Improved access to preventive healthcare resources can help patients guard against developing cardiovascular conditions—a finding in a new study that helps makes the case for comprehensive healthcare expansion.

The study, published in the Canadian Medical Association Journal, was conducted by the Cardiovascular Health in Ambulatory Care Research Team in Ontario, Canada, and led by Jack Tu, a senior scientist at the Institute for Clinical Evaluative Sciences (ICES) and the Sunnybrook Schulich Heart Centre.

The research examined regional variations within Ontario’s 14 local health networks and categorized them by the number of cardiac events each of them had. They looked at 5.5. million adults between 40 and 79 years old without pre-existing cardiovascular diseases. The investigators followed patients for five years, counting the number of heart attacks, strokes and deaths related to cardiovascular events in each network.

The network with the lowest number of events was in the Toronto area, which has relatively open access to healthcare. Because of this, people in these region visited doctors more often and were more likely to be screened for heart disease.

The areas with the highest number of adverse cardiac events were in northern Ontario, a region with very low population density and fewer healthcare facilities. Other, less populated areas had similar rates of cardiac events.

"Residents of high-rate regions were the least likely to receive certain preventive services, even though they had the highest rates of smoking and obesity and the lowest rates of dietary intake of fruits and vegetables," the authors wrote in the study. "What we found was a striking variation in the rates of heart attack, stroke or cardiovascular-related death depending on which LHIN a person lived in. There was a clear division between the healthiest and least-healthy LHINs.”

The authors suggest that increasing access to healthcare in rural areas could improve health outcomes across the board.

"Our study suggests that, even in a country with a universal health insurance system, higher rates of preventive health care contribute to lower rates of cardiovascular disease (CVD) events at a regional level," the authors write. "Our findings provide new information that health system factors may be important contributors to regional variations in CVD event rates.”