The 2015 Heart and Stroke Foundation Report on the Health of Canadians looks back on 60 years of life-saving, ground-breaking research, revealing astonishing improvements in diagnosis, treatments, and outcomes. However, these gains will be threatened as our population changes and some risk factors for heart disease are set to rise sharply.
"We have made incredible progress in improving the heart health of Canadians since the 1950s and 1960s," says David Sculthorpe, CEO of the Heart and Stroke Foundation. "Back then of those who made it to hospital after a heart attack, 30 – 35 per cent did not survive. Today that number is down to five per cent."
Decades of progress
The Foundation interviewed 16 of the country's leading cardiovascular experts, who agree the greatest accomplishment regarding heart disease has been improved survival.
This success is directly related to research advances in prevention, diagnosis, treatment and care including:
- Identifying, treating and managing risk factors such as high blood pressure and cholesterol
- Cutting smoking rates by much more than half
- Developing and continually improving medications to manage risk factors and heart disease
- Producing sophisticated imaging equipment, such as magnetic resonance imaging (MRI) scanners and CT (X-ray) scanners
- Discovering and improving new procedures; for example, open-heart surgery has more and more been replaced by less invasive procedures such as angioplasty.
Comparing the quality of life in heart disease survivors also reveals a transformation. Fifty years ago if someone survived a heart attack, they often convalesced for months and were advised to buy a rocking chair and watch TV. Their lives never went back to normal. Survivors today are often discharged home within a few days and can be back to work in a few weeks.
New challenges threaten advances
Despite the amazing accomplishments, we are in danger of losing the gains we have worked so hard for. "Heart disease and stroke continue to be the second leading cause of death in Canada and a leading cause of disability, responsible for 66,000 deaths each year," says Sculthorpe.
While we have made improvements in managing some risk factors, we have lost incredible ground in other areas:
- Diabetes rates in heart attack patients have skyrocketed.
- Sixty per cent of adult Canadians are overweight or obese.
- Obesity rates in children have tripled over 30 years.
- The population is aging and as people get older, their chances of developing cardiovascular disease increases.
- Poor diets and lack of physical activity are leading risk factors.
Research into a healthier future – we can get there from here
Dr. Paul Dorian, a professor of medicine and cardiology at the University of Toronto, points to research as the best hope for identifying how to help Canadians make healthy changes. "We need a better understanding around how to change behaviour across the population. Many of the diseases we treat are in theory preventable."
The experts also identified a number of exciting research possibilities for the future:
Regenerative medicine to repair damaged hearts. As people with damaged hearts are living longer, they become more susceptible to heart failure. Work continues into finding new ways to repair damaged hearts using stem cells, and other therapies to stop cells from dying or to regenerate new cells.
Predicting the future. Work is being done to identify genetic markers that will reveal which genes predispose a person to cardiovascular disease – information that could help stop the disease before onset or halt its progression.
Putting knowledge into action. Knowledge translation is an area that holds immense potential. It involves sharing information with the right players, and using it to inform decisions about prevention, care, treatment, rehabilitation, and creating the systems and policies to support this.
Promoting recovery. With more Canadians surviving and living with the effects of cardiovascular disease, more research is needed to support them to make the best recoveries possible and improve quality of life.
These are just some of the exciting possibilities that lie ahead to tackle a disease that continues to affect millions of Canadians and their families. We must maintain and increase our investment in research to improve the heart health of Canadians and bring us closer to solving heart disease.
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