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. 2009 Aug 4;181(3-4):E55-66.
doi: 10.1503/cmaj.081629. Epub 2009 Jul 20.

Trends in risk factors for cardiovascular disease in Canada: temporal, socio-demographic and geographic factors

Douglas S Lee  1 , Maria Chiu, Douglas G Manuel, Karen Tu, Xuesong Wang, Peter C Austin, Michelle Y Mattern, Tezeta F Mitiku, Lawrence W Svenson, Wayne Putnam, William M Flanagan, Jack V Tu; Canadian Cardiovascular Outcomes Research Team
Collaborators, Affiliations

Trends in risk factors for cardiovascular disease in Canada: temporal, socio-demographic and geographic factors

Douglas S Lee et al. CMAJ. .

Abstract

Background: Temporal trends in risk factors for cardiovascular disease and the impact of socio-economic status on these risk factors remain unclear.

Methods: Using data from the National Population Health Survey and the Canadian Community Health Survey, we examined national trends in heart disease, hypertension, diabetes mellitus, obesity and smoking prevalence from 1994 to 2005, adjusting for age and sex. We stratified data by income adequacy category, body mass index and region of residence.

Results: An estimated 1.29 million Canadians reported having heart disease in 2005, representing increases of 19% for men and 2% for women, relative to 1994. Heart disease increased significantly in the lowest income category (by 27%), in the lower middle income category (by 37%) and in the upper middle income category (by 12%); however, it increased by only 6% in the highest income group. Diabetes increased in all but the highest income group: by 56% in the lowest income group, by 93% in the lower middle income group and by 59% in the upper middle income group. Hypertension increased in all income groups: by 85% in the lowest income group, by 80% in the lower middle income group, by 91% in the upper middle income group and by 117% in the highest income group. Obesity also increased in all income groups: by 20% in the lowest income group, by 25% in the lower middle income group, by 33% in the upper middle income group and by 37% in the highest income group. In addition to socio-economic status, obesity and overweight also modified the trends in risk factors. Diabetes increased to a greater extent among obese participants (61% increase) and overweight participants (25% increase), as did hypertension, which increased by 80% among obese individuals and by 74% among overweight individuals. Trends in diabetes, hypertension and obesity were consistent for all provinces.

Interpretation: During the study period, heart disease, hypertension, diabetes and obesity increased for all or most income groups in Canada. Further interventions supporting modification of lifestyle and risk factors are needed to prevent future cardiovascular disease.

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Figures

Figure 1
Figure 1
Age- and sex-adjusted trends in heart disease from 1994 to 2005, stratified by income adequacy category.
Figure 2
Figure 2
Age- and sex-adjusted prevalence of hypertension, diabetes, smoking and obesity from 1994 to 2005, stratified by income adequacy category.
Figure 3
Figure 3
Trends in risk factors, by body mass index category.
Figure 4
Figure 4
Map of risk factors for cardiovascular disease in Canada. Health regions for which data were available are shown according to the number of risk factors with a prevalence exceeding the national average by at least 10%.
See this image and copyright information in PMC

Comment in

References

    1. Tu JV, Nardi L, Fang J, et al. for the Canadian Cardiovascular Outcomes Research Team. National trends in rates of death and hospital admissions related to acute myocardial infarction, heart failure and stroke, 1994–2004. CMAJ. 2009;180:1304–9. - PMC - PubMed
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    1. National Population Health Survey (NPHS), cycles 1 (1994–1995) and 2 (1996–1997) Ottawa (ON): Statistics Canada; (accessed remotely 2008 June 10 to 2009 Jan. 9)
    1. Canadian Community Health Survey (CCHS), cycles 1.1 (2001-2001), 2.1 (2003), and 3.1 (2005) Ottawa (ON): Statistics Canada; (accessed remotely 2008 June 10 to 2009 Jan. 9)

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