Heart health: How healthy are Canadians?

As Canadians, we are no strangers to the topic of cardiovascular health. In fact, heart disease and stroke is the leading cause of death in this country. As a physician, I see the impact this spectrum of disease has every day. I spend my days realizing the full effect heart disease and strokes have on the quality of life of my patients.

We’ve made huge strides in treatments and in prevention of cardiovascular disease. We’ve lowered rates of death and disability from this disease. We’ve learned through it all that health is not the default. I think many of us go about our lives and think “if I don’t do anything stupid, I’ll be healthy.” Truth be told, health is a state of being that you work at achieving; it’s something we all have to work at. And even in the best of circumstances, health does not come to us all.

So what does it mean to be healthy? When it comes to the framework of heart disease and stroke – what is the recipe for health? In 2010, the American Heart Association (AHA) introduced a definition of ideal levels of for seven health factor or behaviour with regards to cardiovascular disease.

The “health metrics” they identified were:

• Body Weight
• Blood Pressure
• Presence of Diabetes
• Consumption of Fruit and Vegetables
• Activity level
• Smoking
• Cholesterol

We’ve know these to be risk factors for cardiovascular disease for decades. The novel concept here is that there has been little focus on the cardiovascular health of a population. Studies show that meeting six of the seven parametres would reduce the incidence of cardiovascular disease by 89 per cent, the heart disease death rate in this country by 70 per cent and reduce cancer incidence by 51 per cent compared with meeting only one of the ideal metrics.

When it comes to the AHA parameters, how healthy are Canadians? Enter the CANHEART study. Published in the Canadian Medical Association Journal in December 23, 2013, the CANHEART study looked at what percentage of Canadians meet these healthy heart factors? In truth, the study gave us a cardiovascular report card as a country and unfortunately as a nation we have serious remedial work to do. CANHEART looked at these six healthy heart factors:

1. Smoking: Nonsmoker or former smoker who quit more than 12 months ago
2. Overweight or Obesity as defined by a BMI greater than 25
3. Leisure Physical activity: more than 30 minutes or brisk walking per day
4. Fruits and vegetable consumption of five or more servings per day
5. Hypertension: diagnosed by a health care professional
6. Diabetes: diagnose by a health care professional

In 2009-2010 (the last year of study data) only 9.4 per cent of Canadian adults were in ideal cardiovascular health. This means that less than one in 10 Canadians had ideal health in all six risk factors.

It is no surprise that the prevalence of obesity, hypertension and diabetes increased in this country during the study period. The study showed that 53.3 per cent of Canadians were in intermediate health (4–5 healthy factors or behaviours), and 37.3 per cent were in poor cardiovascular health (0–3 healthy factors or behaviours). Twice as many women as men were in ideal cardiovascular health (12.8 per cent vs. 6.1 per cent). Among youth, the prevalence of smoking decreased and the prevalence of overweight/obesity increased.

In 2009–2010, 16.6 per cent of Canadian youth were in ideal cardiovascular health, 33.7 per cent were in intermediate health (three healthy factors or behaviours), and 49.7 per cent were in poor cardiovascular health (0–2 healthy factors or behaviours).

As a physician who specializes in cardiovascular risk management I’m not “disheartened” by the study and I’m not surprised by it. Canadians too often think we are healthier than we are. Make no mistake, we’re a great country and Canadians are indeed some of the best people I know. This is not personal.

So what can we do with this information? I would ask my readers to take their own CANHEART quiz and see where they score. But don’t stop there. Like any good student see where you can learn from your mistakes. If you are a smoker, seriously, keep trying to quite. If you are inactive – get walking daily for 30 minutes a day. Increase your consumption of vegetables and fruit and don’t give up when it comes to weight loss; every little bit does help. Make sure you have a conversation with your doctor (or any doctor) about blood pressure and diabetes.

In the end, studies like this come down to the numbers. As Canadians, we have learned that we are more than the numbers we make up. But when it comes to cardiovascular health we don’t have to be just another statistic.