Total heart, stroke and vascular disease

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How many Australians have heart, stroke and vascular disease?

An estimated 1.2 million Australians aged 18 and over (6.2% of the adult population) had 1 or more conditions related to heart, stroke or vascular disease, based on self-reported data from the ABS 2017–18 National Health Survey.

Age and sex

In 2017–18, based on self-reported data, the prevalence of heart, stroke and vascular disease among adults:

  • was higher among men (641,000, an age-standardised rate of 6.5%) than women (509,000, an age-standardised rate of 4.8%)
  • increased with age—more than 1 in 4 (26%) of persons aged 75 and over had heart, stroke and vascular disease (Figure 1).

Figure 1: Prevalence of self-reported heart, stroke and vascular disease among persons aged 18 and over, by age and sex, 2017–18.

The bar chart shows the prevalence of self-reported heart, stroke and vascular disease by age group in 2017–18. Rates were highest among men and women aged 75 and over (32% and 20%).

Women and cardiovascular disease

Cardiovascular disease (CVD) is a leading cause of illness and death among Australian women. While more men than women have heart, stroke and vascular disease, the risk in women is largely under-recognised by the population (AIHW 2019). There are aspects of cardiovascular health that are unique among women, with important sex differences in prevention, diagnosis and treatment.

Increased awareness and recognition of these differences will help women avoid under-diagnosis, under-treatment, and under-estimating the risk of dying or becoming seriously unwell due to heart, stroke and vascular disease (World Heart Federation 2021).

More than half a million women have CVD

  • Based on self-reported data, an estimated 509,000 (5.4%) women aged 18 and over in Australia had 1 or more heart, stroke and vascular diseases in 2017–18.

A major cause of illness and death

  • Around 20,400 women had an acute coronary event (heart attack or unstable angina), and 18,400 women had a stroke in 2018
  • 248,000 hospitalisations of women with CVD in 2018–19
  • 21,000 women died from CVD in 2019, equivalent to 1 in 4 female deaths.

Indigenous women are disproportionately affected

  • Indigenous women were up to twice as likely as non-Indigenous women to have CVD in 2018–19, and to die from coronary heart disease or stroke in 2017–19.

CVD and other chronic conditions are key priorities in the National Women’s Health Strategy 2020–2030 (Department of Health 2018). Increased public awareness and education, investment in research, implementing evidence-based practice, and strategies to address equity issues have been identified as areas for action to improve the heart health of Australian women (Heart Foundation 2021).

For more information:

Cardiovascular disease in Australian women—a snapshot of national statistics, and Cardiovascular disease in women.

Kylie's story

‘I always thought that the typical candidate was someone who smoked, sported a beer belly, and had high blood pressure. I was a fit, young, non-smoking woman in my forties. A heart attack couldn’t happen to me – right?'

Kylie survived a heart attack and said cardiac rehab was a turning point in her recovery.

Learn more about Kylie's heart story

Variation among population groups

Aboriginal and Torres Strait Islander people

An estimated 42,700 Aboriginal and Torres Strait Islander adults had heart, stroke and vascular disease, based on self-reported data from the ABS 2018–19 Australian Aboriginal and Torres Strait Islander Health Survey (AIHW analysis of ABS 2019b).

After adjusting for different population age structures, the rate of heart, stroke and vascular disease among Indigenous adults was more than twice that of non-Indigenous adults (11.4% and 5.4%).

Indigenous men were 2.1 times as likely to report having heart, stroke and vascular disease as non-Indigenous men (12.8% and 6.2%), as were Indigenous women (10.1% and 4.7%) (Figure 2).

Socioeconomic group

After adjusting for different population age structures, the prevalence of heart, stroke and vascular disease did not vary significantly between adults living in the most and least disadvantaged socioeconomic areas in 2017–18 (6.4% and 4.8%) (Figure 2).

Remoteness area

After adjusting for different population age structures, the prevalence of heart, stroke and vascular disease among adults did not vary significantly by remoteness area in 2017–18 (5.6% in Major cities, 6.0% in Inner regional, 5.1% in Outer regional and remote) (Figure 2).

Figure 2: Prevalence of self-reported heart, stroke and vascular disease, among persons aged 18 and over, by population group and sex, 2017–18

The horizontal bar chart shows that the prevalence of self-reported heart, stroke and vascular disease in 2017–18 was higher among Indigenous Australians, but did not vary significantly by socioeconomic or remoteness areas.

Hospitalisations

In 2018–19, there were 591,000 hospitalisations where CVD was recorded as the principal diagnosis. This represented 5.2% of all hospitalisations in Australia in 2018–19.

Of these, 530,000 (90%) were for acute care—that is, care in which the intent is to perform surgery, diagnostic or therapeutic procedures in the treatment of illness or injury).

Of all hospitalisations for CVD in 2018–19:

  • 27% had a principal diagnosis of coronary heart disease, followed by
  • atrial fibrillation (12%)
  • heart failure and cardiomyopathy (12%)
  • stroke (11%)
  • peripheral arterial disease (5.5%)
  • hypertensive disease (2.4%)
  • rheumatic heart disease (0.7%) (Figure 3).

Figure 3: Major causes of cardiovascular disease hospitalisations (principal diagnosis), by sex, 2018–19

The bar chart shows the number of hospitalisations for selected cardiovascular diseases in 2018–19, ranging from 161,000 for a principal diagnosis of coronary heart disease to 4,400 for rheumatic heart disease.

Age and sex

In 2018–19, rates of hospitalisation with CVD as the principal diagnosis:

  • were 1.4 times as high for males compared with females (age-standardised rates of 2,460 and 1,560 per 100,000 population). Age-specific rates were higher among males than females across all age groups (Figure 4)
  • increased with age, with over 4 in 5 (83%) CVD hospitalisations occurring in those aged 55 and over. CVD hospitalisation rates for males and females were highest in the 85 and over age group (20,700 and 16,200 per 100,000 population)—1.4 times as high as those in the 75–84 age group for males and 1.6 times as high among females (15,000 and 10,200 per 100,000) (Figure 4).

Figure 4: Cardiovascular disease hospitalisation rates, principal diagnosis, by age and sex, 2018–19

The bar chart shows cardiovascular disease hospitalisation rates by age group in 2018–19. These were highest among men and women aged 85 and over (21,000 and 16,000 per 100,000 population).

Trends

The number of acute care hospitalisations with CVD as the principal diagnosis increased by 35% between 2000–01 and 2018–19, from 391,000 to 530,000 hospitalisations.

Despite increases in the number of hospitalisations, the age-standardised rate declined by 13% over this period, from 2,060 to 1,790 per 100,000 population; the difference being due to population changes.

The rate of CVD hospitalisations for males was higher than for females across the period, with both showing similar declines (Figure 5).

Figure 5: Acute care cardiovascular disease hospitalisations rates, principal diagnosis, by sex, 2000–01 to 2018–19

The line chart shows declines in age-standardised rates of male and female acute care CVD hospitalisations between 2000–01 and 2018–19, from 2,570 to 2,219 per 100,000 population for males, and from 1,614 to 1,398 for females.

Variation among population groups

Aboriginal and Torres Strait Islander people

In 2018–19, there were around 16,100 hospitalisations with a principal diagnosis of CVD among Aboriginal and Torres Strait Islander people.

After adjusting for differences in the age structure of the populations:

  • the rate among Indigenous Australians was 1.7 times as high as the non-Indigenous rate (3,300 and 1,900 per 100,000 population)
  • the disparity between Indigenous and non-Indigenous Australians was greater for females—2.0 times as high (3,000 and 1,500 per 100,000 population) compared with 1.5 times as high for males (3,600 and 2,400 per 100,000 population).

Socioeconomic group

In 2018–19, age-standardised CVD hospitalisation rates were almost 20% higher for people living in the lowest socioeconomic areas compared with those in the highest socioeconomic areas—2,200 and 1,800 per 100,000 population.

This disparity between the lowest and highest socioeconomic areas was greater for females than males (1.24 and 1.16 times as high) (Figure 6).

Remoteness area

In 2018–19, the age-standardised CVD hospitalisation rate was around 30% higher among those living in Remote and very remote areas compared with those in Major cities (2,500 and 1,900 per 100,000 population).

This largely reflects disparities in female rates―2,200 and 1,500 per 100,000 population―for males the difference was smaller (2,700 and 2,400 per 100,000).

Higher hospitalisation rates in Remote and very remote areas are likely to be influenced by the higher proportion of Aboriginal and Torres Strait Islander people living in these areas, who have higher rates of CVD than other Australians.

CVD patients are often transferred from a local regional hospital to a larger urban hospital where more intense or critical care can be provided. In 2018–19, 17% of CVD hospitalisations (principal and/or additional diagnosis) in Remote and very remote areas were transferred to another acute hospital, compared with 16% in Outer regional areas, 14% in Inner regional areas and 10% in Major cities.

The higher rates of transfers are often necessary because certain cardiac procedures, such as angiograms and cardiac revascularisation, are generally performed in large hospitals, which are predominantly located in urban areas.

Figure 6: Cardiovascular disease hospitalisation rates, principal diagnosis, by population group and sex, 2018–19

The horizontal bar chart shows that male and female CVD hospitalisation rates in 2018–19 were higher among Indigenous Australians, people living in the lowest socioeconomic areas, and people living in remote and very remote areas.

Deaths

In 2019, CVD was the underlying cause of 42,300 deaths (25% of all deaths).

CVD was the second leading cause of death group in 2019 behind cancers (29% of all deaths), but ahead of diseases of the respiratory system (9.7%), external causes (6.9%), and mental and behavioural disorders (6.6%).

Where CVD was listed as the underlying cause of death in 2019:

  • 42% were due to coronary heart disease
  • 20% were due to stroke
  • 11% were due to heart failure and cardiomyopathy
  • 5.2% were due to atrial fibrillation
  • 5.1% were due to hypertensive disease
  • 4.6% were due to peripheral arterial disease
  • 0.9% were due to rheumatic heart disease (Figure 7).

Figure 7: Major causes of cardiovascular disease death, 2019

The bar chart shows the number of deaths from selected cardiovascular diseases in 2019, ranging from 18,000 for coronary heart disease as an underlying cause to 400 for rheumatic heart disease.

COVID-19 and CVD deaths

Coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. Research has found that patients with COVID‐19 and pre‐existing CVD are at increased risk of severe disease and death (Zaman et al. 2020). COVID-19 itself can also cause acute cardiovascular injury in the form of left ventricular dysfunction, heart failure, arrhythmias and acute coronary syndromes.

In 2019–20, there were around 2,600 hospitalisations in Australia that involved a COVID-19 diagnosis. The most common comorbid conditions associated with COVID-19 hospitalisations were cardiovascular disease (13%) and Type 2 diabetes (10%) (AIHW 2021).

The Australian Bureau of Statistics has made available provisional data on deaths for the timely measurement of patterns of mortality during the COVID-19 pandemic and recovery period (ABS 2021). These data also allow for observing changes in CVD mortality.

A total of 141,116 deaths occurred in 2020 and were registered by 28 February 2021—in line with the baseline average for 2015–19. Deaths due to coronary heart disease and cerebrovascular disease were below average for every month of 2020, and were 10.7% and 7.8% below average for the year respectively. Deaths due to cancer, dementia and diabetes were above historical averages.

Coronary heart disease

  • 13,500 deaths occurred from coronary heart disease in 2020.
  • The average number recorded between 2015 and 2019 was 15,100.
  • Counts of coronary heart disease deaths were lower than the baseline average since the week ending 12 May 2020. Between 13 May and 29 Dec, there were 8,700 deaths, 1,300 below the average of 10,000.

Cerebrovascular disease

  • 9,000 deaths from cerebrovascular diseases (including strokes) occurred in 2020.
  • The average number recorded between 2015 and 2019 was 9,700.
  • The number of deaths from cerebrovascular diseases has been mostly below the 5-year average since the week ending Jun 23. Between 24 Jun and 29 Dec, there have been 4,650 deaths, 500 below the average of 5,150.

Pre-existing cardiac conditions and complications

COVID-19 was the underlying cause of death of 682 registered deaths occurring up to 31 August 2020 (ABS 2020). Pre-existing chronic cardiac conditions—including coronary atherosclerosis, cardiomyopathies and atrial fibrillation—were reported on 32% of the death certificates. Pre-existing chronic diseases have been found to be risk factors for severity of COVID-19 in people who have contracted it.

Cardiac complications that were found to be caused by COVID-19 were reported on 10.1% of death certificates.

 

Age and sex

In 2019, CVD death rates:

  • were 1.4 times as high for males as for females (age-standardised rates of 150 and 107 per 100,000 population). Age-specific rates for males were higher than females across all age groups
  • increased with age, with over half (52%) of CVD deaths occurring in persons aged 85 and over. CVD death rates for males and females were highest in those aged 85 and over (both 4,300 per 100,000)―4.3 times as high for males and 6.2 times as high for females aged 75–84 (1,010 and 687 per 100,000) (Figure 8).

Figure 8: Cardiovascular disease death rates, by age and sex, 2019

The bar chart shows cardiovascular disease death rates by age group in 2019. These were highest among men and women aged 85 and over (4,340 and 4,250 per 100,000 population).

Trends

Since its peak in the late 1960s, the CVD death rate has declined substantially, and the gap between males and females has narrowed.

The main driver of this decline was the large fall in coronary heart disease deaths, accompanied by falling rates of cerebrovascular disease deaths.

The large fall represents a public health success, which can be attributed to both prevention and treatment—a combination of reductions in risk factor levels, clinical research, improvements in detection and secondary prevention, and advances in treatment and care (AIHW 2017).

Between 1980 and 2019:

  • the number of CVD deaths declined by 22%, from 55,800 to 42,300
  • age-standardised CVD death rates declined by around three-quarters—falling from 700 to 150 per 100,000 population for males and 452 to 107 per 100,000 for females (Figure 9).

Although CVD death rates have fallen for all age groups in Australia, the rate of decline in younger age groups has slowed in recent decades (AIHW 2017).

Figure 9: Cardiovascular disease death rates, by sex, 1980–2019

The line chart shows the decline in age-standardised cardiovascular disease death rates between 1980 and 2019, from 700 to 150 per 100,000 population for males and 560 to 128 for females.

Variation among population groups

Aboriginal an​d Torres Strait Islander people

In 2017–2019, there were 2,100 CVD deaths among Aboriginal and Torres Strait Islander people in jurisdictions with adequate Indigenous identification.

After adjusting for differences in the age structure of the populations, the rate of death from CVD for Indigenous Australians was 1.8 times as high as for non-Indigenous Australians (238 and 130 deaths per 100,000 population).

Indigenous males and females had CVD death rates 1.8 times and 1.9 times as high as non-Indigenous males and females (Figure 10).

Socioeconomic group

In 2017–2019, the CVD death rate was 1.5 times as high for people living in the lowest socioeconomic areas compared with those in the highest socioeconomic areas (age-standardised rates of 158 and 106 per 100,000 population).

This difference was greater for males (1.6 times as high) than females (1.4 times as high) (Figure 10).

Remoteness area

In 2017–2019, the CVD death rate in Remote and very remote areas was 1.4 times as high as in Major cities (age-standardised rates of 172 and 124 per 100,000 population).

The difference was similar for males and females (Figure 10).

Figure 10: Cardiovascular disease death rates, by population group and sex, 2017–2019.

The horizontal bar chart shows that CVD death rates in 2017–2019 were higher among Indigenous Australians, people living in the lowest socioeconomic areas, and people living in remote and very remote areas.