Dr. Milan Gupta has a heartfelt message for plan sponsors, managers and employees: Cardiovascular disease is a problem, and it’s one that’s not going away any time soon.
“Every seven minutes, a Canadian dies of [cardiovascular disease] and it is the leading cause of death in women. It kills more women than all cancers combined,” the Brampton, Ont., cardiologist told participants attending the 2017 Halifax Benefits Summit in late September.
Cardiovascular disease accounts for approximately 29 per cent of all deaths in Canada each year and costs the national economy more than $20.9 billion annually, Gupta noted.
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The bad news belies a very positive reality: 80 per cent of premature heart disease and stroke is actually preventable. “We probably know more about how to prevent [cardiovascular disease] than almost any other disease,” said Gupta.
That prevention starts with a solid understanding of the seven risk factors: high cholesterol, high blood pressure, diabetes, tobacco use, unhealthy diet, physical inactivity and obesity. But a misunderstanding of how to manage one of those risk factors — high cholesterol — may be a barrier to better outcomes, said Gupta.
Statins are a class of drugs that have contributed to large declines in mortality from cardiovascular disease, he noted. “Yet they are plagued with false claims of toxicity.”
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The research on the efficacy and safety of statins is clear that the drugs work, according to Gupta. Twenty-seven large-scale global trials involving almost 200,000 participants conducted on statins are proof of that, he said. “They uniformly show these are life-saving drugs. These drugs are generally safer than an aspirin a day.”
While Gupta emphasized that statins should be the first line of defence in treating cardiovascular disease, he noted 45 per cent of high-risk Canadians are still not achieving recommended target levels for low-density lipoprotein cholesterol. But proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are now available to help those individuals stay healthy. This new class of cholesterol-lowering drugs have no statin-like side-effects, such as the possibility of muscle pain, liver damage and increased blood sugar.
Estimates suggest that 15 out of every 100,000 privately insured high-risk patients in Canada may warrant those drugs on top of statins, according to Gupta.
Read more articles from the 2017 Halifax Benefits Summit