A groundbreaking report from the Heart and Stroke Foundation of Canada shows cases of dementia could soon be on the rise.
The report shows much deeper connections between heart conditions, stroke and vascular cognitive impairment than were previously understood.
A first-ever analysis of hospitalizations over the past decade showed that people thought to have one vascular condition are at significantly higher risk for developing — or already have — multiple vascular conditions that could result in rehospitalizations and death.
And the trend is on the rise.
“I’m really struck by the message that what is good for your heart is good for your head,’’ said Dr. Alex MacLean, a cardiologist at the Queen Elizabeth Hospital in Charlottetown. “It’s all connected. The same blood vessels that get disease when we get heart attacks get disease when we have strokes, and it leads to vascular dementia.’’
The report indicates that vascular diseases are even more interconnected than physicians knew, and that means bigger and more frightening problems for most people in Canada as 90 per cent of people live with risk of cardiovascular disease.
MacLean said “P.E.I. has a lot of heart disease’’, and the report points to the fact that people with heart or stroke issues are increasingly likely to develop vascular cognitive impairment.
“Everyone fears dementia, and we all should. It’s terrible, such a debilitating disease. Having these vascular diseases (such as) heart attacks, heart failure (or) stroke puts you at a significant risk of developing vascular cognitive impairment.’’
The report also points to a comprehensive analysis of hospitalizations for these conditions in Canada between 2007 and 2017. This analysis of hospitalizations and related rehospitalizations, conducted for the first time, shows the conditions are so deeply connected that people who previously were thought to have one condition are likely to develop multiple conditions — many without knowing.
MacLean said it’s partly a result of a huge victory for the medical profession. Over the last 20 to 40 years, physicians have helped people live longer, especially those who have suffered a stroke or heart attack.
“They live longer and have vascular disease and go on to develop cognitive impairment ... (and) there is a higher prevalence among women because they tend to live longer and the longer you live the more risk you are to developing dementia and cognitive impairment.’’
Between 2007 and 2017, 2.6 million hospitalizations in Canada involved people who were experiencing at least one heart condition, a stroke or vascular cognitive impairment. A full 40 per cent of those people were readmitted one or more times for a new related illness.
“Everything is just unbelievably connected, and one thing leads to another,’’ MacLean said. “It’s really hitting home that they’re not in silos. The same blood vessels connect.’’
He said physicians are doing a better job of treating the head and the heart but could be doing a better job when it comes to wait times for treatment.
MacLean added there needs to be more discussion about the connections between heart and stroke conditions and vascular cognitive impairment.
By the numbers
- People with heart failure are 2.6 times more likely to experience vascular cognitive impairment
- Congenital heart disease may triple the risk of early onset vascular cognitive impairment (under age 65) and increase the risk of late onset vascular cognitive impairment by 30 per cent
- People with atrial fibrillation are 1.4 times more likely to experience vascular cognitive impairment
- People with heart valve disease have a 25 per cent increased risk of vascular cognitive impairment
- Thirty per cent of people who experience a second stroke are at risk of developing vascular cognitive impairment
* Source: Heart and Stroke Foundation of Canada