1. Key messages
- In 2018, 1.3% of the population reported suffering from angina pectoris. This percentage increases with age, reaching 3.8% in people aged 65 years and over.
- In people aged 65 years and over, the self-reported prevalence of angina pectoris was higher in men in the three regions.
- Between 2008 and 2018, the percentage of people aged 65 years and over reporting to suffer from angina pectoris has decreased in the three regions, in both genders, and more in women than in men.
- In 2020, Belgium recorded an estimated 15,676 cases of acute myocardial infarction (AMI), with 53% occurring in men. AMI incidence rises with age.
- In 2020, in both genders, the age-adjusted incidence rate of myocardial infarction was higher in the Flemish Region, followed by the Walloon Region and Brussels Capital Region.
2. The prevalence of angina pectoris
1.3% of the Belgian population reported suffering from angina pectoris
In 2018, 1.3% of the population reported suffering from angina pectoris, a symptom of Ischemic heart disease. This prevalence increases with age, going from 0% in people aged 15-24 to 3.8% in people aged 65 years and over, and picking to 4.7% in people aged 75 and over.
Angina pectoris was more commonly reported among men, except in the 25-34 and 55-64 age groups. The self-reported prevalence of angina pectoris was higher in men (1.5%) than in women (1.0%). The gender difference was more pronounced in people aged 65 and over, in whom the prevalence of angina pectoris was 2.6 times higher in men.
Source: Health Interview Survey, Sciensano [1]
The prevalence of angina pectoris was higher in older men across all regions, with the greatest disparity in the Brussels Capital Region
In 2018, among people aged 65 and over, the age-adjusted prevalence of angina pectoris was higher in men in all regions, with the most pronounced difference between sexes in the Brussels Capital Region.
Source: Own calculations based on Health Interview Survey, Sciensano [1]
The number of people aged 65 and older suffering from angina pectoris is decreasing over time
From 2008 to 2018, the age-adjusted prevalence of angina pectoris decreased in both genders aged 65 and over. However, the decline was less pronounced in men (-24%) than in women (-61%).
For men, the prevalence of angina pectoris in the Brussels-Capital Region experienced a decline between 2008 and 2013, falling below the 10% mark, followed by a gradual increase after that. The Walloon Region demonstrates an increase until 2013 for men, reaching around 12%, and then a decline, crossing below the two other Regions by 2018. The Flemish Region maintains a relatively stable prevalence rate among men throughout the period, with a minor dip around 2013, staying below 8% by 2018.
A steady decrease in age-adjusted prevalence of angina pectoris among women over the 10-year period is observed in each region. Starting at slightly above 6% for most regions in 2008, all lines trended downward, with the sharpest drop observed between 2008 and 2013. By 2018, the prevalence in all regions for women falls below 4%, with the Flemish Region showing the lowest prevalence and the Walloon Region the highest among the three regions.
- Men
- Women
Self-reported prevalence of angina pectoris in men aged 65 and over, Belgium, 2008-2018
Source: Own calculations based on the Health Interview Survey, Sciensano [1]
Self-reported prevalence of angina pectoris in women aged 65 and over, Belgium, 2008-2018
Source: Own calculations based on the Health Interview Survey, Sciensano [1]
People with lower educational status self-reported a higher prevalence of angina pectoris
The crude prevalence of angina pectoris is higher among those with lower educational level, but after age adjustment, there are no socioeconomic disparities, even among individuals aged 65 and over.
3. The incidence of acute myocardial infarction
In 2020, 95% of patients diagnosed with acute myocardial infarction were discharged alive from the hospital
In 2020, 15,676 individuals were diagnosed with acute myocardial infarction (AMI), representing 136 diagnoses per 100,000 inhabitants. Among these cases, 14,961 were discharged alive, while 985 resulted in death, according to FPS Health, Food Chain Safety and Environment [2].
Among people with AMI, 53% were men. The number of people having suffered from AMI was higher in men across all age groups except in the oldest age groups (+80 years). The highest number of new AMI cases was observed in the age group 70-74 for men and in the age group 85-89 for women. The incidence rate of AMI increased with age and was higher in men across all age groups, except for the 95+ age category.
- Incident cases
- Incidence rates
Incidence of myocardial infarction, number of cases by age and sex, Belgium, 2020
Source: Own calculations based on FPS Health, Food Chain Safety and Environment [2] and SPMA [3]
Incidence of myocardial infarction, incidence rate by age and sex per 100,000 people, Belgium, 2020
Source: Own calculations based on FPS Health, Food Chain Safety and Environment [2] and SPMA [3]
The incidence of acute myocardial infarction is higher in the Flemish region
In the Flemish Region, the age-standardized incidence rate of AMI was 138 per 100,000 among men and 94 per 100,000 among women. In the Walloon Region, the age-standardized incidence rate of AMI was 131 per 100,000 among men and 88 per 100,000 among women. In the Brussels Capital Region, in 2020, the age-adjusted incidence of AMI was 118 per 100,000 among men and 78 per 100,000 among women, lower than in other regions.
- Men
- Women
Incidence of myocardial infarction among 100,000 men by region, Belgium, 2020
Source: Own calculations based on FPS Health, Food Chain Safety and Environment [2] and SPMA [3]
Incidence of myocardial infarction among 100,000 women by region, Belgium, 2020
Source: Own calculations based on FPS Health, Food Chain Safety and Environment [2] and SPMA [3]
The incidence of acute myocardial infarction has decreased over time
Between 2016 and 2020, the age-adjusted incidence of myocardial infarction decreased in both genders, going from 152 per 100,000 in 2016 to 135 per 100,000 in 2020 in men and from 105 per 100,000 in 2016 to 91 per 100,000 in 2020 in women. This decrease was less pronounced among men (-11.2%) compared to women (-13.3%).
Source: Own calculations based on FPS Health, Food Chain Safety and Environment [2] and SPMA [3]
The incidence of acute myocardial infarction has decreased across all regions of Belgium
Over the past four years, the incidence of AMI has decreased across all regions of Belgium, with varying rates of decline between genders. Between 2016 and 2020, the age-adjusted incidence of myocardial infarction decreased in the three regions across both genders.
Among men, this decrease was different across all regions with a decrease of 13.8% in the Brussels Capital Region, a decrease of 12.1% in the Walloon Region, and a decrease of 11.0% in the Flemish Region.
Among women, the change was more pronounced in the Brussels Capital Region (-17.9%) compared to the Flemish Region (-11.0%) and the Walloon Region (-12.0%).
- Men
- Women
Age-adjusted incidence of myocardial infarction among 100,000 men, Belgium, 2016-2020
Source: Own calculations based on FPS Health, Food Chain Safety and Environment [2] and SPMA [3]
Age-adjusted incidence of myocardial infarction among 100,000 women, Belgium, 2016-2020
Source: Own calculations based on FPS Health, Food Chain Safety and Environment [2] and SPMA [3]
4. Read more
View the metadata for this indicator
Background
Ischemic heart disease (IHD) is the main cause of death worldwide except in the lowest-income countries. IHD, also called coronary heart disease, refers to heart problems caused by a narrowing of the coronary arteries (atherosclerosis), resulting in a reduced blood flow and oxygen supply (ischemia) to the heart muscle. In atherosclerosis, the arteries are narrowed when plaques build up inside, containing fat, cholesterol from low-density lipoproteins (LDL), fibrous tissues and sometimes calcium.
Many people do not experience any symptoms in the early stages of IHD. However, if left untreated, atherosclerosis progresses and symptoms may occur, which can be very disabling. The discomfort experienced when the heart muscle is lacking oxygen is called angina pectoris. When the blockage of the blood flow is complete, the heart cells may die or suffer from serious damage, and this is what is called a myocardial infarction or a heart attack.
The main risk factors for IHD include physical factors such as high blood pressure, high cholesterol risk factor, diabetes, and behavioral factors such as tobacco use, unhealthy diet, alcohol abuse, and lack of exercise, which means that a part of the risk may be preventable by adopting a healthy lifestyle.
Two indicators are presented in the following sections:
- The prevalence of angina pectoris refers to people who have reported suffering from angina pectoris during the last 12 months, and is derived from the Belgian Health Interview Survey [1]. We shall first describe the global prevalence in people aged 15 years and more; then we will focus on people aged 65 and over.
- Different indicators can be defined to describe the occurrence of acute myocardial infarction (AMI). The "attack rate" (or incidence by episode) represents all first or recurrent events, while the term "incidence" means a first-ever event. Based on the availability of the data, we defined the yearly incidence as the first event in a given year. This indicator is built using the hospital discharge data from the Federal Public Service Health, Foodchain safety and Environment [2] from which infarction cases that were hospitalized and discharged alive are derived. It has to be noted that data of 2015 are not available due to the change of classification system from ICD-9 to ICD-10. To these cases have been added the cases of people who died of a heart attack (in hospital or not), extracted from the Sciensano Standardized Procedures for Mortality Analysis (SPMA) [3].
For information concerning mortality, please consult the following pages: Overall mortality by cause and Premature mortality by cause.
Definitions
- Angina pectoris or angor
- Angina pectoris, or angor, is one of the symptoms of coronary heart disease. Angor is defined as a pain or discomfort in the chest or adjacent areas, precipitated by exercise, emotion or a heavy meal, caused by a reduced supply of oxygen to the heart (ischemia) due to a stenosis (narrowing) or blockage of the coronary arteries.
- Acute myocardial infarction
- Acute myocardial infarction (AMI), also called heart attack, is a necrosis (death) of the heart cells, resulting from an acute obstruction of a coronary artery. The symptoms include chest pain or discomfort, dyspnea (shortness of breath), and nausea. In some cases, AMI can be asymptomatic. The main risk factors are age, tobacco, high blood pressure, high blood cholesterol, alcohol abuse, obesity and diabetes.
References
- Health Interview Survey, Sciensano, 1997-2018. https://his.wiv-isp.be/
- Federal Public Service Health, Food Chain Safety, and Environment. https://www.health.belgium.be/en/node/22892
- Standardized Procedure for Mortality Analysis (SPMA), Sciensano. https://spma.wiv-isp.be/SitePages/Methods_mortality.aspx
Please cite this page as: Sciensano. Non-Communicable Diseases: Ischemic heart disease, Health Status Report, 10 Dec 2024, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/non-communicable-diseases/ischemic-heart-disease