In our week 11 of our MSHT 601 course we explored vulnerable populations in Canada related to our specific area of interest I have chosen to focus on curating resources on prevalence of chronic cardiac disease in the aging population and women. Check my updated “Resources” page.
The Canadian surveillance shows that prevalence of diagnosed ischemic heart disease increases as people age and is higher among men than women in all age groups. The data highlights that as women and men get older than 65 years old, the gap in prevalence and incidence lessens. In fact, in 2012/13, there is almost twice as many women aged 85 years and older newly diagnosed with ischemic heart disease than men of the same age. As women live longer than men, they are more likely to be diagnosed with a heart condition in the old age
The report on Canadian seniors really highlights the impact and burden of our aging population on our health care system.
Seniors' life expectancy is increasing, and they report overall good health, although the risk of developing chronic diseases increases with age.
The average 65-year-old Canadian can expect to live an additional 21.0 years (19.5 years for men and 22.3 years for women). However, women spent a greater proportion of their life post-65 years in an unhealthy state (30.9%) compared to men (27.7%).
In 2017–2018, almost half of Canadian seniors (46.5% of men and 48.3% of women) perceived their health as very good or excellent, and over two-thirds (72.0%) reported their mental health as very good or excellent, despite that many are living with chronic diseases. This apparent paradox reflects the fact that people's perception of personal health status is influenced by factors other than the absence of disease, such as economic security, social connectedness, satisfaction with life and psychological well-being. As such, some seniors may report good levels of health, despite living with chronic diseases.
Triposkiadis, A. et al. (2019). Cardiovascular Aging and Heart Failure: JACC Review Topic of the Week. Journal of the American College of Cardiology, 74(6), 804-1097.
This article takes a closer look at the impact of age on our heart and its structures. It also discusses top risk factors that impact on cardiovascular aging and what lifestyle modification should be implemented in childhood to reduce risk.
Age is a major determinant of the risk for cardiovascular disease as aging leads to a progressive decline in structure and function.
Aging is associated with aortic stiffening (more pronounced in women than in men), myocardial hypertrophy, myocardial fibrosis, and frequently, cardiac amyloidosis.
Complex interactions between the cardiovascular aging process and risk factors (hypertension, coronary artery disease, obesity, and others), comorbidities (anemia, atrial fibrillation, chronic kidney disease, diabetes mellitus, depression, pulmonary diseases, sleep disordered breathing, and others), and disease modifiers (sex, genes, and others) determine the left ventricular remodeling pattern.
The extent of cardiac damage and antecedent as well subsequent comorbidities are major determinants of the outcome, which is better in women than in men. DBP = diastolic blood pressure; LV = left ventricular; LA = left atrial; SBP = systolic blood pressure.
This article looks at alternatives to invasive surgery for treating cardiac disease and this touches on alternative complex procedures for our aging population. This currently an interest of mine in my current role to advocate to Alberta Health for additional funding to support our aging population who have an active lifestyle however due to cardiovascular aging are at high risk for complications in an open heart surgery.
When technology and medicine come together in the way they have with the development of TAVR, it can shift the global burden of disease. Currently, due to a lack of resources and capacity, TAVR is only penetrating the burden of cardiovascular disease in the developed world. TAVR, when performed in optimal conditions has proven to increase the life expectancy and quality of life for those with valvular heart disease associated with serve aortic stenosis
This article highlights the prevalence of cardiac disease in women:
CVD is the leading cause of death in women globally, responsible for 33.2% of female deaths in 2008, ahead of infectious and parasitic diseases (13.9%) and cancers (13.0%).
Cardiovascular disease is the leading cause of death for women in Canada, claiming a life every 20 minutes. Globally, one in three women will die as a result of heart disease or stroke. Heart attacks go unrecognized in women up to 54 per cent of the time. This is because women often present different symptoms than men, leading to later diagnosis and fewer options for treatment.
This resource is a strategy being implemented in Alberta to focus on supporting women who have cardiovascular disease and improving education and awareness for early detection.
In 2019, the Libin Cardiovascular Institute introduced CV & Me, a formal program in women’s cardiovascular health that focuses on research, education and clinical care.
The Libin Institute's goal is that we will be recognized internationally as a leading center for women’s cardiovascular health research, training and care.
In partnership with several community organizations and foundations, we will undertake robust outreach to the Calgary community to raise awareness about women’s cardiovascular disease, the risks, symptoms and recovery.
Concurrent with our local and national strategy, we will reach out globally to attract, retain and enable world-class expertise at the Libin Cardiovascular Institute.
CVD is the leading cause of death in women globally, responsible for 33.2% of female deaths in 2008, ahead of infectious and parasitic diseases (13.9%) and cancers (13.0%).
Close to 25,000 women die each year from heart disease, and it is the leading cause of premature death for women in Canada. Women are five times more likely to die from heart disease than breast cancer.
Coronary heart disease is responsible for a 53 percent higher death rate in Indigenous women compared to non-Indigenous women. Heart health in indigenous communities is influenced by access to health care, education, and affordable food and water .
Over the nine months of gestation, women develop pregnancy-related conditions that put them at higher risk of heart disease including pre-eclampsia, diabetes, and hypertension
We know women have smaller arteries. They also lay down heart cholesterol in smaller vessels. This has implications when we diagnose and treat heart disease.
But in women, certain factors — including depression, smoking and diabetes — can be more important and more strongly linked to heart attack.
Women tend to be safeguarded from heart disease prior to menopause because of the protective effect of estrogen. However, this is not always the case. For example, pregnancy is the first increased risk time for women, and pre-menopausal women with diabetes have similar risk to men of the same age because diabetes cancels out the protective effect of estrogen
Unique Risk Factors: https://youtu.be/QuQAmfFU5bg
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