Cardiovascular diseases: a study by Public Health France highlights significant territorial disparities

Heart attacks, strokes, heart failure: from Réunion to the Pays de la Loire, there remain “significant regional disparities” for cardio-neuro-vascular diseases , a study by Public Health France highlighted on Monday, June 30.

The health agency has drawn up an inventory at the regional, departmental and, for the first time, sub-departmental levels, for the three most common pathologies: ischemic heart disease, cardiovascular accidents (CVA) and heart failure.

With 140,000 deaths per year, cardiovascular diseases are the second leading cause of death per year and are responsible for more than one million hospitalizations among adults each year, representing "a considerable burden for public health" according to the same study.

For so-called "ischemic" heart conditions , such as myocardial infarction, several regions have hospitalization rates and prevalence rates (people affected by the disease) that are much higher than those observed for the whole of France. The national average is 459 cases per 100,000 people, while in Corsica it is 577, as are the Grand-Est region (563), Provence-Alpes-Côte d'Azur (554) and Occitanie (519).

Regarding the mortality rate for these same diseases, Réunion is the department with the greatest disparity, with an average capped at 81 deaths per 100,000 inhabitants, compared to a national average of 59 deaths. Regions such as Normandy, with 71 deaths, as well as Centre-Val-de-Loire and Brittany, both with 67 deaths, are also above the national average.

The overseas departments (Réunion, French Guiana, Martinique, and Guadeloupe) have the highest incidence rates of hospitalized patients for cardiovascular accidents (strokes). While strokes affect approximately 2% of the adult population, this disease affects 2.4% to 3.3% of the inhabitants of these overseas territories. The disparity with mainland France is also evident in the mortality rate. While the national average is 58 people dying from a stroke per 100,000 people, the mortality rate in some overseas territories is almost double, with an average of 83 to 93 deaths depending on the department.

For heart failure, Réunion, Hauts-de-France and Normandy have much higher rates of hospitalization incidence and prevalence.

How can these disparities in incidence, prevalence, and mortality be explained? There are behavioral risk factors, such as tobacco and/or alcohol, nutrition (diet, physical activity, and a sedentary lifestyle), and metabolic risk factors, such as high blood pressure, diabetes, or high cholesterol.

Territorial differences also result from differences "in the severity of cases, prognosis, recourse to care, and immediate and long-term management of these pathologies" , according to the health agency.