ARCHIVED- Health Research - Investing in Canada's Future 2003-2004

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Heart Disease

The Canadian Institutes of Health Research (CIHR) is the Government of Canada’s premier agency for health research.

Through CIHR, the Government of Canada is investing more than $110 million in research on heart disease across Canada.

The Facts

• Cardiovascular disease is the leading cause of death in Canada, accounting for at least 36% of all deaths (37% among women, 35% among men), or about 80,000 people each year.
• Men are more likely to develop heart disease early in life; women tend to “catch up” around menopause. Women experiencing heart disease or stroke are often under-diagnosed or managed differently than men.
• More than 450,000 Canadians were hospitalized for cardiovascular disease in 2000.
• The most common heart problems are coronary artery disease, arrhythmias, valve disorders and heart muscle disease, including congestive heart failure. It is estimated that one in four Canadians, or eight million people, has some form of heart disease, disease of the blood vessels, or is at risk for stroke.
• Cardiovascular disease is the most costly disease affecting Canadians. In 1998, it was responsible for $18.8 billion in expenditures, 11.8% of the total cost of all illness in Canada. Of this, $7 billion was in direct costs, particularly for hospital care, and $11.8 billion was in indirect costs, most of it due to premature death.

Research

Strengthening the Health Care System

Research on heart disease is providing the evidence that will save our health care system money while providing better outcomes for patients:

• Introducing reference-based pricing, a system that requires doctors to prescribe lower-cost drugs when they are available, saved the province of British Columbia nearly $15 million on drugs to treat angina pectoris, the pain of an oxygen-starved heart.
• Dual-chamber cardiac pacemakers cost $2,500 more than single-chamber devices, but are no more effective, according to research conducted by Dr. Stuart Connolly of McMaster University. More than 40% of the 10,000 pacemakers implanted each year in Canada are dual-chamber. Switching to single-chamber devices could save the health care system up to $10 million each year.

Research

Improving Health

• Dr. Luis Melo, from the University of Saskatchewan, used his CIHR support to discover a protein that is involved in regulating heart attacks. By understanding this protein better, he hopes to design a safe and efficient gene therapy strategy for protecting the heart from damage due to heart attacks. diologist fared better than those treated by
• Heart failure patients treated by a car-other physicians, according to research by CIHR-funded researcher Dr. Philip Jong of the University of Toronto. He found that cardiologists were more likely to prescribe heart failure medications when patients were discharged from hospital, resulting in a lower one-year mortality rate for their patients (28%) than for patients treated by other physicians (36%). Dr. Jong’s research indicates that physicians can improve the outcomes for their heart failure patients by using the latest evidence-based therapies.
• There may soon be a better way to flag impending heart disease than the current method of measuring blood cholesterol levels. A team of CIHR-funded Quebec researchers headed by Dr. Benoit Lamarche, from Université Laval, discovered that patients with high levels of C-reactive protein (CRP) in their blood are at increased risk of suffering from heart disease. Routine testing of CRP levels may soon be standard for middle-aged patients, particularly those already at risk for heart disease.
• Mixing alternative medicines with prescription heart drugs can have deadly consequences for cardiac patients. CIHR-funded researcher Dr. Jafna Cox, of Dalhousie University, found that about two-thirds of Nova Scotians with heart disease use at least one form of alternative therapy, leading to potentially lethal interactions with prescription drugs. For instance, the blood thinner Warfarin should not be used in conjunction with high doses of vitamin K, ephedra, ginseng, St. John’s wort or echinacea.
• Residents of Atlantic Canada have the highest rates of risk factors for heart disease and the highest risk of dying from it, according to a project that is developing an atlas of cardiovascular disease in Canada. The atlas is being assembled by a group of outstanding researchers from across Canada working under the leadership of Dr. Jack Tu, of the Institute for Clinical Evaluative Sciences in Toronto, and supported by CIHR. By identifying geographical areas across the country at high risk, they hope to encourage policy makers to develop programs to help residents avoid heart disease, such as aggressive anti-smoking campaigns.

The CIHR Institute

The CIHR’s Institute of Circulatory and Respiratory Health (ICRH), under the leadership of Scientific Director Dr. Bruce McManus, supports research into the cause, prevention, screening, diagnosis, treatment, support systems, and palliation for heart disease, as well as a wide range of other conditions associated with the lungs, brain, blood and blood vessels. The Institute’s research priorities include: the influence of sex and gender on the risk of cardiovascular and lung disease, the interaction of genes and environment in determining susceptibility to circulatory and respiratory disease, chronic disease management, palliative and end-of-life care, regenerative medicine, tobacco in relation to heart and lung diseases, inflammation and thrombosis, cellular and molecular imaging, resuscitation for sudden death in the community, the use of computational sciences and mathematics to improve our understanding of circulatory and respiratory diseases, and infectious causes of circulatory and respiratory health.

The Partners

CIHR recognizes the unique role of, and works closely with, all partners in the research process. CIHR’s ICRH has developed a major strategic partnership with the Heart and Stroke Foundation to address priority areas relating to heart disease and stroke. This first partnership agreement signed between ICRH and a voluntary organization is a catalyst for new and innovative initiatives in cardiovascular research, including in the areas of training and knowledge translation. ICRH also works closely with the Canadian Stroke Network. An international partnership that has been established with the National Heart, Lung and Blood Institute of the National Institutes of Health in the United States is bringing great value to Canadian science and to those affected by cardiovascular diseases.

The People

Maxine Yukic has seen something few of us ever will – her own heart. In August 2001, still in her twenties, Ms. Yukic had a heart transplant. And while her new heart is beating in her chest, her old heart is being analyzed by researchers at the University of British Columbia.

The transplant surgery was the end of a long road that started in early 1996, when Ms. Yukic was diagnosed with an undisclosed heart virus. She had a pacemaker implanted in January 1997, and went home thinking all was well. But in 1999, she started to feel sick again and, in January 2001, suffered cardiac arrest. Luckily, finding a donor heart didn’t take long and, in August 2001, Ms. Yukic had a heart transplant.

“It was a really long, painful thing to go through,” she remembers.

Now, researchers at UBC’s iCAPTURE4E Centre, co-directed by ICRH Scientific Director Dr. Bruce McManus, are analyzing her heart to find out what went wrong.

After her surgery, Ms. Yukic was given a tour of the Centre – and came face to face with her own heart.

“I was standing in front of my diseased heart,” she says, “with my new heart beating inside of me. It was really weird to connect the two together.” Ms. Yukic says her old heart looked “rather sick,” but is pleased that it could contribute to helping others.

“If researchers can figure out what happened to my heart and prevent it from happening again,” she says, “that’s definitely worth it. Their work will save other people from going through my experience.”

About the Canadian Institutes of Health Research

The Canadian Institutes of Health Research is the Government of Canada’s premier agency for health research. Its objective is to excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system.

For more information, visit: www.cihr-irsc.gc.ca.