Cardiovascular disease

All cardiovascular disease

An estimated 1.2 million (5.6%) Australian adults aged 18 years and over had 1 or more conditions related to heart or vascular disease, including stroke, in 2017–18, based on self-reported data from the Australian Bureau of Statistics (ABS) 2017–18 National Health Survey.

Information based on self-reported data relies on survey participants being aware of and accurately reporting their health conditions. Estimates based on self-reported data are not likely to be as accurate as data based on clinical records or measurements. Note the ABS definition of heart, stroke and vascular disease for the National Health Survey refers to persons who reported having been told by a doctor or nurse that they had any of a range of circulatory conditions comprising: angina, heart attack and other ischaemic heart diseases; stroke and other cerebrovascular diseases; oedema; heart failure; and diseases of the arteries, arterioles and capillaries.

Age and sex

In 2017–18, the prevalence of heart, stroke and vascular disease among adults (based on self-reported data):

• was higher among men (6.5%) than women (4.8%).
• increased with age—more than 1 in 4 (26%) of those aged 75 and over had heart, stroke and vascular disease (Figure 1).

Figure 1: Prevalence of self-reported heart, stroke and vascular disease, among persons aged 18 and over, by age group and sex, 2017–18

Variations between population groups

In 2017–18, the prevalence of heart, stroke and vascular disease (based on self-reported data) among adults did not vary significantly by remoteness area. However, the percentage of people who reported having heart, stroke and vascular disease was significantly higher among those living in the most socioeconomically disadvantaged areas compared with those in the least disadvantaged areas (6.4% and 4.8%, respectively) (Figure 2).

Figure 2: Prevalence of self-reported heart, stroke and vascular disease, among persons aged 18 and over, by sex, remoteness and socioeconomic area, 2017–18

Aboriginal and Torres Strait Islander people

An estimated 42,700 (5.2%) Aboriginal and Torres Strait Islander people had heart, stroke and vascular disease, based on self-reported data from the ABS 2018–19 Australian Aboriginal and Torres Strait Islander Health Survey (ABS 2019b).

After adjusting for age, the prevalence of heart, stroke and vascular disease was higher among Indigenous males compared with Indigenous females (9.4% and 7.6%, respectively). Indigenous Australians were more likely to report having heart, stroke and vascular disease than their non-Indigenous counterparts (4.7% and 3.5%, respectively).

Coronary heart disease

An estimated 580,300 Australians aged 18 and over (2.8% of the adult population) had coronary heart disease (CHD) at some time in their lives, based on self-reported data from the ABS 2017–18 National Health Survey. Of those with CHD, 227,300 had experienced angina while 430,000 had a heart attack or another form of CHD (a person may report more than 1 disease).

Prevalence of CHD:

• was around twice as high among men (3.8%) as women (1.9%).
• increased rapidly with age—around 12 times as high in people aged 75 and over as in those aged 45–54 (13.9% and 1.1%, respectively).

In 2017, an estimated 59,100 people aged 25 and over had an acute coronary event in the form of a heart attack or unstable angina—around 162 events every day, based on hospitalisations and mortality data. Rates of acute coronary events:

• were more than twice as high in men than women (433 and 199 per 100,000 population, respectively)
• declined by 42% between 2007 and 2017 (from 533 to 311 events per 100,000) (Figure 3)
• were 2.6 times as high among Indigenous Australians compared with non-Indigenous Australians (811 and 303 per 100,000, respectively).

Figure 3: Trends in acute coronary events, among persons aged 25 and over, by sex, 2007 to 2017

Stroke

In 2018, around 386,900 Australians (1.3% of the population) had experienced a stroke at some time in their lives, based on self-reported data from the ABS 2018 Survey of Disability, Ageing and Carers.

Prevalence of stroke was:

• higher in males than females (1.6% and 1.1% respectively).
• more common in older age groups—over 2 in 3 (71%) people who had a stroke were aged 65 and over. Proportions were highest for those aged 85 and over—almost 3 times as high as for those aged 65–74 (14% and 4.6%, respectively).

In 2017, there were an estimated 38,100 stroke events in Australia—more than 100 every day, based on hospital and mortality data:

• males were more likely to have had a stroke event than females (149 and 110 per 100,000 population, respectively).
• the rate of stroke events fell by 24% between 2001 and 2017, from 169 to 129 events per 100,000 (Figure 4).

Figure 4: Trends in stroke events, by sex, 2001 to 2017

Heart failure

An estimated 104,900 people aged 18 and over had heart failure in 2017–18, based on self-reported data from the ABS 2017–18 National Health Survey. This corresponds to approximately 0.5% of the adult population. Heart failure predominantly affects older Australians. Two-thirds of adults with heart failure (69,500 people) were aged 65 and over.

Using self-reported data to estimate the number of people with heart failure may under estimate the true burden of this disease, as the early stages are only mildly symptomatic. Heart failure and cardiomyopathy have a considerable impact on the health of Australians. For more information see Hospital care for cardiovascular disease – heart failure and cardiomyopathy.

Rheumatic heart disease

As at 31 December 2018 there were around 5,000 (52 per 100,000 population) living persons with rheumatic heart disease (RHD) recorded on state and territory registers in the Northern Territory, Western Australia, Queensland and South Australia combined. Indigenous Australians accounted for 87% of registered cases of RHD (4,325 diagnoses).

During the 4-year period 2014–2018, there were around 1,963 diagnoses for acute rheumatic fever among Indigenous Australians (95% of all cases). In the same period, there were about 1,300 (59.8 per 100,000 population) RHD diagnoses among Indigenous Australians in the Northern Territory, Western Australia, South Australia and Queensland combined. The Northern Territory had the highest rate and greatest number of new RHD diagnoses among Indigenous Australians. Almost two-thirds (64%) of new RHD cases among Indigenous Australians were female and nearly 60% of cases were aged under 25 at diagnosis (AIHW 2020).

Congenital heart disease

Congenital heart disease is a common birth anomaly, affecting an estimated 2,400 Australian babies every year. It is a leading contributor to the burden of disease among infants, with cardiovascular defects contributing 6.4% to the total disease burden of babies aged under 1 year in 2015 (AIHW 2019).

Treatment for congenital heart disease has improved over recent decades with improvements in diagnostic testing, surgical techniques and disease management. In 2016–17, there were around 4,900 hospitalisations in Australia where congenital heart disease was the principal diagnosis—a rate of 20 hospitalisations per 100,000 population. The highest rate of hospitalisation for a specific form of congenital heart disease was for atrial septal defect (6.6 hospitalisations per 100,000 population), followed by ventricular septal defect (1.8 hospitalisations per 100,000 population) (AIHW 2019).

References:

ABS 2019a. Microdata: National Health Survey 2017–18. ABS cat. no. 4324.0.55.001. Canberra: ABS. Findings based on AIHW analysis of ABS microdata. 

ABS 2019b. National Aboriginal and Torres Strait Islander Health Survey, Australia, 2018–19. ABS cat. No. 4715.0. Canberra: ABS.

AIHW (Australian Institute of Health and Welfare) 2020. Acute rheumatic fever and rheumatic heart disease in Australia, 2014–2018. Cat. no. CVD 88. Canberra: AIHW. Viewed 20 May 2020.

AIHW 2019. Congenital heart disease in Australia. Cat. no. CDK 14. Canberra: AIHW. Viewed 15 May 2020.