IEPN123 Introduction to Nursing in Ontario

Introduction

The number one killer in Canada is heart disease or cardiovascular disease. It is still the costliest illness in Canada and the national healthcare system has the biggest burden. Powerful risk factors include medical disorders including such hypertension, high cholesterol in the blood, diabetes and obesity (Smith, et al., 2018). Men usually develop heart disease more often. More and more women are under diagnosed with cardiovascular disease. The risk of heart attack rises with age for all genders. In Canada, cardiovascular disease, which represents almost 20% of all deaths in 2012, is the second most common cause of death after cancer. Heart disease also known as ischemic heart disease or pulmonary disease leads to plaque build-up in the heart arteries that may result in heart attack, stroke and cardiovascular insufficiency. Heart disorders are Canada and other developing countries' most prevalent heart diseases and responsible for nearly half of all deaths associated with cardiovascular disease.

This report will discuss the health care issues of Canada and along with that, it will also discuss about current epidemiological evidences of rates of heart disease. This report will also discuss the where the rates of heart disease are higher in Canada and which population group suffers the most. This report will also highlight the evidence about the trends for heart disease in Canada and along with that, it will also discuss the community-based strategies that are used to address this health issue. This report will also compare the rates of heart disease in Canada and USA and along with that; it will discuss the impact of heart disease in Canada.

Current Epidemiological Evidences Of Rates Of Heart Disease

In 2012–2013, about 2.4 million Canadians, or 1 in 12, had a myocardial infarction at the age of 20 or older, of is achemical heart disease. Additional Canadians who are around 40 years and more were diagnosed with heart disease and this ratio is around 669,600 (3.6 percent).

With time, the outcomes of heart disease improve. Age-standardized cardiac and heart failure and death rates decreased, though both factors remain relative stability, from 2000–2001 to 2012–2013. Incidence rates have decreased by 45% and by 35%, and death rates for all causes have decreased by 24 and 26% (Einarson, et al., 2018). A similar trend for acute myocardial infarction has been found, but this occurred over the sample period increased by approximately 67%.

Today for people who have heart disease, mortality rates for some reason are higher than without. Canadian ischemic-hearted adults (IHDs) were three times higher than someone without the disease in a given year than those without the disease (Bai, et al., 2018). The result has been less positive for younger males and females between the ages of 20 and 39, who are 18 and 11 times more likely to suffer from any cause than people of the same age without IHD.

The main cause of death is heart disease worldwide.  Approximate 8.9 million deaths in 2015 and the reason is heart disease, accounting for 45% of the world's deaths from non-communicable diseases (Dietrich, et al., 2017). In comparison, the main cause of Disability - adjusted life destroyed due to poor health, injury and early mortality throughout the world is heart disease. In Canada the second most common cause of death after cancer and a major cause of hospitalization is the heart attack, despite significant changes in prevention, control of illness and public health initiatives over the past couple of decades. In 2015, coronary failure in Canada is the first cause of life loss as a result of premature death and the second most common cause in 2015 of DALYs.

Where In Canada Rates For Heart Disease Are High (In Terms Of Population Groups)

The top regions of Canada are Nunavut and Quebec, with 'A' scores on coronary disease and stroke mortality Although Nunavut rankings are puzzling, cardiac and stroke risk factors are high.

The rate of ischemic heart disease diagnosed rises with age and is greater in all age ranges among males than females. The heart failure and acute myocardial infarction show similar patterns. For example, acute myocardial infarction incidence and prevalence in men 25 to 44 years old is around four times higher than the average relative to women in the same age range (Wijeratne, et al., 2018). However, the frequency and occurrence disparity are decreased as women and men are older than 65 years. Indeed, in 2012-2013 there were about double the number of recently diagnosed coronary heart disease women aged 85 years and older relative to men of the same generation. Since women live longer than men, a cardiac disease is more likely to be found in their old age.

Epidemiological Evidences About Trends For Heart Disease In Canada(10-15yrs)

Many reports have addressed the burden on healthcare systems of coronary heart disease mortality as well as coronary heart disease death, a substitute sudden heart death out from the hospital. These tests have shown that the incidence of sudden cardiac death has decreased significantly. However, the burden and habits of coronary heart disease mortality outside healthcare and without advance diagnosis of coronary heart disease remain little understood (Do Minh, Vicky & Mendez, 2017). A new research showed that patients without established coronary diseases with first myocardial infarction had small changes over time in risk factor profiles. Documents of the occurrence of Cardiovascular death without even a previous Diagnosis of CHD are helpful because ventricular arrhythmias constitute life threatening consequences of sudden cardiac death that are fairly common in individuals without even a history of CHD15.

There have been no current reports on a wide-ranging spectrum of coronary, cardiovascular and mental disorders in Canada. Researchers followed the Canadian Institute for Health Information Abstract Database for people up to 105 years of age in more than 2,6 million hospital reports from 2007-2016 (Michalski, et al., 2018). The records were reviewed for diseases aligned with six priority areas of Canada's Heart and Stroke Foundation. There are the six diseases grouped together that are of significant concern to human wellbeing, the economy and society: vascular conditions and coronary artery; insufficiency of heart; disturbances of heart function; systemic heart problems which includes congenital heart disease and inherited heart valve disease, paralysis and cognitive vascular deficiency. Every province and territory with the exception of Quebec have been provided with data.

In 2007 to 2016 Canada's standard rates of hospital admission reduced with comparatively minor declines in stroke and cardiac damage for coronary artery and vascular diseases 27.4 percent and atrial fibrillation conditions 16.8 percent (Stephenson, et al., 2017). Increased outpatient care like advanced community hospitals for cardiac failures and vascular disease and protection of stroke; treatment enhancements and cuts in some clinical risks including hypertension and blood sugar; and improved control of lifestyle illnesses such as heart disease, low diet and physical inaccuracy Factors have also been included.

Comparison Of Rates Heart Disease In Canada And Usa

Heart diseases the most common problem of health that people are facing worldwide in the system of healthcare. The whole North American continent consists of development in the economics, susceptibility to genetics, practices in cultures and various trends present in the risk factors and the treatments that contributes to the differences in the continent and inter-continent. Canadian ASCEND-HF patients were elderly, more likely than U.S. patients with lower weights and blood pressure (Smith-Bindman, et al., 2019). The baseline-adjusted chances of 30-day death and improved quality of life for Canadians is smaller than the U.S. patients. Test patients in both countries varied greatly from cohorts at population level. Unadjusted in hospital fatalities at community level is considerably smaller in the U.S. (3.4%) than in Canada (11.1%) (P<.01%), in comparison to ASCEND-HF. Heart disease is the primary cause of mortality in the United States for men, women and the majority of racial and ethnic populations. In the United States, one person dies of heart disease every 36 seconds. Every year, almost 655,000 Americans die, one in four deaths. The U.S. spends about 219 billion dollars annually from 2014 to 2015 for heart disease. This covers the costs of health insurance, drugs and death-related loss of productivity (Lopez & Adair, 2019). North America has difference in the etiology and demographics of each country exists due to which the economic burden of the heart failure continues to be growing large on a global scale.

Community Based Strategies To Address This Health Issue

In late February 2009, the Canadian Heart Health Policy and Action Plan, assisted by The Honourable Dr David Butler-Jones, Chief Public Health Officer and Leona Aglukkaq, Minister of Health of Canada, were issued to the public (Schwalm, et al., 2019). That culminated in a committed community of two and a half years working on all facets of cardiovascular health – starting with public policies that are necessary for building healthier communities through preventive, acute and chronical treatment, recovery and preparation at the end. The implementation of the plan involved taking into account the demands for knowledge, research and, in particular, the needs of our indigenous and aboriginal communities.

This approach covered both the vascular disorders – cerebrovascular, CV, peripheral – as well as other categories of cardiovascular disease, including incurable malformations, cardiomyopathy and arrhythmia. From the very beginning, it has been understood that intervention in the health sector is maybe the major opportunity for meaningful effects. This is the primary explanation for atherosclerosis that induces about 70% to 85% cardiovascular disease burden, a significant proportion of stroke, and most artery diseases in the periphery (Jull, Giles & Graham, 2017). There is accumulated evidence that most of the effect of this disorder will also be avoided if the community and the entire medical system are treated early. The Guiding Members of the committee were also committed to adopting and integrating the suggestions, in compliance with the Canada Health Act and the expertise of the jurisdiction. The Executive Board also agreed that an all-government and community solution would be required to adequately deal with the challenge of the chronic condition, as demonstrated by CV disease. This is, for the health sector, not just an issue (Jull, Giles & Graham, 2017).

Impact Of Heart Disease On Health Care Of Canada (Direct And Indirect Impact)

Canada has faced around 74,255 deaths which is 33% of the total deaths that occurred in the year 2003 due to cardiovascular problems. The cardiovascular diseases are among the costliest diseases of all time due to which there is a threat on the economy of Canada that falls in the category of healthcare systems (Malla, et al., 2018). The direct impact is on the economy of the nation which has been due to a major percentage of deaths from a single source. The indirect cost that affects the economy of the nation is the cost that is used in taking care of the patient (Marra, et al., 2017). This does not affect the family directly but in small fractions that cumulatively affects the economy indirectly. These effects are not noticed by people on a small scale but on a wider scale the number increases collectively.

Conclusion

From the above this can be concluded that heart disease rate in Canada is much higher than the extent and the Canadian government has deployed several acts and policies to reduce the effect of this heart disease. The number one killer in Canada is heart disease or cardiovascular disease. It is still the costliest illness in Canada and the national healthcare system has the biggest burden. Powerful risk factors include medical disorders including such hypertension, high cholesterol in the blood, diabetes and obesity. Today for people who have heart disease, mortality rates for some reason are higher than without. Canadian ischemic-hearted adults (IHDs) were three times higher than someone without the disease in a given year than those without the disease. The rate of ischemic heart disease diagnosed rises with age and is greater in all age ranges among males than females. The heart failure and acute myocardial infarction show similar patterns. For example, acute myocardial infarction incidence and prevalence in men 25 to 44 years old is around four times higher than the average relative to women in the same age range. The top regions of Canada are Nunavut and Quebec, with 'A' scores on coronary disease and stroke mortality Although Nunavut rankings are puzzling, cardiac and stroke risk factors are high.

References

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Dietrich, T., Webb, I., Stenhouse, L., Pattni, A., Ready, D., Wanyonyi, K. L., ... & Gallagher, J. E. (2017). Evidence summary: the relationship between oral and cardiovascular disease. British Dental Journal, 222(5), 381-385.

Do Minh, T., Chang Vicky, C., & Mendez Michelle, A. (2017). Urinary bisphenol A and obesity in adults: results from the Canadian Health Measures Survey. Health promotion and chronic disease prevention in Canada: research, policy and practice, 37(12), 403.

Einarson, T. R., Acs, A., Ludwig, C., & Panton, U. H. (2018). Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017. Cardiovascular diabetology, 17(1), 1-19.

Jull, J., Giles, A., & Graham, I. D. (2017). Community-based participatory research and integrated knowledge translation: advancing the co-creation of knowledge. Implementation Science, 12(1), 1-9.

Lopez, A. D., & Adair, T. (2019). Is the long-term decline in cardiovascular-disease mortality in high-income countries over? Evidence from national vital statistics. International journal of epidemiology, 48(6), 1815-1823.

Malla, A., Shah, J., Iyer, S., Boksa, P., Joober, R., Andersson, N., ... & Fuhrer, R. (2018). Youth mental health should be a top priority for health care in Canada. The Canadian Journal of Psychiatry, 63(4), 216-222.

Marra, C., Johnston, K., Santschi, V., & Tsuyuki, R. T. (2017). Cost-effectiveness of pharmacist care for managing hypertension in Canada. Canadian Pharmacists Journal/Revue des Pharmaciens du Canada, 150(3), 184-197.

Michalski, J. M., Moughan, J., Purdy, J., Bosch, W., Bruner, D. W., Bahary, J. P., ... & Sandler, H. (2018). Effect of standard vs dose-escalated radiation therapy for patients with intermediate-risk prostate cancer: the NRG oncology RTOG 0126 randomized clinical trial. JAMA oncology, 4(6), e180039-e180039.

Schwalm, J. D., McCready, T., Lopez-Jaramillo, P., Yusoff, K., Attaran, A., Lamelas, P., ... & Yusuf, S. (2019). A community-based comprehensive intervention to reduce cardiovascular risk in hypertension (HOPE 4): a cluster-randomised controlled trial. The Lancet, 394(10205), 1231-1242.

Smith, P., Ma, H., Glazier, R. H., Gilbert-Ouimet, M., & Mustard, C. (2018). The relationship between occupational standing and sitting and incident heart disease over a 12-year period in Ontario, Canada. American journal of epidemiology, 187(1), 27-33.

Smith-Bindman, R., Kwan, M. L., Marlow, E. C., Theis, M. K., Bolch, W., Cheng, S. Y., ... & Miglioretti, D. L. (2019). Trends in use of medical imaging in US health care systems and in Ontario, Canada, 2000-2016. Jama, 322(9), 843-856.

Stephenson, A. L., Sykes, J., Stanojevic, S., Quon, B. S., Marshall, B. C., Petren, K., ... & Goss, C. H. (2017). Survival comparison of patients with cystic fibrosis in Canada and the United States: a population-based cohort study. Annals of internal medicine, 166(8), 537-546.

Wijeratne, D. T., Lajkosz, K., Brogly, S. B., Lougheed, M. D., Jiang, L., Housin, A., ... & Archer, S. L. (2018). Increasing incidence and prevalence of World Health Organization groups 1 to 4 pulmonary hypertension: a population-based cohort study in Ontario, Canada. Circulation: Cardiovascular Quality and Outcomes, 11(2), e003973.

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