Heart disease – the facts
In all my life, I have personally known one person who has died from heart disease (a hereditary heart condition). I worked as an HR Director for 12 years for large corporations and I can’t remember having to deal with a death from heart disease in that time.
Heart charities and researchers love to position the stats as “one in three people dies from heart disease.” It makes them seem more important and needed and should lead to increased funding.
But doesn’t it make you wonder why you haven’t lost a third of your friends and family?
Fact 1 – death rates are tiny
There were 270,804 male deaths and 288,813 female deaths from all causes, for people under the age of 65, in the UK in 2009.[i] Table 1.1 in the European statistics document further tells us that 17% of the deaths in men were from coronary heart disease (CHD) and 32% from cardiovascular disease (CVD). The data for women shows that 12% of the deaths were from CHD and 32% from CVD. (CHD includes angina and heart attacks. CVD includes all diseases of the circulation including CHD, cardiomyopathy and stroke.)
32% is where the “one third” comes from. One third from cardiovascular disease, not the narrower term heart disease, is the first thing to note. However, this is a trivial point in comparison to the significant one…
The number of deaths, without knowing ‘out of how many’, is pretty meaningless. So, table 1.4 in the same Euro document, is the most useful one. This gives death rates for CHD for people under the age of 65. These are usually presented in terms of “deaths per 100,000″ i.e. for every 100,000 UK people – how many died from coronary heart disease?
The figures are 33 for men in 2009 and 8 for women. Yes – 33 in every 100,000 men died from coronary heart disease in 2009 and 8 in every 100,000 women died from CHD in 2009. How small is that?!
You would have needed to know 3,030 men (under the age of 65) for 1 of them to have been likely to die from heart disease during 2009. You would have needed to know 12,500 women (under the age of 65) for 1 of them to have been likely to die from heart disease during 2009.
How different is that to the headlines “one in three die from heart disease”?
That’s why I personally know one person who has died from heart disease.
Fact 2 – being male has a significant impact, but death rates are still tiny
You can see from the UK figures that we could claim that four times as many men as women die from heart disease (33 in 100,000 vs. 8 in every 100,000). And indeed heart disease is weighted against men and in favour of women (while women have higher cholesterol ha ha). However, this is also misleading. The reality is that you’d still need 3,030 male friends and 12,500 female friends just to be likely to lose 1 of them. Being a UK woman under 65, I’ve got the 1 in 12,500 stats on my side and I wouldn’t lose any sleep over my numbers or 1 in 3,030.
Fact 3 – age is the massive and unavoidable factor
The US death rate from all causes for 2006 was 0.78%.[ii] Don’t compare these figures directly with the UK deaths because these US deaths include everyone of all ages (not just under 65s). The third key fact about heart disease is that it is massively dependent on age…
The US death rate from all causes of 0.78% means that 777 people, per 100,000 residents of the population, died in 2006. Death certificates recorded 200 of these deaths as being from heart disease.[iii] So 0.2% of the USA population died from heart disease in 2006. That means, if you had 500 friends of any age, you were likely to lose 1 of them to heart disease during 2006.
However – the single most important factor is the age of your friends. You would need to have known 166,667 children aged 5-14 to have a likelihood of 1 dying from heart disease and yet you only needed to know 22 people aged 85 and over, for 1 of them to have been likely to have heart disease on their death certificate during 2006.
So the next time someone tells me that I have a 1 in 3 chance of dying from heart disease I’ll tell them “I’ve got a 1 in 12,500 chance of that happening in any year before I’m 65.”
[i] Table 1.1 from the full 2012 report available here: http://www.ehnheart.org/cvd-statistics.html
[ii] Centres for Disease Control and Prevention, (Using age adjusted data), http://www.cdc.gov/nchs/hus/contents2010.htm (Table 29).
[iii] http://www.cdc.gov/nchs/hus/contents2010.htm (Table 30).
p.s. can you do anything about heart disease?
The three main factors in heart disease you can do nothing about:
If you’re male and your brother(s), father, father’s father and father’s brother(s) died young (under 65) from heart disease, you’d better hope that you inherited your mother’s genes and that they were better than the male side of your family. Or get your bucket list done early. If you were born male, too bad, but don’t lose sleep over 35 in 100,000 – stress is very bad for your heart. As for aging, as George Burns allegedly quipped “aging is better than the alternative”!
Genetics aside, you may be able to improve your odds, against the 35 in 100,000 average, by not smoking, not eating processed food, managing stress, having purpose in life and being naturally active (walking the dog, not marathon running). Table 1.4 [i] tells us that France had the lowest male death rate from CHD in Europe. French men had a rate of 15 deaths per 100,000 people (data for 2008) – twice that of British women (i.e. being French couldn’t trump being female) and half that of British men, if you like those nonsense relative numbers.
Living in France has got to be pretty marvelous – the odd lorry blockade, but no war; red wine and red steak; quality cheese and chocolate; skiing and sand dunes; work life balance and family units. However, even if you move there, and hope that the French advantage is nurture, not nature, you’d need to know 6,600 French men under 65 to lose 1 from heart disease vs. 3,030 men in the UK. Neither is worth worrying about. Your biggest risk comes with every year beyond 65 no matter which country you’re in.