Cardiovascular Disease

Sex and Gender-based Analysis of this topic

Definition
Cardiovascular disease (CVD) includes conditions that affect the heart or blood vessels, including arteriosclerosis, coronary artery disease, arrhythmia, heart failure, hypertension (high blood pressure), and cerebrovascular heart disease (stroke), to name a few. According to Statistics Canada data for 2002, CVD accounted for over 74,000 Canadian deaths; 32% of male deaths and 34% of female deaths[1]. Women’s mortality rates are expected to continue rising with the aging population.
 
 
Sex Issues
CVD represents the greatest cause of mortality for Canadian women. More women die from congestive heart failure and cerebrovascular disease, whereas more men die from ischemic heart disease and myocardial infarction[2]. Furthermore, high blood pressure, a major risk factor for cardiovascular insult is a particularly important indicator for women’s health, as women report having higher rates of high blood pressure than men[3]. 
 
 
Gender Issues
According to the Heart & Stroke Foundation’s 2007 Annual report, men’s and women’s rates for the number of deaths from heart disease and stroke are roughly equal, which is the first time rates have been the same in 30 years[4]. Diagnoses of heart disease are more often delayed and/or missed in women. As well, women are less likely to receive treatment or preventative counseling compared to men, less likely to be treated by a specialist, less likely to be transferred to another facility for treatment, and have higher in-hospital mortality rates following a heart attack.
 
 
Diversity
Women belonging to ethnically diverse populations may be at a greater risk for developing CVD due to barriers of accessing preventative health care. For example, CVD is 1.5 times higher among First Nations and Inuit Populations[5]. For both men and women, CVD rates are higher for individuals with less post secondary education[6]. This may be a key factor to further explore as women with less post secondary education are at greater social and economic disadvantages compared to their male counterparts. Furthermore, women with low income often report more risk factors, such as smoking, physical inactivity, and/or being overweight, as well as decreased access to proper nutrition[7]. These risk factors are especially problematic for women who also have limited social support, such as lone mothers.
 
 
Critique
Surveillance of CVD limited is in Canada, with most data coming from physician billing, hospitalization, and mortality data. Currently there is a lack of physical and biochemical measures of cardiovascular risk and self-report data may be inherently biased with only individuals who have been diagnosed by a physician reporting CVD who may not recognize the signs of CVD in women. Many provinces have not repeated the Heart Health Surveys, which makes comparing provincial data out of date and difficult. Furthermore, more research is needed to understand gender-specific risk factors that may contribute to cardiovascular disease, such as depression, physical inactivity, smoking, education, and low income.
 
 
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