Prepared by: Victoria Zakrajšek 
Date of last change: March 2017

Purpose and justification of the indicator

Cardiovascular diseases have been the most common cause of morbidity and mortality in adults in the developed part of the world and also in Slovenia for decades. In Slovenia, cardiovascular diseases accounted for almost 40% of the causes of all deaths in 2013. Half of patients die within the first two hours after the onset of symptoms. Most deaths and long-term disability among cardiovascular diseases are caused by heart attack and stroke, which are sudden complications of coronary heart disease and cerebrovascular disease, respectively. Despite advances in their treatment, they still represent an important health and socioeconomic problem.
Reducing the burden of cardiovascular diseases is highly dependent on primary prevention, where we often encounter organizational and financial problems, lack of staff and, last but not least, the challenge of people's motivation. In addition to the establishment of effective interdepartmental cooperation, it is also important to create legislation, strategies and programs in the field of public health, which, when implemented effectively, will contribute to reducing the burden of cardiovascular diseases. Above all, with a healthy lifestyle, the onset, progression and occurrence of complications of atherosclerotic disease can be delayed, their weight reduced and life extended. Activities to improve behavioral risk factors are the responsibility of the individual and the environment in the narrower and wider society in which we as individuals live, work and learn. With a stimulating environment, local environments can influence the decisions that an individual carries out activities that are beneficial for health.

Definition of indicator

The heart attack hospitalization rate describes the number of non-fatal or fatal heart attack hospitalizations in people aged 35 to 74 per 1,000 population in an observed calendar year.
An age-standardized rate is calculated, which enables mutual comparison of populations with different age structures.

Unit of measure

Calculation of the indicator

The standardized rate of hospitalizations due to heart attack is the ratio between the number of hospitalizations with the main discharge diagnosis of heart attack among persons aged between 35 and 74 years in the observed calendar year and the number of residents aged 35 to 74 inclusive in the middle of the same year, multiplied by 1,000.
The disease categories according to the ICD-10 classification, which are included in the calculation, are I21 and I22. Only first admissions for hospital treatment due to these diagnoses are included.
Heart stroke
<math xmlns="http://www.w3.org/1998/Math/MathML"><mo>=</mo><mfrac><mrow><mi>N</mi><mi>u</mi><mi>m</mi><mi>b</mi><mi>e</mi><mi>r</mi><mo>&#160;</mo><mi>o</mi><mi>f</mi><mo>&#160;</mo><mi>h</mi><mi>o</mi><mi>s</mi><mi>p</mi><mi>i</mi><mi>t</mi><mi>a</mi><mi>l</mi><mi>i</mi><mi>z</mi><mi>a</mi><mi>t</mi><mi>i</mi><mi>o</mi><mi>n</mi><mi>s</mi><mo>&#160;</mo><mi>d</mi><mi>u</mi><mi>e</mi><mo>&#160;</mo><mi>t</mi><mi>o</mi><mo>&#160;</mo><mi>h</mi><mi>e</mi><mi>a</mi><mi>r</mi><mi>t</mi><mo>&#160;</mo><mi>a</mi><mi>t</mi><mi>t</mi><mi>a</mi><mi>c</mi><mi>k</mi><mo>&#160;</mo><mo>(</mo><mn>35</mn><mo>-</mo><mn>74</mn><mo>&#160;</mo><mi>y</mi><mi>e</mi><mi>a</mi><mi>r</mi><mi>s</mi><mo>)</mo></mrow><mrow><mi>N</mi><mi>u</mi><mi>m</mi><mi>b</mi><mi>e</mi><mi>r</mi><mo>&#160;</mo><mi>o</mi><mi>f</mi><mo>&#160;</mo><mi>i</mi><mi>n</mi><mi>h</mi><mi>a</mi><mi>b</mi><mi>i</mi><mi>tan</mi><mi>t</mi><mi>s</mi><mo>&#160;</mo><mo>(</mo><mn>35</mn><mo>-</mo><mn>74</mn><mo>&#160;</mo><mi>y</mi><mi>e</mi><mi>a</mi><mi>r</mi><mi>s</mi><mo>)</mo></mrow></mfrac><mo>&#215;</mo><mn>1</mn><mo>.</mo><mn>000</mn></math>
The direct standardization method is used for standardization, where the Slovenian population from 2014 is used as the standard population. The 2016 publications show the average of three consecutive years (2011-2013), and the publications from 2017 onwards show the average of five consecutive years.

Data sources for Slovenia

Record of Diseases, Poisonings, and Injuries Requiring Hospital Treatment, National Institute of Public Health.
Population, Statistical Office of the Republic of Slovenia.

Time availability

Data on hospital treatments are published annually.

Men in literature

<ol>
<li>Health for All Database ( <a href="http://data.euro.who.int/hfadb/" target="_blank" rel="noopener">http://data.euro.who.int/hfadb/</a> )</li>
<li>Eurostat ( <a href="http://ec.europa.eu/eurostat" target="_blank" rel="noopener">http://ec.europa.eu/eurostat</a> )</li>
<li>European Community Health Indicators Monitoring ( <a href="http://www.echim.org/" target="_blank" rel="noopener">http://www.echim.org/</a> )</li>
<li>J. &Scaron;elb &Scaron;emerl, Z. Fras. Angina pectoris and heart attack. In: J. Maučec Zakotnik et al (eds). Health and behavioral style of the inhabitants of Slovenia. Trends in CINDI research 2001-2004-2008. IVZ RS, 2012 ( <a href="http://www.nijz.si/sites/www.nijz.si/files/publikacije-%20datoteke/trendi_cindi_2012.pdf" target="_blank" rel="noopener">http://www.nijz.si/sites/www.nijz.si/files/publikacije- filje/trendi_cindi_2012.pdf</a> )</li>
</ol>

Notes

The indicator does not take into account persons who died of a heart attack before being admitted to hospital.

Health status

Prepared by: Metka Zaletel 
Date of last modification: September 2016

Residents and community

Prepared by: Mojca Simončič and Metka Zaletel 
Date of last change: January 2018

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Date of last change: September 2016

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Date of last change: March 2017

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Health risk factors

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Preventive

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Date of last change: March 2017

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Date of last change: November 2019

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Date of last change: March 2019

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Date of last change: October 2019

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Mortality

Prepared by: Sonja Tomšič, Tatjana Kofol Bric 
Date of last change: March 2019

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Date of last change: March 2019

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Prepared by: Tina Lesnik 
Date of last change: March 2020