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Heart disease in Canada Published: ()
Heart disease is a general term used to refer to several diseases of the heart and blood vessels. In Canada, heart disease is the second leading cause of death and accounted for over 51,500 deaths in 2015.Footnote 1
Heart disease is a condition in which the heart muscle is damaged or does not function properly. Plaque (composed of fat, cholesterol, calcium and other substances) builds up on the inner walls of coronary arteries and, over time, it can harden or rupture. As a result, the inside of the coronary arteries narrow and the flow of blood to the heart muscle is reduced. A blood clot can also form in a coronary artery when plaque ruptures. In such a case, the flow of blood to the heart muscle is blocked.
Commonly known heart diseases include: ischemic heart disease (IHD), acute myocardial infarction (AMI) [also known as a heart attack], angina, cardiac arrhythmias, stroke, and heart failure. Heart disease symptoms may include chest pain, shortness of breath, palpitations, fatigue and sweating, among others.
The Canadian Chronic Disease Surveillance System (CCDSS) is a collaborative network of provincial and territorial chronic disease surveillance systems led by the Public Health Agency of Canada. Using data from the CCDSS, estimates are provided from 2000–2001 to 2012–2013 for the number of Canadians living with heart disease and those who are newly diagnosed. Trends in mortality are also explored.
PHAC recently released the publication, ‘Report from the Canadian Chronic Disease Surveillance System: Heart Disease in Canada, 2018’ that describes epidemiological trends and profiles of IHD, AMI (which is a subset of IHD) as well as heart failure.
Who is affected?
In 2012–2013, about 2.4 million (or 1 in 12) Canadians aged 20 years and older were living with IHD, the most common type of heart disease. Of those, about 578,000 (2.1%) individuals had a history of AMI. Another 669,600 (3.6%) Canadians adults aged 40 years and older had heart failure.
Men vs. Women
In any given year observed, more men than women live with or are newly diagnosed with IHD, AMI or heart failure. The only exception is for those aged 85 years and over. Although the rates for these diseases are still higher in men than in women at that age, the difference in rates between the sexes diminishes.
Similarly, among individuals with IHD or heart failure, rates of death (due to any cause) were higher in men than in women. However, among those with a history of AMI, women aged 45 to 74 years old were about 1.3 times more likely to die of any cause in a given year compared to men of the same age.
One of the factors that may explain poorer outcomes in women with a history of AMI compare to men is the fact that women sometimes have more subtle symptoms which may contribute to delays in seeking medical care. In addition, women tend to have more complications (e.g. major bleeding) than men during hospitalizations.
To find out the estimates by age group and sex, check out the ‘Dive into the Data’ section below.
Young vs. Old
More Canadians are affected by heart disease as they get older. About two thirds of Canadians who live with IHD and over 80% of those who have heart failure are 65 years or older.
Heart disease can develop at a younger age too. As many as 38,000 Canadians aged 20 to 39 years old were living with IHD and over 35,000 Canadians aged 40 to 54 years old were living with heart failure in 2012–2013.
To find out the estimates by age group and sex, check out the ‘Dive into the Data’ section below.
Increasing or decreasing?
The proportion of Canadians living with IHD and heart failure remained relatively stable over the 13-year period from 2000–2001 to 2012–2013 while all-cause mortality rates declined respectively by 24% and 26%.
The proportion of those with a history of AMI increased by 67% over the same period while all-cause mortality rates declined by close to 35%. These trends are a likely indication of better survival, mostly due to the reduction of certain risk factor and improvements in disease management and treatments.
To see trends over the years, check out the ‘Dive into the Data’ section below.
Dive into the Data
Heart disease prevalence (%) by age group and sex, Canada, 2012-2013
Select Disease Type:
Table 1: Heart disease prevalence (%) by age group and sex, Canada, 2012-2013
| Age Group | Female | Male | Total | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Prevalence (%) | 95% CI (lower limit) | 95% CI (upper limit) | Prevalence (%) | 95% CI (lower limit) | 95% CI (upper limit) | Prevalence (%) | 95% CI (lower limit) | 95% CI (upper limit) | |
| 20-39 | 0.36 | 0.36 | 0.37 | 0.42 | 0.42 | 0.43 | 0.39 | 0.39 | 0.4 |
| 40-54 | 2.28 | 2.26 | 2.29 | 4.15 | 4.13 | 4.17 | 3.22 | 3.2 | 3.23 |
| 55-64 | 7.32 | 7.28 | 7.35 | 13.63 | 13.58 | 13.67 | 10.44 | 10.42 | 10.47 |
| 65-74 | 16.06 | 15.99 | 16.12 | 26.81 | 26.73 | 26.9 | 21.27 | 21.22 | 21.33 |
| 75-84 | 28.32 | 28.21 | 28.42 | 40.89 | 40.75 | 41.04 | 33.95 | 33.86 | 34.04 |
| 85+ | 38.49 | 38.33 | 38.65 | 47.87 | 47.62 | 48.12 | 41.71 | 41.57 | 41.85 |
| Age Group | Female | Male | Total | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Prevalence (%) | 95% CI (lower limit) | 95% CI (upper limit) | Prevalence (%) | 95% CI (lower limit) | 95% CI (upper limit) | Prevalence (%) | 95% CI (lower limit) | 95% CI (upper limit) | |
| 20-39 | 0.02 | 0.02 | 0.02 | 0.07 | 0.06 | 0.07 | 0.04 | 0.04 | 0.04 |
| 40-54 | 0.33 | 0.32 | 0.33 | 1.26 | 1.25 | 1.27 | 0.79 | 0.79 | 0.8 |
| 55-64 | 1.17 | 1.16 | 1.19 | 4.32 | 4.29 | 4.35 | 2.73 | 2.72 | 2.75 |
| 65-74 | 2.65 | 2.62 | 2.67 | 7.62 | 7.58 | 7.67 | 5.06 | 5.04 | 5.09 |
| 75-84 | 5.35 | 5.31 | 5.4 | 10.96 | 10.89 | 11.03 | 7.86 | 7.82 | 7.9 |
| 85+ | 9.05 | 8.97 | 9.13 | 13.74 | 13.61 | 13.88 | 10.66 | 10.59 | 10.73 |
| Age Group | Female | Male | Total | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Prevalence (%) | 95% CI (lower limit) | 95% CI (upper limit) | Prevalence (%) | 95% CI (lower limit) | 95% CI (upper limit) | Prevalence (%) | 95% CI (lower limit) | 95% CI (upper limit) | |
| 40-54 | 0.34 | 0.33 | 0.34 | 0.53 | 0.53 | 0.54 | 0.44 | 0.43 | 0.44 |
| 55-64 | 1.35 | 1.34 | 1.37 | 2.32 | 2.30 | 2.34 | 1.83 | 1.82 | 1.84 |
| 65-74 | 3.81 | 3.78 | 3.84 | 6.03 | 5.99 | 6.06 | 4.88 | 4.86 | 4.91 |
| 75-84 | 10.33 | 10.26 | 10.39 | 13.55 | 13.47 | 13.63 | 11.77 | 11.72 | 11.82 |
| 85+ | 22.32 | 22.19 | 22.44 | 24.37 | 24.19 | 24.55 | 23.02 | 22.92 | 23.12 |
Data source: Public Health Agency of Canada, using Canadian Chronic Disease Surveillance System data files contributed by provinces and territories, May 2016.
Notes: Data from Yukon were not available. The 95% confidence interval shows an estimated range of values that is likely to include the true prevalence 19 times out of 20.
Heart disease prevalence and associated all-cause mortality, by sex, Canada, from 2000-2001 to 2012-2013
According to the age-standardized rate, ischemic heart disease increased from 7.1 to 8.1 between 2000 and 2012 for both sexes.
Sources: Public Health Agency of Canada, using Canadian Chronic Disease Surveillance System data files contributed by provinces and territories, May 2016.
Notes: Data from Yukon were not available. Estimates are age-standardized to the 2011 Canadian population. All-cause mortality refers to deaths due to any cause of death during a given time period.
Definitions: Individuals aged 20 years and older are identified as having ischemic heart disease (IHD) if they have at least one hospital separation listing a diagnostic code* for IHD or a procedure code (for a percutaneous coronary intervention or coronary artery bypass graft) in any diagnostic field or at least two physician billing claims listing a diagnostic code for IHD in any diagnostic field in a one-year period. *International Classification of Diseases (ICD) 9(-CM) codes: 410-414, 36.01, 36.02, 36.05, 36.10-36.19 or ICD10 codes: I20-I25.
Individuals aged 20 years and older are identified as having a history of acute myocardial infarction (AMI) if they have at least one hospital admission listing a diagnostic code* of AMI. *ICD9(-CM) code: 410 or ICD10 codes: I21-I22.
Individuals aged 40 years and older are identified as having heart failure if they have at least one hospital separation listing a diagnostic code* of heart failure in any diagnostic field or at least two physician billing claims listing a diagnostic code of heart failure in any diagnostic field in a one-year period. *ICD9(-CM) code: 428 or ICD10 code: I50.
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