title: Trends in risk factors for cardiovascular disease in Canada: temporal, socio-demographic and geographic factors.
abstract: BACKGROUND
  Temporal trends in risk factors for cardiovascular disease and the impact of socio-economic status on these risk factors remain unclear.
  
  
  METHODS
  Using data from the National Population Health Survey and the Canadian Community Health Survey, we examined national trends in heart disease, hypertension, diabetes mellitus, obesity and smoking prevalence from 1994 to 2005, adjusting for age and sex. We stratified data by income adequacy category, body mass index and region of residence.
  
  
  RESULTS
  An estimated 1.29 million Canadians reported having heart disease in 2005, representing increases of 19% for men and 2% for women, relative to 1994. Heart disease increased significantly in the lowest income category (by 27%), in the lower middle income category (by 37%) and in the upper middle income category (by 12%); however, it increased by only 6% in the highest income group. Diabetes increased in all but the highest income group: by 56% in the lowest income group, by 93% in the lower middle income group and by 59% in the upper middle income group. Hypertension increased in all income groups: by 85% in the lowest income group, by 80% in the lower middle income group, by 91% in the upper middle income group and by 117% in the highest income group. Obesity also increased in all income groups: by 20% in the lowest income group, by 25% in the lower middle income group, by 33% in the upper middle income group and by 37% in the highest income group. In addition to socio-economic status, obesity and overweight also modified the trends in risk factors. Diabetes increased to a greater extent among obese participants (61% increase) and overweight participants (25% increase), as did hypertension, which increased by 80% among obese individuals and by 74% among overweight individuals. Trends in diabetes, hypertension and obesity were consistent for all provinces.
  
  
  CONCLUSIONS
  During the study period, heart disease, hypertension, diabetes and obesity increased for all or most income groups in Canada. Further interventions supporting modification of lifestyle and risk factors are needed to prevent future cardiovascular disease.
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ont. dlee@ices.on.ca
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Lee
authors.forename: Maria
authors.initials: M
authors.lastname: Chiu
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Manuel
authors.forename: Karen
authors.initials: K
authors.lastname: Tu
authors.forename: Xuesong
authors.initials: X
authors.lastname: Wang
authors.forename: Peter C
authors.initials: PC
authors.lastname: Austin
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Mattern
authors.forename: Tezeta F
authors.initials: TF
authors.lastname: Mitiku
authors.forename: Lawrence W
authors.initials: LW
authors.lastname: Svenson
authors.forename: Wayne
authors.initials: W
authors.lastname: Putnam
authors.forename: William M
authors.initials: WM
authors.lastname: Flanagan
authors.forename: Jack V
authors.initials: JV
authors.lastname: Tu
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003710:Demography; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005843:Geography; D006306:Health Surveys; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D013997:Time Factors