Projections of preventable risks for cardiovascular disease in Canada to 2021: a microsimulation modelling approach
Open Access
- 31 March 2014
- journal article
- Published by CMA Impact Inc. in CMAJ Open
- Vol. 2 (2), E94-E101
- https://doi.org/10.9778/cmajo.2012-0015
Abstract
Background Reductions in preventable risks associated with cardiovascular disease have contributed to a steady decrease in its incidence over the past 50 years in most developed countries. However, it is unclear whether this trend will continue. Our objective was to examine future risk by projecting trends in preventable risk factors in Canada to 2021. Methods We created a population-based microsimulation model using national data on births, deaths and migration; socioeconomic data; cardiovascular disease risk factors; and algorithms for changes in these risk factors (based on sociodemographic characteristics and previous cardiovascular disease risk). An initial population of 22.5 million people, representing the Canadian adult population in 2001, had 13 characteristics including the risk factors used in clinical risk prediction. There were 6.1 million potential exposure profiles for each person each year. Outcome measures included annual prevalence of risk factors (smoking, obesity, diabetes, hypertension and lipid levels) and of co-occurring risks. Results From 2003 to 2009, the projected risks of cardiovascular disease based on the microsimulation model closely approximated those based on national surveys. Except for obesity and diabetes, all risk factors were projected to decrease through to 2021. The largest projected decreases were for the prevalence of smoking (from 25.7% in 2001 to 17.7% in 2021) and uncontrolled hypertension (from 16.1% to 10.8%). Between 2015 and 2017, obesity was projected to surpass smoking as the most prevalent risk factor. Interpretation Risks of cardiovascular disease are projected to decrease modestly in Canada, leading to a likely continuing decline in its incidence.Keywords
This publication has 16 references indexed in Scilit:
- Changes in the rates of awareness, treatment and control of hypertension in Canada over the past two decadesCMAJ : Canadian Medical Association Journal, 2011
- IMPACT: A Generic Tool for Modelling and Simulating Public Health PolicyMethods of Information in Medicine, 2011
- Validation of population-based disease simulation models: a review of concepts and methodsBMC Public Health, 2010
- A population-based risk algorithm for the development of diabetes: development and validation of the Diabetes Population Risk Tool (DPoRT)Journal of Epidemiology and Community Health, 2010
- Association of Temporal Trends in Risk Factors and Treatment Uptake With Coronary Heart Disease Mortality, 1994-2005JAMA, 2010
- Using Data Augmentation to Correct for Non-Ignorable Non-Response When Surrogate Data are Available: An Application to the Distribution of Hourly PayJournal of the Royal Statistical Society Series A: Statistics in Society, 2006
- A Potential Decline in Life Expectancy in the United States in the 21st CenturyThe New England Journal of Medicine, 2005
- Framingham-based tools to calculate the global risk of coronary heart diseaseJournal of General Internal Medicine, 2003
- Overweight and Obesity as Determinants of Cardiovascular RiskArchives of Internal Medicine, 2002
- What price perfection? Calibration and discrimination of clinical prediction modelsJournal of Clinical Epidemiology, 1992