Death rates from heart disease have fallen by 30 per cent in the last 10 years in Canada, thanks in part to better prevention, an encouraging new study has found. But the findings are not all good news.

The study led by researchers at ICES, the Institute for Clinical Evaluative Sciences, found that while fewer people are dying of heart attacks, heart disease is affecting more women, who have traditionally had an advantage over men in this area.

While most heart attack deaths are in men -- 56 per cent of all heart attack deaths -- the majority of deaths from heart failure and stroke are in women: 60 per cent of all heart failure deaths and 59 per cent of all stroke deaths.

The study looked at death rates and hospital admission rates in Canada between 1994 and 2004, with a particular focus on heart attacks, heart failure and stroke.

They found a sharp decline in death rates from heart attacks that have translated into 4,000 fewer Canadians dying from a heart attack in 2004 than in 1994.

The study authors think declines in smoking rates, and increases in the use of medications to lower cholesterol can take much of the credit for the drop in death rates.

Hospitals are also now providing better treatment for patients having heart attacks, with an improved survival rate for heart attack patients who reach hospital.

Dr. Jack Tu, an ICES researcher and an author of the study, which appears in the Canadian Medical Association Journal, says the findings represent good news for Canadians.

"The thing I am most happy about is the striking 30 per cent decline in heart disease deaths. It's a reflection of better prevention and better treatment," he told CTV.

"Overall, that's very good news and it suggests that the massive societal investment in education is having an impact and is improving the life of Canadians."

But he added: "This study does not mean we have won the war against heart disease." Heart disease is still the No. 1 killer of both women and men over 45, he noted.

What's more, the study found rates that older women appear to be dying of heart disease and being admitted to hospital admission for heart disease conditions more often.

"Heart disease is becoming an increasing problem affecting elderly women in part because of previous successful efforts to prevent and treat heart disease among younger men," Tu notes. 

Dr. Beth Abramson, a cardiologist at St. Michael's Hospital in Toronto, says there may be other reasons for the gender shift.

"It may be women are older and sicker when they come to emergency, or they are getting different care than men," she says.

With more people surviving the effects of heart disease, there are now thousands of Canadians disabled by strokes and living with the effects of a damaged heart.

Many of these patients, particularly women, never recover and go on to die of heart failure.

Marco Di Buono, director of research for Heart and Stroke Ontario, says efforts to prevent heart and stroke have been successful, but in many cases, may have simply delayed heart events until people are older and perhaps more difficult to treat.

"We are saving people by intervening with treatments and therapies developed with research but we are delaying inevitable death and disability," Di Buono said.

He added that there are now more Canadian men and women living with heart disease than ever before, and there may be more in the future, if rates for childhood obesity continue or rise further.

This highlights the need for increased investment in education and research on cardiovascular health and disease in women, writes Tu and his coauthors.