the U.S. recommends five strategies to prevent circulatory disease:

• don’t smoke or use tobacco products
• get active
• eat a heart-healthy diet
• maintain a healthy weight
• get regular health screenings

Addressing the modifiable risk factors that exist in 80 per cent of the population would make a significant positive impact on the economic and emotional cost of circulatory disease.

A number of countries have developed health promotion policies to help prevent circulatory disease through behaviour modification. The U.K., for example, developed a program in partnership with the food and drink manufacturing industry to reduce salt content in about a quarter of manufactured foods.²

Because of recent treatment advances, many individuals who would have died of circulatory disease in the past are now living with the disease. But although a reduction in mortality due to circulatory disease has increased life expectancy for Canadians, a longer life lived in poor health is not necessarily indicative of improved health outcomes.

Circulatory disease has a major impact on a patient’s quality of life. According to a survey conducted by the Heart and Stroke Foundation in 2000, 90 per cent of the population with no history of circulatory disease reported “good, very good, or excellent” health. Meanwhile, respondents with self-reported heart disease or stroke claimed much lower levels of “good, very good, or excellent health,” at 51 per cent and 37 per cent respectively.

Besides causing considerable difficulties for patients, the cost of circulatory system disease is significant. In 1998, the total (direct and indirect) cost of illness was estimated at $159 billion in Canada. Of that, circulatory diseases are calculated to account for $18.5 billion, the most expensive of the disease categories. Not only does circulatory system disease affect the health system, but it affects the overall economy through missed work and lower productivity.

The Conference Board is currently forecasting what the direct and indirect costs of cardiovascular diseases will be through to 2020. Results will be available this fall and will provide important data to guide and assess the effectiveness of population health interventions to reduce the impact of these diseases in Canada.

¹ Missing data up to 2006 were obtained by projecting the most recent year of data using a 10-year average annual growth rate.

² Clifton Coles, "Lifestyle diseases strike new targets: Fat, salt contribute to Third World health woes," The Futurist, March–April 2003 [online, cited September 23, 2009].