What is the biggest threat to the health of Australian women? The answer: diseases of their heart and blood vessels, also known collectively as cardiovascular disease.

Why the focus on women?

  • Cardiovascular diseases (CVDs)—a highly preventable and treatable group of diseases— are a major threat to the health of Australian women. But there is a lack of awareness of this threat.
  • This report provides both the evidence that CVDs are an important health issue for Australian women, and the baseline picture against which future monitoring can be compared.

The message

There is enormous potential to improve the risk profile of Australian women, and therefore reduce the number of women and families affected by CVDs.

• This potential exists because many of the known risk factors for CVD are very common among Australian women and can be reduced, in terms of both severity and the number of coexisting risk factors per person.

What are cardiovascular diseases?

  • Cardiovascular diseases are diseases of the heart (cardio) and blood vessels (vascular).
  • The main cardiovascular diseases, and the focus of this report, are coronary heart disease (CHD, including heart attack and angina), stroke and heart failure.

What makes CVDs such a major health issue for women?

  • CHD, stroke and other heart diseases (including heart failure) are the three leading causes of death among women.
  • CVDs not only cause more deaths than any other disease group (more than one in three deaths among women in 2006), but are also responsible for more than one-quarter of premature death among women. CHD and stroke were the two leading causes of years of life lost to premature death among women in 2003.
  • CVDs are also in the top 10 causes of disability—CHD and stroke were the fifth and ninth leading causes of years of healthy life lost to poor health or disability.
  • About two million Australian women have CVD—about 226,000 women have CHD, 168,000 have had stroke and 176,000 have heart failure.

What does this mean for health services, treatments and expenditure?

  • CVDs are the second most expensive diseases in terms of health system expenditure on women, with $2,682.8 million spent treating CVD in women in Australia in 2004–05.
  • About two million women filled 36.5 million prescriptions for cardiovascular medicines through the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS) in 2007–08. This accounted for 52% of these prescriptions and 52% of users of these cardiovascular medicines in that year.
  • CVDs are responsible for a significant proportion of general practitioners’ workload— general practitioners treated at least one CVD problem in one-fifth of encounters with women in 2007–08.
  • CVDs account for about 5% of all hospitalisations for women—nearly 200,000 hospitalisations in 2006–07.
  • Many important diagnostic and therapeutic procedures for CVD tend to be less common among women than men. In 2006–07, women hospitalised with relevant cardiovascular diagnoses were less likely than men to: have coronary angiography or echocardiography; undergo carotid endarterectomy; receive coronary artery bypass grafting or percutaneous coronary interventions; or have a heart defibrillator implanted. More research is needed into the reasons for these differences. But women were as likely as men to have heart valves repaired or replaced, or have a CT (computerised tomography) or MRI (magnetic resonance imaging) scan of the brain when hospitalised with stroke or transient ischaemic attack.

How common are CVD risk factors among Australian women?

  • Much of CVD burden can be explained by known modifiable risk factors. Most Australian women (more than 90%) have at least one modifiable risk factor for CVD, and half of all women have two or three.
  • Many of these risk factors are very common among Australian women—the vast majority consume inadequate amounts of fruit and/or vegetables, three-quarters are physically inactive, more than half are overweight or obese, and almost half have high blood cholesterol.
  • Many of these risk factors are already common among young females—from as young as 35–44 years, it is more common for females to be overweight or obese than to have a healthy weight; and one in five of those aged 20–29 years smoke daily.

How do CVDs compare with other diseases for women?

  • Prevalence—among Australian women overall, CHD, stroke and heart failure are all less common than asthma, chronic obstructive pulmonary disease and diabetes, and more common than breast cancer, dementia and lung cancer.
  • Deaths—CHD is by far the biggest cause of death among Australian women overall, followed by stroke and dementia.
  • Disease burden—for females overall, CHD (9% of total) is second only to anxiety and depression (10%), followed by stroke (5%).

Can the threat of CVDs to Australian women be effectively assessed and monitored?

  • The ability to monitor CVDs and their risk factors is seriously impaired by important data gaps. There is a lack of data that are national, recent and of sufficient quality on: CVDs such as heart failure, peripheral vascular disease and rheumatic heart disease; services such as cardiac rehabilitation; survival following cardiovascular events; and risk factors such as high blood pressure, high blood cholesterol and diet. Access to more detailed data on individual patients (such as those collected by registers) would enable better monitoring at a national level of disease management, outcomes and access to interventions.