Researchers behind a new index for measuring cardiovascular health have found that more than 90 per cent of Canadian adults are falling short of the optimal result when assessed on key risk factors and behaviours associated with heart disease.
The troubling statistic is based on data drawn from nearly half a million individuals over a 10-year period. Trends within the data suggest that while some Canadians are making modest improvements to their heart health – for example, by quitting smoking, eating healthier and becoming more active – those gains are collectively being offset by increases in risk factors such as obesity, hypertension and diabetes, all of which are harbingers of heart disease.
"We need to reinforce the message and encourage people to try to achieve health lifestyles," said Jack Tu, a cardiologist at Sunnybrook Health Sciences Centre in Toronto and a member of the Cardiovascular Health in Ambulatory Care Research Team (CANHEART), which developed the index. "There's lots of room for improvement."
Cadiovascular disease, including heart attack and stroke, is second only to cancer as a leading cause of death in Canada. It is also one of the most preventable because many of the risk factors associated with heart disease are a function of individual behaviour, including diet and exercise.
According to the index, Canadians are scoring an average of 3.87 on a scale where 6 represents ideal cardiovascular health. The number is based on six factors – including diet, exercise, smoking, obesity, hypertension and diabetes – that can be readily assessed by individuals or gathered by researchers in telephone surveys.
A separate index, which excludes hypertension and diabetes, was used to score youths aged 12 to 19. Data from 464,883 people who participated in the Canadian Community Health Care Survey show how Canadians have been faring over the past decade.
A provincial breakdown of the data, presented in the Canadian Medical Association Journal, shows that, on average, British Columbians enjoy the greatest level of heart health, while Newfoundlanders score lowest. (The breakdown does not include averages for Yukon, Nunavut and the Northwest Territories which are sparsely populated.)
Researchers said the index offers a more quantitative way of assessing cardiovascular health and will help the Heart and Stroke Foundation with its goal of increasing cardiovascular health in Canadians by 10 per cent by the year 2020.
"You can't improve what you can't measure," Dr. Tu said, adding that the index will also help determine where health promotion resources can be best allocated for maximum impact.
The index, published Monday, just ahead of holiday feasting, shines a spotlight on the growing issue of body weight as perhaps the thorniest challenge underlying heart health scores. The data used for determining the index suggest that more than half of Canadians are overweight or obese.
Obesity is also linked to high blood pressure and diabetes, two other factors in the index that are on the rise in Canada, even when numbers are adjusted for age.
Yet while the new year will undoubtedly spur many to take up new diets or exercise regimes, ongoing research suggests such changes rarely result in lasting weight loss, and that broader public health policies coupled with medical research will be needed to crack an obesity epidemic that is decades in the making.
"This is no longer about prevention," said Arya Sharma, a professor of medicine at the University of Alberta and scientific director of the Canadian Obesity Network, which brings together researchers studying the problem.
"We need to start thinking about how we're going to treat the 11 million Canadians who are already obese."