Where you live in Ontario could determine your risk of cardiovascular disease
Researchers find a striking variation in the rates of heart attack, stroke and cardiovascular-related death
Where you live in Ontario has a lot to do with how likely you are to receive preventative health care and whether you will suffer a heart attack, stroke or die of cardiovascular disease according to a new study from Institute for Clinical Evaluative Sciences (ICES) and Sunnybrook Health Sciences Centre.
In the study, published today in CMAJ, the researchers looked at 5.5 million adults from 40 to 79 years of age as of January 1, 2008 in Ontario with no previous cardiovascular disease and followed them for five years looking for heart attacks, strokes or cardiovascular-related deaths.
“What we found was a striking variation in the rates of heart attack, stroke or cardiovascular-related death depending on which LHIN a person lived in. There was a clear division between the healthiest and least-healthy LHINs,” says Dr. Jack Tu, the study’s lead author, cardiologist at Sunnybrook and senior scientist at ICES and Sunnybrook.
People in the three healthiest LHINs, all located in the Greater Toronto Area (Mississauga Halton LHIN, Toronto Central LHIN and Central LHIN ), had the highest average number of family doctor visits, were also more likely to receive an annual physical and be screened for cardiac risk factors such as high cholesterol and diabetes. Blood pressure control in patients with hypertension and statin use (to lower cholesterol levels) among people with diabetes was also higher among those living in the healthiest LHINs. The researchers also found the healthiest LHINs had a relatively high proportion of ethnic minority residents and recent immigrants.
The four least-healthy LHINs were those located in Northern Ontario (North East LHIN and North West LHIN), as well as the North Simcoe Muskoka LHIN and Erie St. Clair LHIN. People in these LHINs were more likely to be obese, smoke and have the lowest dietary intake of fruits and vegetables. People in the highest cardiac event LHINs were also less likely to receive preventative screening tests, have an annual physical and visited a family doctor less frequently.
“Our study shows that the differences in patient and health system factors accounted for nearly 75 per cent of the variation in cardiovascular events between LHINs, suggesting that greater preventative health care contributes to lower cardiovascular event rates,” adds Tu.