Only one in ten French people have optimal cardiovascular health

According to the latest data of Public Health France (SPF) published on March 4[1], cardiovascular diseases (CVD) were responsible for more than one million hospitalizations in 2022 and 140,000 deaths in 2021, or more than one in five deaths. Among these pathologies, ischemic heart disease affects approximately 3 million people (5.6% of the adult population), and heart failure represents a growing issue with increasing life expectancy.

Despite therapeutic advances and progress in interventional cardiology, cardiovascular diseases remain the leading cause of death in women and the second leading cause of death in men after cancer. In addition, they are responsible for many disabilities and chronic complications, having a heavy impact on patients' quality of life and weighing on the health system, recalls SPF.

Avoidable risk factors such as smoking cause many CVDs

The epidemiology of CVD is strongly influenced by modifiable risk factors. Among the main behavioral factors is smoking. The latter still concerns 31% of French people aged 18 to 75 (with 23% of daily smokers). It constitutes a major risk factor for ischemic heart disease and stroke. An unbalanced diet also plays a determining role, with excessive salt consumption, greater than 6 g per day for 80 TP3T of French adults, as well as a diet rich in saturated fats and low in fruits and vegetables (70% of adults do not consume enough fruits and vegetables). The lack of physical activity, for its part, concerns nearly 39 TP3T of adults and promotes the onset of obesity, diabetes and hypertension. Alcohol consumption remains high, with three men and more than one in ten women having a level of consumption that increases their cardiovascular risk.

Added to these factors are high blood pressure, which affects 30% of adults, as well as metabolic determinants, such as diabetes and hypercholesterolemia, which affect 7% and 23% of the population respectively. Nearly one in two patients hospitalized for ischemic heart disease had at least one of these modifiable risk factors before admission. Public Health France also highlights the lack of awareness of these pathologies by the population. Nearly 45% of hypertensive patients are unaware of their condition, as are 50% of people with hypercholesterolemia and 20% of diabetics. This lack of early detection promotes worsening complications and limits the possibilities of intervention at a reversible stage of the disease.

Social, territorial and gender inequalities

Health inequalities play a central role in the prevalence and management of CVD in France. Only 11% of the French population have ideal cardiovascular health, with significant gaps related to education level: only 4 % of adults with an education level below the baccalaureate have optimal cardiovascular health, compared to 21 % among those with a higher education degree. Similarly, the prevalence of obesity and smoking is significantly higher in disadvantaged areas.

Significant regional disparities are also observed, particularly in the North-East and South-East of France, where the rates of hospitalisation for cardiovascular diseases are the highest. These gaps are partly explained by an unequal distribution of risk factors and healthcare infrastructures, particularly with regard to access to neurovascular units and cardiac rehabilitation centres.

Women are particularly vulnerable to cardiovascular diseases. They are less often treated in intensive care, receive less appropriate treatment and have a higher mortality rate after a myocardial infarction. The incidence of acute coronary syndrome has increased in women under 65 years of age over the last fifteen years, particularly due to the increase in smoking. Some risk factors specific to women, such as hypertensive disorders of pregnancy or polycystic ovary syndrome, remain under-evaluated in cardiovascular prevention.

A call to strengthen prevention and care

In light of these findings, experts stress the need for a comprehensive approach to cardiovascular prevention. Improving the screening of risk factors must be a priority, systematically integrating the monitoring of blood pressure, cholesterol and blood sugar, as well as the identification of smoking and problematic alcohol consumption during routine medical consultations. Health education also represents an essential lever, with the need to implement more targeted awareness campaigns on diet, physical activity, as well as smoking and alcohol consumption, with effective management and monitoring of these factors.

Strengthening public policies is imperative, particularly through stricter anti-smoking measures, actions to combat sedentary lifestyles and better regulation of salt and sugar consumption in the food industry. In addition, particular attention must be paid to optimizing patient care after a first cardiovascular event, with enhanced monitoring and care pathways that systematically include cardiac rehabilitation.

Current data remind us that nearly 80% of cardiovascular diseases are avoidable through prevention and modification of risky behaviors. The new prevention appointments at key ages of life represent a major opportunity to identify subjects at risk and intervene as early as possible. In particular, regarding tobacco, health experts remind us that if quitting tobacco quickly provides major benefits regardless of age, these benefits are all the more important if this cessation occurs early, in particular avoiding the early cardiovascular accidents specific to this risk factor.

©Generation Without Tobacco

AE