Risk factors for cardiovascular disease in Canada.
BACKGROUND
This paper provides an update of the prevalence of important cardiovascular disease (CVD) risk factors in subgroups of the Canadian population. To improve awareness of the impact of CVD risk factor variations on disease burden, smoking-attributable mortality (SAM) has been estimated for the first time for each health region in Canada.


METHODS
The 2000/01 Canadian Community Health Survey (CCHS) was used to estimate the prevalence of current smoking, obesity, physical inactivity, low income, diabetes and hypertension. Combining smoking prevalence data from the 2000/01 CCHS, mortality data from the 1995 to 1997 Canadian Mortality Database, and relative risk estimates (relating smoking and smoking-associated deaths) from the American Cancer Society's Cancer Prevention Study II, SAM values were generated using population-attributable risk techniques.


RESULTS
Based on self-reported data, the 2000/01 CCHS shows that 26.0% of Canadians currently smoke, 14.9% are obese, 53.5% are physically inactive, 11.3% have low income, 13.0% have hypertension and 4.2% have diabetes. Cardiovascular and all-cause SAM were estimated at 18,209 and 44,271 annual deaths, and contributed to 23% and 22% of total CVD and all-cause mortality in Canada, respectively. There are large variations in the prevalence of CVD risk factors and in SAM estimates between sexes and across age groups and geographic regions.


CONCLUSIONS
The high prevalence of potentially modifiable CVD risk factors and the large variation that exists between subgroups of the Canadian population suggest that the burden of CVD could be reduced through risk factor modification. While prevalence data for risk factors in a population give an initial understanding of some of the contributing causes of a disease, the actual burden of disease caused by a risk factor is also modified by the magnitude of the increased risk to mortality and morbidity, and is best represented by its estimated attributable mortality and morbidity.
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Peter
P
Tanuseputro
Douglas G
DG
Manuel
Mark
M
Leung
Kathy
K
Nguyen
Helen
H
Johansen
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D002648:Child; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D011322:Primary Prevention / Q000458:organization & administration*; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects; D016019:Survival Analysis