Public health

1 in 5 Australians at high risk of a cardiovascular event

New government data released this week has prompted concern at the rate of cardiovascular related deaths in younger people.

Ischaemic heart disease continues to be the leading cause of death and disability followed by cerebrovascular disease, according to the latest data from the Australian Institute of Health and Welfare (AIHW).

While massive gains in CVD treatment and prevention over the last three decades has seen death rates on a steady decline among older Australians those gains look to be stalling among younger age groups where the decline in death rates has slowed.

Declines in the coronary heart disease (CHD) death rate among 35-54 year olds has dropped from 7.2% each year between 1980 and 1993 to just 3.1% each year in the years up to 2015.

And for those aged 55–64, the fall in cerebrovascular disease deaths has slowed from an average of 6.0% each year between 1980 and 2005 to an average of just 2.2% in the years up to 2015.

Researchers say the toxic combination of obesity and diabetes and its increasing prevalence in younger people has contributed to the dramatic slow down.

Meanwhile poor nutrition, high levels of blood pressure and cholesterol, physical inactivity, overweight, and tobacco use are also on the rise with the report highlighting that a staggering 95% of Australian adults still have at least one modifiable risk factor while two thirds have three or more risk factors at the same time.

According to the report an estimated:

  • 34% of adults had high blood pressure, a slight rise from 32% in 2011–12 (including those with uncontrolled high blood pressure, and whose blood pressure was controlled by medication)
  • 63% of adults were overweight or obese, a rise from 56% in 1995
  • 15% of adults still smoked daily, although prevalence has declined
  • 45% of those aged 18–64 did not participate in sufficient physical activity in the previous week
  • 2 million people (5.1% of the total population) had diabetes

Based on those figures about one in five Australians aged 45–74 (or 1.4 million people) are estimated to have a high absolute risk of a future cardiovascular event.

But around 67% (or 970,000) of those people were not receiving recommended therapies to control their levels of blood pressure and cholesterol, the report noted.

Reducing these levels in young and middle-aged adults would halt the slowing of the decline in cardiovascular disease death, the report added.

The good news:

The report also said that, despite the magnitude of the current CVD burden, deaths from both CHD and stroke have declined substantially in Australia over the past 30 years.

In 2015 CVD was responsible for 29% of all deaths down from 55% (about 60,000 a year) in the late 1960s and early 1970s.

These falls are the results of a combination of improvements in preventing and detecting the disease, as well as clinical management of people who have it, the report stated.

If the CVD death rate had remained at its 1968 peak, there would have been close to 200,000 deaths from CVD alone in 2015—more than the total number of deaths from all causes that year, according to the report.

Meanwhile falls in CVD death rates continue to improve for Australians aged 75 years and older.

Rates of decline in CHD death rates has improved since 1980 from 0.5% annually to 4.9% for those aged 85 and over, and from 2.2% to 6.3% for those aged 75–84 while cerebrovascular disease death rates has remained steady since 1980 dropping from 4.4% to 4.8% among people aged over 75 years.

The trade-off:

While the death rate from CVD continues to fall especially among older Australians, rates from other diseases such as dementia are on the rise.

Dementia might soon overtake coronary heart disease as the single leading cause of death in Australia, the report added.

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