Transcript History of the Canadian Heart Health Surveys

History
of the
Canadian Heart Health Surveys
www.chhsnet.ca
Context in the 1980s:
– The burden of cardiovascular disease (CVD)
• 39% of deaths due to CVD
• Increasing rates of hospitalization and procedures
– Growing evidence base
• Risk factors known – high blood pressure,
smoking, dyslipidemia
• CVD largely preventable
• Community-based health promotion, as well as
clinical interventions, have demonstrated benefit
Promoting Heart Health in Canada
– A report of the Federal Provincial Working
Group on Cardiovascular Disease Prevention
and Control 1987.
– Recognized the importance of developing a
comprehensive epidemiologic database for:
• Goal-setting
• Baseline for future program evaluation
• Mobilization of the public health system
– Established the foundation for the Canadian
Heart Health Initiative
Leadership
– Department of Health and Welfare Canada
• Dr. Andres Petrasovits
• Dr. Sylvie Stachenko
– Statistics Canada
• Dr. M. Nargundkar
• Dr. C. Nair
– Provincial Ministries of Health
• Dr. David MacLean, Nova Scotia
• Dr. Brian O’Connor, British Columbia
• Dr. Richard Lessard, Quebec
– Heart and Stroke Foundation of Canada
Canadian Heart Health Surveys
– Standardized methodology
• Developed for the 1986 Nova Scotia Heart Health
Survey
• Approved by REB in each province
– Provincial heart health surveys conducted in
all 10 provinces between 1986-92
– Compilation of the Canadian Heart Health
Surveys database 1995, available on CDROM and housed at the Database Centre in
Memorial University.
Methodology
• Stratified, two-stage probability sample
survey
• Target population
– adults 18-74 years, not including people living
in Indian reserves, military camps and
institutions
• Sampling frame
– Provincial health insurance registration files
• Contact mail/telephone and consent
Methodology
• Data collection in 2 phases:
– Home interview by public health nurse
• Demographics, lifestyle behaviors, self-reported
diabetes and hypertension, knowledge and
awareness of the causes and consequences of CVD
and risk factors. Questionnaire comprised of
previously validated components.
• BP measured twice
– Clinic visit to public health dept. within 2 weeks
• Anthropometric measurements - Ht, Wt, (WC, HC),
BP measure twice, fasting blood sample drawn
Methodology
• Blood samples
– Kept cold, centrifuged within 3 hours, plasma
shipped on ice, received within 24 hours and
analyzed at the Lipid Research Lab,
University of Toronto
• Questionnaire
– Identifying face sheets removed, stored
securely. Data double-entered
• Provincial dataset
– De-identified
– Prepared, cleaned and analyzed
Canadian Heart Health Surveys Database
• 10 provincial databases combined
– Ms. Allison Edwards, Canadian Heart Health
Database Centre, Memorial University
• Two probability weights calculated for each
subject to account for the survey design:
– interview and clinic weight
• Database (2)
– Database Centre: includes PSU, Postal code
– CD-ROM: includes only designation of province
Canadian Heart Health Surveys Database
Total Sample
Sample
selected
Interview
completed
Clinic visit
completed
Fasting blood
sample
29,855
23,129
(78%)
19,841
(66%)
19,401
(65%)
Canadian Heart Health Surveys Database
Province
BC
AB
SK
MA
ON
PQ
NB
PE
NS
NF
2394
2237
2158
2766
2538
2353
2093
2088
2108
2394
Canadian Heart Health Surveys Database
Age-Sex Group
Male
Female
TOTAL
18-34
5755
6041
11,796
35-64
3621
3741
7362
65-74
2000
1971
3971
TOTAL
11,376
11,753
23,129
Canadian Heart Health Surveys Database
• CHHS Research Group
• Publications:
– Canadian Heart Health Surveys: a profile of
cardiovascular risk. CMAJ 1992.
– Canadians and heart health: reducing the risk. Health
Canada 1995.
– Obesity: a risk factor for cardiovascular disease.
CMAJ monograph 1997.
– Cardiovascular disease and socioeconomic status.
CMAJ monograph 2000
– Cardiovascular disease in seniors. CMAJ monograph
2002
– Hypertension (2). J Hypertension, JAMA.
– Metabolic syndrome (2). Obesity Research.
The Canadian Heart Health Surveys
Follow-up Study is a New Emerging
Team, funded by the Canadian Institutes
for Health Research and the Heart and
Stroke Foundation of Canada
www.chhsnet.ca