Recent Temporal Changes in Atherosclerotic Cardiovascular Diseases in Ontario: Clinical and Health Systems Impact

Background: It is unknown how the contemporary burden of atherosclerotic cardiovascular disease (ASCVD) compares with historical trends. Methods: As part of the Cardiovascular Health in Ambulatory Care Research Team big data initiative, we used information from multiple population-based databases to study 20-year temporal trends in hospitalizations and deaths from ASCVD. We calculated hospitalization rates for 6 ASCVD events (acute myocardial infarction, unstable angina, stroke, transient ischemic attack, peripheral arterial disease, and congestive heart failure) and death rates resulting from ischemic heart disease, cerebrovascular disease and circulatory and noncirculatory causes in adults aged 20-105 years in Ontario, Canada from 1994- 2014 (to 2012 for deaths). Results: The overall age-standardized composite rate of hospitalization for the 6 conditions or circulatory deaths declined 49.2% in men (from 1533.4 per 100,000 in 1994 to 778.3 per 100,000 in 2012)