Abstract
BackgroundThe objective of this study was to examine long-term trends in rates of ischaemic heart disease (IHD) mortality, a leading cause of mortality in Hungary. The study examined the effects of age, period, and cohort on IHD mortality rates and compared mortality rates between the capital (Budapest) and non-capital counties.MethodsData on IHD deaths and population censuses were obtained from the Hungarian Central Statistical Office. Age-period-cohort analysis utilized nine age-group classes for ages 40 to 84 years, eight time periods from 1970 to 2009, and 16 birth cohorts from 1886 to 1969.ResultsAge-adjusted IHD mortality rates for men and for women generally increased from 1970 to 1993 and from 1980 to 1999, respectively, decreasing thereafter for both sexes. IHD mortality rates for men and for women from Budapest were lower from 1991 and from 1970, respectively, than corresponding rates in non-capital counties, with the difference increasing after 1999. Age had a more significant influence on mortality rates for women than for men. The period effect increased from 1972 to 1982 and decreased thereafter for men, while the period effect decreased consistently for women from 1972 to 2007. The decline in period effect for both sexes was larger for individuals from the capital than for those from non-capital counties. The cohort effect for both sexes declined from birth years 1890 to 1965, with a steeper decline for individuals from the capital than for those from non-capital counties.ConclusionsThe findings indicate a need for programs in Hungary for IHD prevention, especially for non-capital counties.
Highlights
Ischaemic heart disease (IHD) is one of the major causes of death in Hungary
The rates of premature ischaemic heart disease (IHD) mortality increased for both men and women in Hungary between 1970 and the mid-1990s, while that in western European countries has substantially declined since the 1970s
The numbers of deaths are shown in parentheses. bMortality rates were standardised through the direct method, with the Hungarian population aged 40–84 years in 1990 used as standard
Summary
Ischaemic heart disease (IHD) is one of the major causes of death in Hungary. In 1970, the rate of premature IHD mortality (before the age of 65) in Hungary was similar to that in the European Union (average based on mortality rates of member states joining prior to 2004) for men but higher than that in the European Union for women.[1,2] The rates of premature IHD mortality increased for both men and women in Hungary between 1970 and the mid-1990s, while that in western European countries has substantially declined since the 1970s.1–7 the rate of premature IHD mortality in Hungary was about 3 times higher in 1995 and 4 (for men) to 5 (for women) times higher in 2010 than that in the European Union, surpassing the rates of mostEuropean countries, with the exception of some post-Soviet states.[1,2] In addition, there were clear differences in lifestyles and prevalence of IHD risk factors between urban and rural populations in Hungary,[8,9,10,11,12] potentially leading to differences in mortality rates between the capital and noncapital counties. No previous studies have compared IHD mortality rates between the capital and non-capital counties. The objective of this study was to examine long-term trends in rates of ischaemic heart disease (IHD) mortality, a leading cause of mortality in Hungary. The study examined the effects of age, period, and cohort on IHD mortality rates and compared mortality rates between the capital (Budapest) and non-capital counties. Results: Age-adjusted IHD mortality rates for men and for women generally increased from 1970 to 1993 and from 1980 to 1999, respectively, decreasing thereafter for both sexes. IHD mortality rates for men and for women from Budapest were lower from 1991 and from 1970, respectively, than corresponding rates in non-capital counties, with the difference increasing after 1999. Conclusions: The findings indicate a need for programs in Hungary for IHD prevention, especially for non-capital counties
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