Six million Canadians are living with heart disease or stroke, and 9 in 10 have at least one key modifiable risk factor, according to a new report from Heart & Stroke.
“Releasing a comprehensive report on risk factors this Heart Month was a deliberate response to a growing body of evidence showing emerging and concerning trends in Canadians’ personal risk for heart disease and stroke,” Kathryn Rand, RD, told Medscape News Canada. Rand is Heart & Stroke’s director of health policy and systems for Nova Scotia, Newfoundland and Labrador, and Prince Edward Island.
“What [stood] out to me is the extent to which our population, especially our children and youth, are so drastically far away from meeting minimum recommendations on core components of a healthy lifestyle, such as nutrition and physical activity,” she said. “I find this very alarming.”
Furthermore, she noted, “The fact that Canada has some of the highest youth vaping rates in the world is very troubling, especially as Canada was a leader in tobacco control. Now more than one in four grade 12 students vape, and we know that teens who vape are four times more likely to smoke.”
The report, “By the numbers: The state of risk factors for heart disease and stroke in Canada,” was published online on February 3.
Key Findings
The report provides data on lifestyle, medical, and nonmodifiable risk factors for heart disease and stroke in Canada. It draws on the latest data on risk factors from various sources, including government surveys, and includes data from a national, bilingual online poll of 2842 Canadian residents between ages 30 and 74 years that was carried out in May 2025 by Ipsos.
The report’s key findings include the following observations:
* Smoking remains the leading cause of preventable death and disability, killing 46,000 Canadians each year despite the decrease in adult smoking rates from 50% in 1965 to 11% in 2024.
* Only about half of adults, just over half of children, and only two in 10 youths meet their daily or weekly physical activity recommendations.
* Children and youth get more than half of their total daily energy from ultraprocessed foods.
* Fruit and vegetable consumption has been declining since 2015 across all age groups.
* The number of Canadian adults with high blood pressure has increased each year since 2000.
* More than 1 in 4 Canadians aged 18-79 years and 6 in 10 aged 60-79 years have high cholesterol.
* More than 3.9 million Canadians of all ages have diabetes.
* For Indigenous peoples in Canada, colonialism has created conditions that have led to wide disparities in health outcomes, including a higher risk for heart disease and stroke.
* Some racialized groups face a bigger burden of the risk for heart disease and stroke, including Black Canadians and those of South Asian descent.
‘Health-in-All-Policies’ Approach
The report suggests action steps for clinicians, including talking to patients about risk factors; recommending credible information and tools available from trusted organizations; referring patients to programs in the community; counseling patients about quitting smoking or vaping; and screening for high blood pressure, high cholesterol, and diabetes.
Suggested action steps for governments include regulating the marketing of unhealthy foods and beverages to children, taxing sugary drinks to reduce consumption, ensuring that mandatory physical activity is part of the school curriculum, restricting the sale of flavored vape products, increasing taxes on tobacco and vaping products, and expanding the national pharmacare formulary to cover prescription medications for heart disease and stroke.
As Rand pointed out, however, “to make the substantial changes required to alter Canada’s disease trajectory and truly become a nation focused on health and well-being, we require a complete cultural shift and focus on a health-in-all-policies approach at all levels of government.
“In a nutshell,” she explained, “this means systematically integrating health considerations into all government policies, not just those related to the delivery of what we would consider healthcare. This type of approach will be costly in terms of all forms of resources needed, but the payoff will be a healthier, happier society that can thrive for centuries to come.”
Real-World Constraints
More must be done to reduce risks, agreed Jeffrey Habert, MD, family physician and assistant professor of family and community medicine at the University of Toronto, Toronto. “One major challenge is that lifestyle change occurs within real-world constraints,” he told Medscape News Canada. “While many risk factors are modifiable, the ability to make healthy choices is not equal for everyone and can depend on socioeconomic status, geography, work demands, mental health, food access, and environmental factors.”
Another challenge is that “lifestyle changes don’t provide immediate feedback, which can make them feel less rewarding than medications,” he said. “Effective counseling requires setting realistic, achievable goals and reinforcing that even modest, sustained changes can have meaningful long-term impact.
“Progress has been made, but overall, we still underinvest in prevention,” said Habert, who was not involved in the report. “If nearly 80% of premature heart disease and stroke is preventable, then prevention should be a core health system priority and be funded as such.”
Supporting healthy behaviors requires more than education, he noted. “It requires policies that address the food environment, physical activity infrastructure, air quality, and socioeconomic inequities that shape cardiovascular and brain health.
“This is not just a Canadian issue,” he added. “Cardiovascular and cerebrovascular disease worldwide is increasingly driven by modifiable risk factors layered on top of nonmodifiable factors such as age, genetics, sex, and ethnicity. Patients are highly motivated to prevent disease, but success depends on timely risk identification, access to primary care, and systems that make prevention practical and sustainable.”
Heart & Stroke has produced an online risk tool to help patients understand their risks and support them to take action.
The report was produced by the Heart and Stroke Foundation. Rand and Habert reported having no relevant financial relationships.
Marilynn Larkin, MA, is an award-winning medical writer and editor whose work has appeared in numerous publications, including Medscape Medical News and its sister publication MDEdge, The Lancet (where she was a contributing editor), and Reuters Health.
