- + Key points: Stroke
• Circulatory diseases cause more than 15,000 deaths and 150,000 hospitalisations of NSW residents in each year. Coronary heart disease and atrial fibrillation and flutter contribute the most to these diseases' hospitalisation burden, followed by heart failure and strokes.
• Death rates, and numbers of deaths, from circulatory disease are consistently higher in males than in females. Death rates are higher in Inner regional, Outer regional and Remote areas of NSW than in Major cities.
• Death rates from all forms of circulatory disease have more than halved in the last twenty years after adjusting for population ageing. This is due to both:
• decreased incidence, associated with reductions in some risk factors, including smoking, saturated fats in the diet, and levels of blood pressure;
• increased survival, as a result of improvements in medical and surgical treatment and follow-up care.
• Coronary heart disease caused 6,527 deaths in 2013. Coronary heart disease was the principal reason for more than 47,000 hospitalisations in NSW in 2014-15.
• Stroke caused just over 2,871 deaths in NSW in 2013. Stroke was the principal reason for more than 12,000 hospitalisations in NSW in 2014-15.
• Heart failure was the underlying cause of 1,083 deaths in NSW in 2013 and was a contributing cause in many more. Heart failure was the principal reason for over 17,000 hospitalisations in NSW in 2014-15.
• In the treatment of coronary heart disease, the number of percutaneous transluminal angioplasty (PCTA) procedures (with and without stents) first exceeded the number of the more invasive coronary artery bypass graft (CABG) procedures in 2000-01. More than 13,000 PCTAs were performed in 2014-15, more than three times as many as CABGs at around 4,000 procedures.
- + Background: Stroke
Cardiovascular (or circulatory) diseases comprise all diseases of the heart and blood vessels. Among these diseases, the four types responsible for the most deaths in NSW are: coronary heart disease (or ischaemic heart disease), stroke (or cerebrovascular disease), heart failure, and peripheral vascular disease. Other causes of death are cardiac arrhythmias (most notably atrial fibrillation), heart valve disorders, non-ischaemic cardiomyopathies, pulmonary embolism, and hypertensive renal and heart disease. Significant causes of morbidity include hypertension, deep vein thrombosis, haemorrhoids and varicose veins.
Burden of disease
Cardiovascular diseases accounted for 18% of the total disease burden in Australia in 2003, second only to cancers. Almost 80% of this burden was due to mortality. Ischaemic heart disease accounted for 56% of the total burden and stroke for one-quarter of the total burden of cardiovascular disease (Begg et al. 2007)
Presently, cardiovascular diseases account for around 48,000 deaths in Australia (around 33-34% of all deaths), more than any other group of diseases. This proportion has been in decline since 1970, when nationally cardiovascular diseases were responsible for over half of all deaths.
The four major causes of death from cardiovascular disease share a number of behavioural risk factors (tobacco smoking, physical inactivity, poor diet, risky alcohol consumption) leading to physiological risk factors (high blood pressure, elevated blood lipids, diabetes mellitus, and overweight or obesity).
Begg S, Vos T, Barker B. The burden of disease and injury in Australia, 2003. Cat. no. PHE 82 edition. Canberra: AIHW, 2007. http://www.aihw.gov.au/publication-detail/?id=6442467990
- + Interventions: Stroke
Circulatory diseases share many modifiable risk factors with other lifestyle-related chronic diseases such as type 2 diabetes. These include smoking, physical inactivity, poor diet, harmful alcohol consumption and being overweight. This means that strategies related to the prevention, early detection and optimal management of these risk factors will lead to better health outcomes for people with circulatory diseases and other lifestyle-related chronic diseases.
Information on NSW Health programs and policies is available at http://www.health.nsw.gov.au/healthyliving/Pages/default.aspx.