Cardiovascular disease in Australia Current state and recent trends

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Cardiovascular disease in AustraliaCurrent
state and recent trends

• Chris Stevenson

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Talk outline

• Overview of CVD burden
• Incidence, prevalence, mortality and disability
  for main CVD conditions
• Health service use for CVD
• Inequalities in CVD burden

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What is cardiovascular disease?

• All diseases and conditions of the heart and
  blood vessels.
• Coronary heart disease (CHD)
• Cerebrovascular disease (mainly stroke)
• Heart failure
• Peripheral vascular disease
• Rheumatic fever and rheumatic heart disease
• Congenital heart diseases

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What causes CVD?

• The main underlying problem is atherosclerosis
• abnormal build-ups of fat, cholesterol and other
  substances in the inner lining of the arteries.
• most serious when it affects the blood supply to
  the heart (angina or heart attack) or to the
  brain (stroke).
• The process leading to atherosclerosis is slow
  and complex,
• often starting in childhood and progressing with
  age.

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Major risk factors for CVD

• Tobacco smoking
• High blood pressure
• High blood cholesterol
• Insufficient physical activity
• Overweight and obesity
• Poor diet
• Diabetes

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Cardiovascular disease burden in Australia

• Cardiovascular disease is
• the largest cause of death (36)
• largest component of allocated health system
  expenditure (11)
• a leading cause of disability
• 1.4 million Australians (6.9)
• 3.5 million Australians (18) have one or more
  long term CVD conditions

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Cardiovascular disease burdenDALYs, 2003
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Incidence (new cases)

• Incidence of major coronary events
• Sum of CHD deaths and non-fatal heart attack
  hospital separations

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CHD incidence and mortality, 2003
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Prevalence (existing cases)
11
Mortality, 2004
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Death rates for CHD and cerebrovascular disease,
1950 to 2004
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Death rates for CHD and cerebrovascular
disease19952004

• Age standardised death rates declined by
• 39 for CHD for both men and women
• 32 for men and 31 for women for cerebrovascular
  disease

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Level of disabilitystroke survivors

• 282,600 stroke survivors live with a disability
• 42 disability resulted from stroke
• 157,500 (56) have a severe or profound core
  activity limitation

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CVD conditions and GPs 2004-05

• 11 of all problems managed in general practice
• 16 per 100 patient encounters
• High blood pressure8.9 per 100 encounters

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Hospital separations 2003-04

• CVD principal diagnosis for 448,859 separations
  (7)

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CVD socioeconomic inequalities

• Comparing most disadvantaged with least
  disadvantaged
• Deaths rates 1.5 to 2.0 times as high
• Separation rates 1.2 to 2.2 times as high