Making the Connection - Vascular 2013

7/27/2019 Making the Connection - Vascular 2013

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mking the ll to tion on vlr helth

Vascular diseases are the leading cause o preventable death and disability in

Canada. Twenty our million Canadians have at least one risk actor or vascula

disease while 10 million have three or more. Every Canadian is directly or

indirectly afected by vascular disease or its complications.

Coming together or vascular health.


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2 mkng h nnn:

Makg th Cct: A ca t act

asca hath, is a direct result of Vascular 2013,

aadas rst atioal coress for owlede

ecae ad couity buildi i vascular

ealt. Vascular 2013 brout toeter aadas

leadi eperts ad ealt care advocates

fro ultiple sectors ad ealt disciplies

to focus o ad epad our uderstadi of

vascular disease prevetio ad aaeet.

Recoizi te uret eed for collective actio

o vascular ealt, oraizatioal parters

aadia ardiovascular Society, aadia

Diabetes ssociatio, aadia Society of

docrioloy ad metabolis, aadia Stroe

networ, heart ad Stroe Foudatio ad

hypertesio aada edorse Makg th

Cct: A ca t act asca hath.

objetive

1) Focus attention on the scope and impact o

vascular diseases in Canada

2) Identiy unmet needs, and opportunities to

improve prevention, treatment and recovery

3) Issue a call to collective action on vascular

health by multiple stakeholders1

ere is treedous potetial to reduce teipact of vascular diseases trou ealty

public policy, supporti aadias to ae

ealty lifestyle caes, ad coordiati eorts

across te cotiuu of care i a patiet-focused

aer. o reduce te deats, ua sueri

ad ecooic burde of vascular diseases we

eed to wor toeter to d solutios usi a

oraized, iterated approac.

ll to tion onvlr helth

Vascular ealt requires partersips for actio

across ay sectors te ealt sector caot

solve tis proble aloe. We eed to for a uited

frot aaist tis assive callee to our society

ad ecooy, ive populatio treds. Direct

actio icludi advocacy is required at all levels

to acieve eaiful ipact o vascular ealt.

e call to actio below is a starti poit for

staeolders to coe toeter for vascular ealt.

For all Canadians mae your ealt a priority.

dopt ealty beaviors. dvocate for ealty

couities. Wor wit your ealt care

provider to odify your vascular ris.

For health care practitioners maiize

iter-professioal collaboratio to copreesively

aae vascular ris ad prevetio. keep

up-to-date o ad follow best care practices.

ollaborate wit oter sectors to advocate for ad

address leislative, social ad built eviroet

factors tat ipact populatio ealt.

For ederal, provincial and municipal

governments oit to sustaied actio o

vascular ealt by ipleeti eective public

policies ad reulatios tat foster ealty food,

pysical activity ad soe-free eviroets.

Be iclusive of te eeds, iterests ad abilities

of specic populatios witi teir local cotets

ad settis. moitor te ipact of public

policies ad reulatios o ealt, ecooic

productivity ad croic care costs.

For researchers and academia Develop

approaces to address evidece aps o

vascular ealt issues. Foster te iteratio

of owlede across sectors, disciplies adcoditios to ipact vascular ealt trou

advocacy, proras ad best practices.

For not-or-proft organizations maiize

ipact trou joit actio. li essai

ad resources for te public o vascular ris ad

croic disease aaeet. Build partersips

for actio o vascular ealt, advocate for

ealty public policies ad traslate owlede

o vascular ealt ito proras tat iprove

te ealt of aadias.For the private sector - sure a ealtier

ad ore productive worforce trou

ipleetatio of ealty worplace policies

ad proras. Build itersectoral partersips

to advocate for ealty public policies. Parter

wit te ealt syste to support prevetio ad

screei. n

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n n VSR hh 3

Vascular diseases are a result o disorders

in the blood vessels (large and small)

throughout the entire human body.

Stroke, heart attack, heart ailure,

dementia, kidney diseases, certain lung

and eye conditions are all vascular

diseases. Most vascular diseases share

common risks (high blood pressure,

diabetes, high cholesterol and obesity),

which can be inuenced by modiable

health behaviours such as unhealthy diet,

smoking, lack o physical activity, stress

and excess alcohol intake.

giding priniple for tion on

vlr helth

Recoize te ua ad ecooic ipactof vascular diseases, ad te uret eed to

act ow

ddress ealt callees across te carecotiuu (i.e. prevetio, screei,

treatet, secodary prevetio,reabilitatio ad recovery, ed-of-life care)

dopt a iterated, patiet-cetred,iterdiscipliary approac to aiizi

vascular ealt i te patiets priary care

edical oe

ollaborate across sectors (e.. eviroet,sustaiable developet, urba plai,

wor places ad educatio) as well as

professioal disciplies ad brea dow silos

Build o eisti ealt syste adcouity assets ad proras to foster

eciecy ad best practices

Be iclusive of ultiple approaces to ealt,reecti te aadia roic Disease

Prevetio ad maaeet Fraewor,

icludi:

healty public policy

Supportive eviroets (leislative, social

ad built)

healt prootio

ouity actio

Persoal sills ad self aaeet

support

healt syste desi ad delivery

Provider decisio support

ae ad support all aadias toiprove teir vascular ealt

prove patiet eperiece ad sealessaviatio trou te ealtcare syste

Be iclusive of i ris, vulerablepopulatios to esure ealt equity across

diverse cotets (urba/rural; boriial;

socio-ecooic; etocultural). ddress te

ecooic ad social deteriats wic

ipact te ris of vascular diseases. n

Wh Rvlr diee?


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4 mkng h nnn:

Wh Sthe impt of vlr diee

in nd?

Vascular diseases are the leading cause

o preventable death and disability in

Canada2. Every Canadian is directly or

indirectly afected by vascular disease

or its complications.

rik ftor

aadas ai populatio, cobied wit

alari treds i obesity, pysical iactivity,

i blood pressure ad diabetes are epected

to furter icrease te social ad ecooicipact of vascular diseases i te coi

decades, uless tere are ajor caes

i ealt policy. t is well docueted tat

ecooic ad social factors ipact all croic

diseases icludi vascular ealt. aadias

i te lowest socio-ecooic roup are ore

liely to die preaturely of circulatory disease3.

wety four illio aadias ave at least oe

ris factor for vascular disease wile 10 illio

ave tree or ore4. ve ore coceri

is te icrease i vascular ris factors ao

aadas yout, ad etically diverse

populatios.

Betwee 1994 ad 2005, rates of i blood

pressure ao aadias aed 35-49

icreased by 127 per cet, diabetes by 64 per

cet ad obesity by 20 per cet5. e

icreases i tese ris factors epose

idividuals to te alari ris of early

croic disease developet as well as

decreased quality of life i teir ostproductive years.

Five uealty beaviours uealty

diet, soi, lac of pysical activity,

ecess alcool itae ad stress - are

well-establised riss for ore ta

50 diseases6. eir ipact o te

body oras ca be wide-spread if te

vessels supplyi essetial utriets to various

parts of te body are diseased.

Vascular ris factors ad daae are ajor

cotributi factors for te 747,000 aadias

wo are livi wit coitive ipairet

icludi deetia7 as well as te 2.6 illio

wo ave idey disease or are at ris8.

more ta 1.6 illio aadias are curretly

estiated to be livi wit eart disease

or te cosequeces of stroe9. very year

alost 250,000 potetial years of life are lost

i aada due to eart disease ad stroe10.Vascular diseases aect ot oly te patiets,

but teir spouses, failies, frieds ad

couities.

the rrent vlr helth

of ndin

s easured by te Public healt ecy

of aada usi data fro te aadia

ouity healt Survey (hS), 40 per cet

of aadias ca be cosidered to be at iris of eperieci vascular diseases by virtue

of avi tree or ore odiable vascular ris

factors (Fiure )11. Fifty per cet of aadias

ca be cosidered to be at oderate ris of

vascular disease by virtue of avi 1-2 vascular

ris factors ad beaviours. s aadias ae

Twenty our million

Canadians have at

least one risk actor

or vascular disease.


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0%

10%

20%

30%

40%

50%

60%

10%

50%

40%

0

Low Risk

1-2

Moderate Risk

3 or more

High Risk

Prevalence

Figure A

Prevalence of Vascular Risk Factors

among Canadian Adults

Number of vascular risk factors

n n VSR hh 5

teir cardiovascular ealt cooly

deteriorates ad teir ris of vascular

diseases ofte icreases.

ly 10 per cet of aadias are at truly

low ris of developi vascular disease by

virtue of eibiti o vascular ris factors.

niety per cet of aadias are faci a

uacceptable ris wic could be odied

by aai tese ealt beaviours ad

factors. is illustrates te uret eed for

proress.

Studies ave sow tat te prevalece of

ve or ore ealty vascular beaviours

ad factors i a idividual is associated

wit a 88 per cet reductio i te ris of

deat due to circulatory causes12.

set of cardiovascular disease ca be delayed

by as uc as 14 years if a low ris factor

burde is aitaied at iddle ae13. ifestyle

caes ad prevetio or treatet of croic

coditios suc as ypertesio ca prevet

a estiated 54 per cet of lzeiers cases

i nort erica14. e Diabetes Prevetio

Prora deostrated a 58 per cet reductio

i icidece of diabetes trou itesive

lifestyle odicatio15. ective aaeet

of ris factors, i cobiatio or aloe, as also

bee sow to be very eective i reduci te

ris of repeated vascular evets, suc as eart

attac ad stroe, as well as deat16,17,18.

eonomi impt

Beyod te direct ua costs, vascular

diseases ave a siicat ecooic ipact.

Rouly 75 per cet of aadias aed 65 ad

over ave at least oe croic coditio. ut of

tese, oe i tree report avi tree or ore

croic coditios (alost always icludi

ypertesio). ose wit tree or ore croic

coditios tae si prescriptio edicatios

o averae, traslati to 40 per cet of

ealtcare spedi for aadias aed 65 ad

above19. is icreases te copleity i disease

aaeet ad ay ider acieveet of a

ealty quality of life. n

Seve well-establised vascular ris factors ad beaviours ow to icrease

te ris of vascular disease were icluded i te aalysis: soi, pysical

iactivity, iadequate cosuptio of veetables ad fruit, stress, beioverweit or obese, avi i blood pressure, ad avi diabetes.

Source: Public healt ecy of aada. raci heart Disease ad Stroe i

aada, 2009.


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nhelthy

behvior

ontribte

to rik

ftor

btntil

peronl

& finnil

impt

Despite overweli ipact ofvascular ealt issues it is callei toave a accurate estiate of te collectiveprevalece ad ecooic burde of vasculardiseases i aada because tere is a ap i availabledata. stiates preseted i tis iforapic caot becosidered utually eclusive ad terefore ave ot beeadded up to preset a overall picture. o avoid uder-estiatio of te true burde,copreesive data collectio ad aalysis is required. is sceatic illustrates tat 3 ealtbeaviours (pysical iactivity, poor diet, soi) are coo to developet of ris factors

(i blood pressure, i colesterol, diabetes, obesity) wic i tur lead to developet ofvascular disease across various ora systes.

prevlene nd etimted otF VSR DSSS n nD

Strokecosts

$3.6billion/

year16

Dementiacost

$15billionin 200812

Direct &indirectcosts ofcardio-

vasculardiseaseare

$21billion/

year17

$1.4billion/yearis spenton hemo-

dialysis15

High bloodpressure

costs

$4billion

/year8

Diabetes

cost

$11.7billionin 20109

Obesitycost

$4.6billion

in 200810

Physical

inactivityrelated costs

are

$6.8billion/year2

Economicburden of

poor diet

is$6.6billion/year3

$16billion/yearis spent on

smokingrelated

diseases4

1

5

11

12

12

13

14

15

6

7

1

1

1


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n n VSR hh 7

ere is treedous potetial to reduce te

burde of vascular diseases trou ealty

public policy, supporti aadias to ae

ealty lifestyle caes, ad coordiati

eorts across te cotiuu of care i a

patiet-focused aer.

Vascular ealt requires partersips for actio

across ay sectors te ealt sector caot

solve tis proble aloe. We eed to for a

uited frot aaist tis assive callee to

our society ad ecooy, ive populatio

ealt treds. Direct actio icludi advocacy

is required at all levels to acieve eaiful

ipact o vascular ealt. e call to actiobelow is a starti poit for staeolders to

coe toeter for vascular ealt.

for ll ndin

Make your health a priority. Adopt

healthy behaviours. Advocate or healthy

communities. Work with your health care

provider to modiy your vascular risk.

al to your ealt care provider aboutyour vascular ris ad tis you ca do toreduce your persoal ris

dopt ealty beaviours (ealty diet,pysical activity, bei soe-free)

Be your ow advocate. al to your ealtcare provider about ow you ca play a

active role i oitori ad aai your

overall ealt

dvocate for ealty public policies soyou ad your faily live, wor ad play i a

ealty food, pysical activity friedly ad

soe-free eviroet

for helth re prtitioner

Maximize inter-proessional collaboration

to comprehensively manage vascular

risk and prevention. Collaborate with

other sectors to advocate or and

address legislative, social and built

environment actors that impact

population health.

ae a olistic approac to croic diseaseprevetio ad aaeet for patiets

bei served trou teir edical oe

Build iterprofessioal collaboratio toprovide ore sealess ad iterated care

to iprove ealt outcoes ad patiet

eperiece

dvocate for ealty public policies soyou ad your faily live, wor ad play i a

ealty food, pysical activity friedly ad

soe-free eviroet

keep up-to-date o ad follow best carepractices

nonvlr helth

n n VSR hh 7


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for governmentCommit to sustained action on vascular

health by implementing efective public

policies and regulations that oster

healthy ood, physical activity and

smoke-ree environments. Monitor the

impact o public policies and regulations

on health, productivity and chronic

care costs.

FederAl And provinCiAl

rasitio fro volutary iitiatives adapproaces to address uealty diets

(i.e. saturated fats, trasfats, suar, sodiu

cotet of food) to ore copreesive

reulatory approaces

ae actio o areti of uealty foodsad beveraes to cildre

Develop copreesive populatio

ealt strateies tat address teiter-relatiosips betwee poverty,

socioecooic disparity ad ealt ad

assess teir ipact

pleet policies ad proras tatecourae all aadias to eae i

ealty lifestyles, tailored to te eeds,

iterests ad abilities of specic

populatios, witi teir local

cotets ad settis

i tri-level overetproras ad fudi to

iproved ealt outcoes

opreesively capture adreport o atioal ad reioal

data o vascular ris

Fud a atioal researcetwor i vascular ealt

courae policies tat supportte productio of, ad facilitate

access to foods tat cotribute

to ealty diet, ad provide

reater opportuities for utilizatio ofealty local ariculture products

crease focus o pysical activity, utritio,ad ealt educatio i scools to address

te icreasi icidece of vascular ris i

cildre ad yout. madate ealty scool

eviroets i.e. ealty diet, pysical

activity ad soe-free preises to reduce

future vascular ris

pleet policies ad oitor outcoes

of couity eviroet ad educatioproras tat support aadias to eae

i ealty beaviours

MuniCipAl

reate ifrastructure tat supports pysicalactivity ad proras tat support

couities to adopt ad aitai ealty

beaviours

act by-laws to create ealty food,pysical activity ad soe-freeeviroets tat reduce vascular ris at

te local/reioal level

Support public ad oe-basedadaptatios to facilitate pysical tess

activities for special eeds populatios

We need toorm a united

ront againstthis massive

challenge.


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for reerher nd demi

Develop approaches to address evidence

gaps on vascular health issues. Foster

knowledge mobilization across sectors

and disciplines to impact vascular

health through advocacy, programs and

best practices.

Foster collaboratio across acadeicdisciplies to ipleet updated ad

iterated curricula

pasize iteratio ad collaboratiofor vascular ealt across acadeic ad

professioal disciplies i cotiui

educatio proras

terate owlede across sectors,

disciplies ad coditios

pleet researc o ew tecoloiesor approaces tat support people to

self-aae teir ealt (i.e., persoalized

eetic/ealt iforatio; icetives

for ealty beaviour; ealt oitori

ad traci trou obile tecoloy;

tele-reab or web-based oitori ad

couseli teciques)

Build reioal ad atioal etwors for data

collectio ad researc o vascular ealt

otetualize ad traslate iteratioalbest practices i vascular ealt for te

aadia populatio

Develop iovative tools for ipleetatio(owlede to actio)

dvocate for ealty public policies tosupport a ealty food, pysical activity ad

soe-free eviroet

for not-for-profit

orgniztion

Maximize impact through joint action.

Align messaging and resources or the

public on vascular risk and chronic

disease management. Build partnerships

or action on vascular health, advocate

or healthy public policies and translate

knowledge on vascular health into

programs that improve the health

o Canadians.

ducate te public o vascular ealt issues

dvocate for ealty public policies adprora fudi to support ealty

food, pysical activity ad soe-free

eviroets

Parter wit patiets, overets, ealtsyste leaders, private eterprise ad

researc staeolders ad wit eac oter

i te traslatio ad ipleetatio of

owlede i vascular ealt

pleet proras to ecouraeaadias to eae i ealty lifestyles,

tailori suc proras to eeds ad

iterests of specic populatios ad

dieret ae roups

for the privte etor

Ensure a healthier and more

productive workorce through

implementation o healthyworkplace policies and programs.

Build intersectoral partnerships

to advocate or healthy public

policies. Partner with the health

system to support prevention and

screening. n

We need to buildpartnerships

or action on

vascular health.


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knWDgmnS

vascua dcaa W gu

Heather Arthur, PhDProfessor of nursi, mcmasteriversityief Scietic cer,hailto healt Scieces etre

Sandra E. Black, O.ONT, MDBrill air i neuroloy,Departet of medicie,Director, apbell oitiveneuroloy Researc it,iversity of orotoad Suybroo healtScieces etreecutive Director, orotoDeetia Researc lliace,iversity of orotoSite Director, Suybroo Site,heart ad Stroe Foudatioetre for Stroe Recovery

Director of Researc, BraiScieces Prora, SuybrooResearc stitute

Norm Campbell, MDProfessor of medicie,ouity healt Scieces adPysioloy ad Paracoloy,iversity of alary ad ibiardiovascular stitute of lbertahSF hR air i hypertesioPrevetio ad otrol

Hon. Mary Collins, P.C.Director, B healty ivilliace Secretariat

air, roic Disease Prevetiolliace of aada

Martin Juneau, MDDirector, Divisio of Prevetio,motreal heart stitutemedical Director, mh Prevetioad ardiac Reabilitatio eterssociate Professor,Faculty of medicieiversity of motreal

Katie Lafertyecutive Directorheart ad Stroe Foudatioetre for Stroe Recovery

Lawrence A. Leiter, MDProfessor, medicie ad nutritioalScieces, iversity of orotoDivisio of docrioloy admetabolis, St. micaels hospitalScietic Director, St. micaelshospital ardioetabolicRis itiative

Peter Lin, MDDirector of Priary are itiativesaadia heart Researc etre

Peter Liu, MDScietic Directoriversity of ttawaheart stituteDirector, ardiacFuctio aboratory

iversity of ttawaheart stituteProfessor, Faculty of medicieiversity of ttawa

Christina OCallaghanecutive Directortario Stroe networ

Blair ONeill, MDSeior medical Director,ardiovascular healt ad StroeStrateic liical networ,lberta healt ServicesProfessor, Departet of medicie,iversity of lberta

ediate Past Presidet,aadia ardiovascular Society

Glen J. Pearson, PharmDProfessor of medicie,Departet of medicie,Divisio of ardioloy,iversity of lbertao-Director of ardiacrasplatatio liicmazaowsi lbertaheart stituteiversity of lberta hospital

Duncan Stewart, MD

as Scietic Director adSeior Scietist,Reeerative medicie Prora,ad velye ad Rowell aisleyair, ttawa hospitalResearc stituteVice Presidet, Researc,e ttawa hospitalProfessor, Departet of medicieFaculty of medicie,iversity of ttawa

Jean-Claude Tardi, MDDirector, motreal heartstitute (mh) Researc etre

Professor of medicie,iversity of motrealiversity of motreal dowedResearc air i terosclerosis

Sheldon Tobe, MDssociate Professor ofneproloy ad hypertesio,iversity of orotoProfessor, norter tarioScool of mediciehSF/nSm air i boriialad Rural healt Researc

Jack V. Tu, MD, PhDSuybroo Sculic heart etrestitute for liical valuativeSciecesDepartet of medicie,iversity of oroto

Richard A. Ward, MDliical ssociate Professor,Departet of Faily medicieiversity of alarymedical Director, Priary arealary Zoe lberta healtServices

suas

Laura Maclaganpideioloiststitute for liical valuativeScieces

a

Vincent BowmanDirector, Researc, tarioheart ad Stroe Foudatio

Jane-Diane Fraserorporate ouicatiosmaaerheart ad Stroe Foudatio

Chris GraySeior maaer, goveret

Relatiosheart ad Stroe Foudatio

Mary Elizabeth HarrimanVice-Presidet, Resuscitatio,Stroe, Survivor Supportheart ad Stroe Foudatio

Ryan MofatSeior maaer ofouicatios adProfessioal mebersipsaadia Diabetes ssociatio

Beverley Powell-Vinden

maaer, missio otetheart ad Stroe Foudatio

Shadab Rana, MDSeior Specialist, missio otetheart ad Stroe Foudatio


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RFRnS

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3. healt aada its your ealt article o nutritio

abelli, SBn # h50-3/159-2004-PDF.

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wareess i te aadia healt measures Survey.

aadia Joural of Public healt. Vol 104, no 3 (2013).

Data used fro hmS 2007-2009.

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8. e aadia heart healt Stratey ad ctio Pla

2009; Ph cooic Burde of lless study 2010,

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for healt foratio. besity i aada, 2011.

ttp://www.pac-aspc.c.ca/p-ps/l-vs/oic-oac/

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ttp://www.pac-aspc.c.ca/cd-c/cvd-cv/s-fs-2011/

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of aada, 2012.

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ad Stroe i aada 2009.

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Replaceet Reister.

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are i aada, 2011. www.caadiastroeetwor.ca/

wp-cotet/uploads/2011/06/QoS-n1.pdf.

17. oferece Board of aada, 2010.

Appendix 1: The Current Vascular Health o Canadians

o deterie te curret state of te vascular ealt of aadias, oe ca easure te uber of idividuals i aada

wo ave oe or ore of seve well-establised vascular ris factors ad beaviours ow to icrease te ris of vascular

disease: soi, pysical iactivity, iadequate cosuptio of veetables ad fruit, stress, bei overweit or obese,

avi i blood pressure, ad avi diabetes.

1 Vascular health stakeholders include patients and their families, health

care professionals, health system policy and management leads,

government, private industry, non-prot organizations; community

and professional associations.

2 Statistics anada, Summary list of mortality causes, 2009. onsidering

mutually exclusive deaths under cardiovascular diseases, diabetes, renal

failure and alzheimers; nstitute for Health Metrics and valuation. Global

Burden of Diseases, njuries and Risk Factors Study, 2010. GBD Prole for

anada. http://www.healthmetricsandevaluation.org/sites/default/les/

country-proles/GBD%20ountry%20Report%20-%20anada.pdf.

3 he health ofcers council of British olumbia. Health inequities in B.

April 2013; Lee DS, hiu M, Manuel DG, et al rends in risk factors for

cardiovascular disease in anada: temporal, socio-demographic and

geographic factors. an Med Assoc J 2009;181:55-66; Saposnik G,

ote R, Phillips S, Gubitz G, Bayer , Minuk J, Black S; Stroke utcome

Research anada (SRan) Working Group. Stroke outcome in those

over 80: a multicenter cohort study across anada. Stroke. 2008; 39:

23102317.

4 Public Health Agency of anada. racking Heart Disease and Stroke

in anada. 2009; Statistics anada. able 051-0001 - stimates of

population, by age group and sex for July 1, anada, provinces and

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Footnotes


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Documents

Making the Connection - Vascular 2013