Ambient fine particulate matter, constituents, and ischemic heart disease mortality: a time-stratified case-crossover analysis in Central China

Objective. To measure ethnic differences in overall, cardiovascular, ischaemic heart disease and stroke mortality in the Republic of Mauritius. Design. Analysis of vital registration mortality data from 1989 to 1994 among Hindus, Muslims, Chinese and Creoles, aged 30–64 years, presented as age‐standardized mortality rates, proportional mortality ratios and standardized mortality ratios. Results. During the six year period of analysis 10 657 deaths were recorded in men and 5008 in women. Mortality rates from ischaemic heart disease in Mauritian men are above the average of those found elsewhere. Ischaemic heart disease mortality in women and stroke mortality in both sexes are among the highest recorded in the world. Due to large ethnic differences in overall mortality, which could not be explained by the uncertainty about the exact population size by ethnic group, proportional mortality ratios are an inadequate measure of differential mortality between ethnic groups. ‘Best’ estimates of standardized mortality ratios indicate that in comparison to Hindus as the ‘standard’ population: (i) Creole women have lower ischaemic heart disease (by 34%) and stroke (by 22%) mortality; (ii) Creole women have lower ischaemic heart disease mortality (by 19%); (iii) Muslim men have lower stroke mortality (by 51%) and similar ischaemic heart disease mortality; (iv) Chinese men and women have markedly lower ischaemic heart disease (by 48% and 70%, respectively) and stroke mortality (by 54% and 48%, respectively). Conclusion. The mortality rates of ischaemic heart disease and stroke of all ethnic groups in Mauritius, with the exception of the small Chinese ethnic minority, are very high by international standards. This pleads against differential allocation of resources for prevention strategies despite considerable differences in mortality rates from cardiovascular diseases between ethnic groups.

Objective To quantitatively evaluate the relationship between atmospheric particulate matter PM2.5, PM10 exposure and ischemic heart disease (IHD) mortality. Methods Domestic and international database were retrieved online, and the epidemiologic studies about the association between exposure to particulate matter and IHD mortality were systematically collected. Meta-analysis was performed using Stata 14.0 software. Risk estimates were combined by different effect models according to the result of heterogeneity test. Sensitivity analysis and publication bias analysis were performed. Results A total of 56 literatures were included. With PM2.5, PM10 and PM10-2.5 increasing per 10 μg/m3, the combined effect values of IHD mortality were 1.0236(95%CI: 1.0184-1.0288), 1.0106(95%CI: 1.0075-1.0137) and 0.9920(95%CI: 0.9669-1.0178), respectively. The combined effect values of acute effect of PM2.5 and PM10 on IHD mortality [1.0082(95%CI: 1.0057-1.0107); 1.0088(95%CI: 1.0064-1.0113)] were less than the chronic effect [1.2120(95%CI: 1.1470-1.2806); 1.0831(95%CI: 0.9944-1.1797)]. Compared to the European and American people[1.1010(95%CI: 1.0756-1.1269); 1.0186(95%CI: 1.0083-1.0290)], the combined effect values of exposure to PM2.5 and PM10 on IHD mortality in Asian population [1.0052(95%CI: 1.0031-1.0074); 1.0079(95%CI: 1.0049-1.0109)] were much lower. Conclusions Exposure of an increase in the concentration of atmospheric particulate matter PM2.5 and PM10 may increase the risk of IHD mortality. Key words: Atmosphere; Particulate matter; Myocardial ischemia; Mortality; Meta-analysis

Tendencias de la mortalidad por infarto de miocardio en España y Estados Unidos: ¿una carrera cuesta abajo o cuesta arriba en el siglo xxi?

ObjectiveTo examine the effects of extremely cold and hot temperatures on ischaemic heart disease (IHD) mortality in five cities (Beijing, Tianjin, Shanghai, Wuhan and Guangzhou) in China; and to examine...

Our aim was to test the hypothesis that a high level of physical activity during leisure time increases the risk of ischemic heart disease (IHD) mortality among men with high physical work demands. We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 caucasian, male workers aged 40-59 years; 274 men with overt cardiovascular disease were excluded from the follow-up. During the follow-up period, 591 men (11.9%) died from IHD. Cox analyses of men with low (N=1236), medium (N=2651), and high (N=858) physical work demands showed that those with high demands had a higher risk of IHD mortality compared to men with low demands [age-adjusted hazard ratio 1.51, 95% confidence interval (95% CI) 1.18-1.94]. In all three groups, men with a low level of physical activity during leisure time had a higher risk of IHD than men with a medium or high level. Overall, the age-adjusted hazard ratio for IHD mortality associated with a high level of leisure time physical activity was 0.49 (95% CI 0.34-0.70). Among workers with high physical work demands, the hazard ratio for IHD mortality (adjusted for confounders) was 0.82 (95% CI 0.42-1.56) for a high level of leisure time physical activity and 0.62 (95% CI 0.40-0.97) for a moderate level. We did not find support for the hypothesis that a high level of physical activity during leisure time increases the risk of IHD mortality among men with high physical work demands and with no pre-existing clinical cardiovascular disease. In contrast, moderate and high levels of activity during leisure time seemed to be protective against IHD mortality among people with medium and high physical activity at work.

BackgroundFew studies have used spatially resolved ambient particulate matter with an aerodynamic diameter of <10 μm (PM10) to examine the impact of PM10 on ischemic heart disease (IHD) mortality in China. The aim of our study is to evaluate the short-term effects of PM10 concentrations on IHD mortality by means of spatiotemporal analysis approach.MethodsWe collected daily data on air pollution, weather conditions and IHD mortality in Beijing, China during 2008 and 2009. Ordinary kriging (OK) was used to interpolate daily PM10 concentrations at the centroid of 287 township-level areas based on 27 monitoring sites covering the whole city. A generalized additive mixed model was used to estimate quantitatively the impact of spatially resolved PM10 on the IHD mortality. The co-effects of the seasons, gender and age were studied in a stratified analysis. Generalized additive model was used to evaluate the effects of averaged PM10 concentration as well.ResultsThe averaged spatially resolved PM10 concentration at 287 township-level areas was 120.3 ± 78.1 μg/m3. Ambient PM10 concentration was associated with IHD mortality in spatiotemporal analysis and the strongest effects were identified for the 2-day average. A 10 μg/m3 increase in PM10 was associated with an increase of 0.33% (95% confidence intervals: 0.13%, 0.52%) in daily IHD mortality. The effect estimates using spatially resolved PM10 were larger than that using averaged PM10. The seasonal stratification analysis showed that PM10 had the statistically stronger effects on IHD mortality in summer than that in the other seasons. Males and older people demonstrated the larger response to PM10 exposure.ConclusionsOur results suggest that short-term exposure to particulate air pollution is associated with increased IHD mortality. Spatial variation should be considered for assessing the impacts of particulate air pollution on mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-069X-13-109) contains supplementary material, which is available to authorized users.

Background:Fine particulate matter (PM2.5) air pollution exposure has been identified as a global health threat. However, the types and sources of particles most responsible are not yet known.Objectives:We sought to identify the causal characteristics and sources of air pollution underlying past associations between long-term PM2.5 exposure and ischemic heart disease (IHD) mortality, as established in the American Cancer Society’s Cancer Prevention Study-II cohort.Methods:Individual risk factor data were evaluated for 445,860 adults in 100 U.S. metropolitan areas followed from 1982 through 2004 for vital status and cause of death. Using Cox proportional hazard models, we estimated IHD mortality hazard ratios (HRs) for PM2.5, trace constituents, and pollution source–associated PM2.5, as derived from air monitoring at central stations throughout the nation during 2000–2005.Results:Associations with IHD mortality varied by PM2.5 mass constituent and source. A coal combustion PM2.5 IHD HR = 1.05 (95% CI: 1.02, 1.08) per microgram/cubic meter, versus an IHD HR = 1.01 (95% CI: 1.00, 1.02) per microgram/cubic meter PM2.5 mass, indicated a risk roughly five times higher for coal combustion PM2.5 than for PM2.5 mass in general, on a per microgram/cubic meter PM2.5 basis. Diesel traffic–related elemental carbon (EC) soot was also associated with IHD mortality (HR = 1.03; 95% CI: 1.00, 1.06 per 0.26-μg/m3 EC increase). However, PM2.5 from both wind-blown soil and biomass combustion was not associated with IHD mortality.Conclusions:Long-term PM2.5 exposures from fossil fuel combustion, especially coal burning but also from diesel traffic, were associated with increases in IHD mortality in this nationwide population. Results suggest that PM2.5–mortality associations can vary greatly by source, and that the largest IHD health benefits per microgram/cubic meter from PM2.5 air pollution control may be achieved via reductions of fossil fuel combustion exposures, especially from coal-burning sources.Citation:Thurston GD, Burnett RT, Turner MC, Shi Y, Krewski D, Lall R, Ito K, Jerrett M, Gapstur SM, Diver WR, Pope CA III. 2016. Ischemic heart disease mortality and long-term exposure to source-related components of U.S. fine particle air pollution. Environ Health Perspect 124:785–794; http://dx.doi.org/10.1289/ehp.1509777

To compare statin utilization and ischemic heart disease (IHD) mortality trends in Lithuania and Sweden and to assess correlations between the total utilization of statins and IHD mortality. An ecological study assessing time trends in statin utilization (DDDs per 1000 inhabitants per day; DDD/TID) and IHD mortality in Lithuania and Sweden between 2000 and 2020. Statin utilization data in Lithuania were wholesale trade data, and Swedish data were drugs dispensed at pharmacies. IHD mortality data were extracted from national databases as rates per 100 000 inhabitants. Associations between statin utilization and IHD mortality in Lithuania and Sweden were examined using Spearman's rank and Pearson's correlation coefficients, respectively. Statin utilization increased from 16.8 to 135.8 DDD/TID in Sweden and from 0.2 to 61.8 DDD/TID in Lithuania between 2000 and 2020. Medium intensity was the most common statin dosage in Lithuania, while Sweden used more high intensity than moderate-intensity statins from 2017. IHD mortality in Lithuania remained high between 2000 and 2020 (from 359.1 to 508.8 deaths per 100 000 population), while it decreased markedly in Sweden (from 226.87 to 88.7 deaths per 100 000 population). IHD mortality and statin utilization were inversely correlated in Sweden (r = -0.993, P < 0.001), while a positive correlation was found in Lithuania (rs = 0.871, P < 0.001). Despite the growing statin utilization in both countries, Lithuania recorded a slight increase in IHD mortality rates unlike the situation in Sweden. This indicates room for improvement in the management of modifiable cardiovascular risk factors in Lithuania including how statins are prescribed and used in clinical practice.

Objective: To assess the association between socioeconomic status and ischaemic heart disease (IHD) mortality in 10 western European populations during the 1990s. Design: Longitudinal study. Setting: 10 European populations (95...

The objective of this study was to analyse the population level association between alcohol consumption and ischaemic heart disease (IHD) mortality in Canada. Yearly changes in IHD mortality rates from 1950 to 1998 were analysed in relation to yearly changes in alcohol consumption, employing the Box & Jenkins technique for time-series analyses. All models controlled for cigarette smoking and one analysis with focus on men also included female IHD mortality as an indicator of other risk factors for IHD. A 1-litre increase in per capita alcohol consumption was associated with an increase in overall IHD mortality as well as among men and women with fully 1%, but no estimate reached statistical significance. A positive and significant relationship between smoking and IHD mortality was demonstrated in all models. According to the model with focus on male IHD mortality, an increase in per capita consumption by 1 litre was related significantly to a 1% increase in male IHD mortality. No significant effects were found in different male age groups. The idea that alcohol saves more IHD deaths than it causes in Canada is not in accordance with these findings. An increase in overall alcohol consumption is more likely to cause an increase in IHD mortality than to lower the number of IHD deaths, at least among men.

Objective: To evaluate the acute effects of daily mean temperature on ischemic heart disease (IHD) mortality in 12 counties across Hubei Province, China. Methods: We obtained the daily IHD mortality data and meteorological data of the 12 counties for 2009-2012. The distributed lag nonlinear model (DLNM) was used to estimate the community-specific association between mean temperature and IHD mortality. A multivariate meta-analysis was then applied to pool the community-specific relationship between temperature and IHD mortality, and the effects of cold and heat on mortality risk. Results: In 2009-2012, of the 6 702 012 people included in this study, 19 688 died of IHD. A daily average of 1.2 IHD deaths occurred in each community. The annual average mean temperature was 16.6 ℃ during the study period. A nonlinear temperature-IHD mortality relationship was observed for different cumulative lag days at the provincial level. The pooled heat effect was acute but attenuated within 2 days. In contrast, the cold effect was delayed and persisted for more than 2 weeks. Compared with a reference temperature (25th percentile of mean temperature during the study period, P25), the cold effect for P10 of mean temperature was associated with IHD mortality, the RR(95% CI) was 1.084 (1.008-1.167) at lag 0-14, and 1.149 (1.053-1.253) at lag 0-21. For the P1 cold temperature, the mortality RR (95% CI) values were 1.116 (0.975-1.276) and 1.220 (1.04-1.428), respectively. We found no significant association between high temperatures and IHD mortality in the present study at different lag days. Conclusion: In Hubei Province, low temperature was associated with increased IHD mortality risk, and cold effects lasted for several days; no significant effect of high temperature was observed.

HomeCirculationVol. 58, No. 3Secular trends in ischemic heart disease and stroke mortality from 1970 to 1976 in Spanish-surnamed and other white individuals in Bexar County, Texas. Free AccessAbstractPDF/EPUBAboutView PDFSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toFree AccessAbstractPDF/EPUBSecular trends in ischemic heart disease and stroke mortality from 1970 to 1976 in Spanish-surnamed and other white individuals in Bexar County, Texas. M P Stern and S P Gaskill M P SternM P Stern Search for more papers by this author and S P GaskillS P Gaskill Search for more papers by this author Originally published1 Sep 1978https://doi.org/10.1161/01.CIR.58.3.537Circulation. 1978;58:537–543 Previous Back to top Next FiguresReferencesRelatedDetailsCited ByMitchell B, Hazuda H, Haffner S, Patterson J and Stern M (1991) Myocardial infarction in Mexican-Americans and non-Hispanic whites. The San Antonio Heart Study., Circulation, 83:1, (45-51), Online publication date: 1-Jan-1991.Martinez-Maldonado M (1991) Hypertension in Hispanics, Asians and Pacific-Islanders, and Native Americans., Circulation, 83:4, (1467-1469), Online publication date: 1-Apr-1991.Caplan L (1991) Strokes in African-Americans., Circulation, 83:4, (1469-1471), Online publication date: 1-Apr-1991.Shulman N and Hall W (1991) Renal vascular disease in African-Americans and other racial minorities., Circulation, 83:4, (1477-1479), Online publication date: 1-Apr-1991.Yu P (1991) Heart disease in Asians and Pacific-Islanders, Hispanics, and Native Americans., Circulation, 83:4, (1475-1477), Online publication date: 1-Apr-1991.Yatsu F (1991) Strokes in Asians and Pacific-Islanders, Hispanics, and Native Americans., Circulation, 83:4, (1471-1472), Online publication date: 1-Apr-1991.Curry C (1991) Coronary artery disease in African-Americans., Circulation, 83:4, (1474-1475), Online publication date: 1-Apr-1991.Savage D (1991) Hypertensive heart disease in African-Americans., Circulation, 83:4, (1472-1474), Online publication date: 1-Apr-1991.Becker T, Wiggins C, Key C and Samet J (1988) Ischemic heart disease mortality in Hispanics, American Indians, and non-Hispanic whites in New Mexico, 1958-1982., Circulation, 78:2, (302-309), Online publication date: 1-Aug-1988.Stern M, Bradshaw B, Eifler C, Fong D, Hazuda H and Rosenthal M (1987) Secular decline in death rates due to ischemic heart disease in Mexican Americans and non-Hispanic whites in Texas, 1970-1980., Circulation, 76:6, (1245-1250), Online publication date: 1-Dec-1987.Fortmann S, Williams P, Hulley S, Maccoby N and Farquhar J (1982) Does dietary health education reach only the privileged? The Stanford Three Community Study., Circulation, 66:1, (77-82), Online publication date: 1-Jul-1982.Kautz J, Bradshaw B and Fonner E (1981) Trends in cardiovascular mortality in Spanish-surnamed, other white, and black persons in Texas, 1970--1975., Circulation, 64:4, (730-735), Online publication date: 1-Oct-1981. September 1, 1978Vol 58, Issue 3Article InformationMetrics Download: 46 Copyright © 1978 by American Heart Associationhttps://doi.org/10.1161/01.CIR.58.3.537 Originally publishedSeptember 1, 1978 PDF download Advertisement

There is an apparent paradox in the geographical distribution of ischaemic heart disease (IHD) mortality in Spain. The Mediterranean regions, those with the lowest consumption of total and saturated fats, register the highest mortality due to IHD. This paper seeks to explain this paradox by examining the provincial distribution of IHD mortality in Spain and their known risk factors, dietetic and non-dietetic. The study was based on data aggregated by province. Mortality data were taken from official vital statistics, while data on diet and other lifestyle habits were obtained from representative, large-scale, sample-based population surveys. Correlation and multiple regression analyses were run on standardized IHD mortality ratios for the period 1983-1987 and potential dietetic and non-dietetic determinants in 1989-1981. Intake of total lipids, saturated and polyunsaturated fatty acids, fish and wine were lower in Spain's southern and eastern provinces. Consumption of wine, fish, chicken, dairy products, vegetables and blond cigarettes, as well as unemployment, explained 53% of the variation in IHD mortality. Consumption of fish and wine alone exhibited a statistically significant relationship (P < 0.05) with IHD mortality. Moderate consumption of wine was negatively associated with IHD mortality, whereas heavy consumption patterns revealed a positive association. Based on correlation analyses of ecological data, lower consumption of wine and fish may explain the apparent paradox of higher IHD mortality in the presence of a lower intake of saturated fats in Spain's Mediterranean regions.

The Seven Countries Study, carried out in the 1960s, showed a low cardiovascular disease (CVD) mortality in the Greek population. Since then, although the age-adjusted all-cause mortality has gradually and steadily decreased, CVD mortality has increased, mainly due to a rise in ischaemic heart disease (IHD) mortality, and, more specifically, myocardial infarction (MI). The number of MIs per 100,000 men aged 30-69 years increased from 195 in 1981 to 297 in 1988 and from 35 to 52 in women, respectively. Age-adjusted IHD mortality in men aged 45-74 years almost doubled from 1956 to 1978. The rate of increase slowed down for a decade and since 1990 it has declined slightly. In women, the age-adjusted IHD mortality increased, but to a lesser degree until 1990, and then it started to decline. Cerebrovascular mortality was higher than IHD mortality in women and equal to IHD mortality in men in the late 1950s and early 1960s, but it started to decrease in 1972 in men, and in 1973 in women. Cancer mortality is the second commonest cause of death in both genders. Age-adjusted cancer mortality (in those aged 45-74 years) increased slightly in men until 1979 and then remained stable. In women, it remained stable until 1991 and then started to decline. The eradication of malaria and rheumatic fever, the decrease in infectious diseases, the improvement of the medical care system and the rise of the population's socio-economic level achieved during the last five decades in Greece have reduced all-cause mortality. On the other hand, the changes in lifestyle (lack of physical exercise, new dietary habits) have resulted in a higher IHD mortality. However, this increase is less than would be expected, taking into account the rise in blood cholesterol levels and the high prevalence of smoking. The recent small decline in IHD mortality is probably attributable to better treatment of IHD rather than to preventive measures.

SUMMARYThe Seven Countries Study, carried out in the 1960s, showed a low cardiovascular disease (CVD) mortality in the Greek population. Since then, although the age-adjusted all-cause mortality has gradually and steadily decreased, CVD mortality has increased, mainly due to a rise in ischaemic heart disease (IHD) mortality, and, more specifically, myocardial infarction (MI). The number of MIs per 100000 men aged 30-69 years increased from 195 in 1981 to 297 in 1988 and from 35 to 52 in women, respectively. Age-adjusted IHD mortality in men aged 45-74 years almost doubled from 1956 to 1978. The rate of increase slowed down for a decade and since 1990 it has declined slightly. In women, the age-adjusted IHD mortality increased, but to a lesser degree until 1990, and then it started to decline. Cerebrovascular mortality was higher than IHD mortality in women and equal to IHD mortality in men in the late 1950s and early 1960s, but it started to decrease in 1972 in men, and in 1973 in women. Cancer mortality is the second commonest cause of death in both genders. Age-adjusted cancer mortality (in those aged 45-74 years) increased slightly in men until 1979 and then remained stable. In women, it remained stable until 1991 and then started to decline.The eradication of malaria and rheumatic fever, the decrease in infectious diseases, the improvement of the medical care system and the rise of the population's socio-economic level achieved during the last five decades in Greece have reduced all-cause mortality. On the other hand, the changes in lifestyle (lack of physical exercise, new dietary habits) have resulted in a higher IHD mortality. However, this increase is less than would be expected, taking into account the rise in blood cholesterol levels and the high prevalence of smoking. The recent small decline in IHD mortality is probably attributable to better treatment of IHD rather than to preventive measures.