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What is cardiovascular health?
Cardiovascular health relates to the health of the heart and blood vessels. It also relates to the health of organs that are critically dependent on a strong blood supply. Maintenance of cardiovascular health and prevention of cardiovascular disease are the focus of the NHPA initiative in this particular priority area.
Major cardiovascular diseases are:
- coronary heart disease
- stroke
- heart failure
- peripheral vascular disease.
The main underlying causal mechanism of cardiovascular disease is atherosclerosis, a process marked by abnormal build-ups of fat, cholesterol and other substances in the inner lining of the arteries. It is most serious when if affects the blood supply to the heart (causing angina or heart attack) or to the brain (causing a stroke).
Why is cardiovascular health a National Health Priority Area?
Cardiovascular disease is the largest cause of premature death in Australia. Although death rates for cardiovascular disease have declined considerably in recent decades, it continues to be one of the biggest health problems requiring attention in Australia. Its health and economic burden continues to exceed that of any other disease.
Improved treatment and management of risk factors for cardiovascular disease may also result in the burden of death and disability to shift to older age groups. This age-associated shift in disease focus, in combination with growing number of older Australians, is likely to add considerably to health care costs over the next several decades. This will also require a stronger focus on the prevention of disability and enhancement of the quality of life in the ageing population, in addition to the continued emphasis on avoiding premature mortality.
In 2007, CVD was recorded as the primary cause of death for 46,623 Australians, accounting for just over a third of all deaths in that year. Half of these deaths (22,727) were due to coronary heart disease, and 8,623 to stroke. Over 78% of the CVD deaths were of people aged 75 years and over, and more than half were female (52.7%). (Australia's health 2010 pages: 140-144, June 2010)
Based on the 2007-08 National Health Survey (NHS), an estimated 3.4 million Australians (16.5% of the population) had one or more long-term diseases of the circulatory system that year. A higher proportion of females in the survey (17.6%) reported having CVD than males (15.3%) and the prevalence increased with age. (Australia's health 2010 pages: 141-144, June 2010)
It is estimated that 3.5 million Australians aged 16-85 years had a long-term chronic condition of CVD in 2007. As with the NHS, estimates are based on self-reported responses. Of those reporting CVD, 23.1% (corresponding to 800,000 people) reported also having a disability that led to a mild to profound restriction to core activities such as self-care, mobility and communication. Compared with those without CVD, and after adjusting for age, those reporting a CVD condition were more likely to report that they had a disability, medium or high levels of psychological distress, fair or poor mental and physical health, depression or a schooling or employment restriction. (Australia's health 2010 pages: 142-144, June 2010)
The major, preventable risk factors for cardiovascular disease are:
- tobacco smoking
- high blood pressure
- high blood cholesterol
- insufficient physical activity
- overweight and obesity
- poor nutrition
- diabetes.
Some of these risk factors are common to several other diseases and conditions, such as cancer and kidney disease, suggesting that successful prevention would assist in the reduction of other diseases besides cardiovascular disease.
From 1986 to 2006, the steady decline in CVD death rates has continued. In men, the age-standardised death rates for CVD decreased on average by 3.3% per year during 1987-1996 and 5.0% during 1997-2006. For women, the decline was 3.2% per year and 4.5% per year, respectively, over the two periods. (Cardiovascular disease mortality Pages: 6-10, April 2010)
CVD is projected to account for 16% of the overall disease burden in Australia in 2010, with coronary heart disease and stroke contributing over four-fifths of this burden. Most of the CVD burden comes from premature death. For 2010, it is estimated that CVD will be responsible for 26% of total years of life lost due to premature mortality in Australia, second only to cancer (34%), and 7% of Australia's total years lost due to disability. (Australia's health 2010 pages: 143-145, June 2010)
CVD is the most expensive disease group in Australia in terms of direct health-care expenditure. In 2004-05 it cost $5.94 billion-11% of overall recurrent health system expenditure that could be allocated to various diseases. (Australia's health 2010 pages: 143-145, June 2010)