Cardiovascular disease in Canada.

Since the first national mortality statistics were published in 1921, cardiovascular disease (CVD) has been the leading cause of death in Canada, accounting for almost half of all deaths each year. In 1987, more than 77,000 Canadians died from CVD, almost 60% more than cancer, the second leading cause of death. The costs of CVD are high in economic as well as human terms. CVD accounts for 21% of all hospital days and is responsible for 25% of all disability pensions paid by the Canadian Pension Plan before age 65. CVD hospital costs alone, excluding doctors' fees and costs of surgery, exceed $3 billion annually. Not all the news about CVD is bad, however. Overall CVD incidence has been steadily declining since the early 1950s, and since 1979 the total number of CVD deaths has actually been decreasing, despite a growing and aging population. Improved survival rates are probably the result from more widespread use of advanced surgical technology during the acute phases of heart attacks, and better medical care for people who survive heart attacks. As this paper shows, CVD incidence varies by sex, age, region, and socio-economic status, as does the prevalence of controllable factors that increase the risk of CVD. These risk factors include smoking, high blood pressure, overweight, lack of physical activity, high levels of dietary fat, and elevated cholesterol levels. Lowering CVD rates to those of nations such as Japan and France, both with less than half the Canadian rate, requires increased public awareness of the dangers of the 'typical' Canadian lifestyle. At the same time, lower-income Canadians, the group with the highest CVD rates, must be given increased opportunities to make healthy lifestyle choices.