CHD burden can be attributed to several risk factors. In 2015, dietary risk factors were responsible for the most CHD burden (62%), followed by high blood pressure (43%), high cholesterol (37%), overweight and obesity (25%), tobacco use (14%) and physical inactivity (12%). It is important to note that these risk factors overlap and, as a result, the associated risk does not sum to 100%.
Between 2003 and 2015, the overall burden from CHD reduced by 43%, with a 45% drop in the fatal burden of CHD. The non-fatal burden also fell, by 33% (AIHW 2019a).
Expenditure
In 2015–16, the estimated expenditure on CHD was more than $2.2 billion. The greatest cost was due to private hospital services and public hospital admitted patient services ($813 million and $693 million respectively). The estimated Pharmaceutical Benefits Scheme (PBS) expenditure related to CHD was around $218 million (AIHW 2019b).
See Health expenditure.
Medicines
In 2017–18, 94.5 million PBS and Repatriation Pharmaceutical Benefits Scheme prescriptions for cardiovascular medicines were dispensed to the Australian community—31% of the total prescription medicines dispensed.
Almost three-quarters (73%) of the estimated 4 million Australians who reported having a cardiovascular condition in 2017–18 had used a cardiovascular system medicine in the previous fortnight (ABS 2019a).
See Medicines in the health system.
Hospitalisations
In 2017–18, CHD was the principal diagnosis in about 161,800 hospitalisations (1.4% of all hospitalisations). Of these, 36% were for heart attack (57,400) and 24% for angina (38,900). Most admissions for heart attack (79%) and angina (66%) were emergency admissions (AIHW 2019c).
Between 2000–01 and 2017–18, the age-standardised rate of hospitalisations where CHD was the principal diagnosis declined by 33%, from 833 to 557 hospitalisations per 100,000 population. The decline in hospitalisations over this period was greater among females than among males (39% and 31% respectively). CHD was the leading cause of hospitalisation for cardiovascular disease in 2017–18 (28% of all hospitalisations with a principal diagnosis of cardiovascular disease).
Of all CHD hospitalisations (principal and/or additional diagnoses), 58% had a coronary angiography (a diagnostic procedure) and 29% underwent revascularisation (surgical procedures to restore blood supply to the heart) (AIHW 2019c).
See Hospital care.
Primary care
Regular and timely contact with primary health care providers, such as GPs and cardiologists, can contribute to better outcomes for those with CHD.
An analysis of administrative data from 2012 to 2015 demonstrated that, following a hospital admission for CHD, follow-up care with a primary health care provider reduced the risk of a cardiovascular disease (CVD) related emergency readmission by 5%–11%, or CVD-related death by 4%–6%, when compared with those who did not have contact with primary health care services. Further, regular contact with primary health care services was associated with lower risk of readmission or death when compared with those with more sporadic contact (AIHW 2018).
See Primary health care.
The impact of CHD varies between population groups. Rates of CHD hospitalisation were 1.5 times as high in Remote and very remote areas as in Major cities, and 1.3 times as high in the lowest socioeconomic areas compared with the highest (Figure 3). The rate of hospitalisations and deaths due to CHD were around twice as high among Aboriginal and Torres Strait Islander people as among non-Indigenous Australians.