Where you live in Ontario could determine your risk of a heart attack, study finds
From thestar.com
Nijaz Hodzic, 55, discovered he was close to having a heart attack about a week ago.
After experiencing chest pain in the middle of February, and delaying a trip to the doctor for a few weeks, he was advised to undergo more tests. Hodzic, who lives in Toronto, ended up in the office of Dr. Jack Tu, a senior scientist at the Institute for Clinical Evaluative Sciences and Sunnybrook’s Schulich Heart Centre, who discovered Hodzic’s right coronary artery was almost completely blocked.
“It was almost non-functional,” Hodzic said. “Another 5 per cent and that would be a very bad heart attack, they told me.”
Where one lives in Ontario could determine one’s risk of a heart attack or stroke, or dying of cardiovascular disease, according to a new study conducted by the Cardiovascular Health in Ambulatory Care Research Team. Researchers examined data for 5.5 million adults with no previous cardiovascular disease in Ontario between 40 and 79 years of age as of Jan. 1, 2008. They looked for heart attacks, strokes or cardiovascular-related deaths over five years.
Hodzic’s blockage was removed on March 27 and he is now home, recovering.
“Everything happened very fast and everything was very organized,” he said. “I didn’t do anything.”
Hodzic avoided a major cardiac event, which the study defines as “hospital admission due to myocardial infarction or stroke, or cardiovascular-related death,” but had he lived somewhere else with less access to basic and advanced preventative health care, his story might have ended differently.
“Our data suggests both basic and advanced preventative care contribute to the lower rates of cardiac events seen in the Toronto area,” Tu said.
Those who lived in parts of Ontario with better access to preventative health care had lower rates of cardiac events compared to residents of regions with less access, according to the study, published in the Canadian Medical Association Journal.
Preventative health care includes “having cholesterol levels checked, being checked for diabetes, being checked for high blood pressure and then, assuming you are diagnosed with having these risk factors, getting optimal management of those risk factors,” said Tu, lead author of the study.
“We’ve known for many years that there are geographical variations in cardiovascular mortality in Ontario but it was uncertain what was causing it,” Tu said. “It’s important to understand that health-care factors across the province are contributing to regional disparities.”
According to the study, 74.5 per cent of the regional variation could be accounted for in some way, and 15.5 per cent of that variation was found to be the result of “health system factors.”
Ontario’s 14 Local Health Integration Networks were examined and organized into three categories: regions with a low number of cardiovascular events (3.2–3.5 events per 1,000 person-years), a medium number (3.9–4.7 events per 1,000 person-years) and a high number (4.8–5.7 events per 1,000 person-years).
The regions with the lowest number of cardiac events included Toronto Central and Mississauga Halton, while the highest event rates were found in northern Ontario, the North Simcoe Muskoka region, and the Erie St. Clair region.
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