Mortality from ischaemic heart disease by country, region, and age: statistics from World Health Organisation and United Nations.

Judith A Finegold,Perviz Asaria,Darrel P Francis

doi:10.1016/j.ijcard.2012.10.046

Abstract

BackgroundIschaemic heart disease (IHD) is the leading cause of death worldwide. The World Health Organisation (WHO) collects mortality data coded using the International Statistical Classification of Diseases (ICD) code.MethodsWe analysed IHD deaths world-wide between 1995 and 2009 and used the UN population database to calculate age-specific and directly and indirectly age-standardised IHD mortality rates by country and region.ResultsIHD is the single largest cause of death worldwide, causing 7,249,000 deaths in 2008, 12.7% of total global mortality. There is more than 20-fold variation in IHD mortality rates between countries. Highest IHD mortality rates are in Eastern Europe and Central Asian countries; lowest rates in high income countries. For the working-age population, IHD mortality rates are markedly higher in low-and-middle income countries than in high income countries.Over the last 25 years, age-standardised IHD mortality has fallen by more than half in high income countries, but the trend is flat or increasing in some low-and-middle income countries. Low-and-middle income countries now account for more than 80% of global IHD deaths.ConclusionsThe global burden of IHD deaths has shifted to low-and-middle income countries as lifestyles approach those of high income countries. In high income countries, population ageing maintains IHD as the leading cause of death. Nevertheless, the progressive decline in age-standardised IHD mortality in high income countries shows that increasing IHD mortality is not inevitable. The 20-fold mortality difference between countries, and the temporal trends, may hold vital clues for handling IHD epidemic which is migratory, and still burgeoning.

Highlights

Ischaemic heart disease (IHD) is the leading cause of death worldwide [1,2,3,4], placing a major economic and resource burden on health and public health systems
Reliable information describing time-trends in IHD mortality is essential to understand and monitor the disease [12]
In this article we provide an overview of the global epidemiology of IHD mortality using data submitted by individual member states to the World Health Organisation

Summary

Introduction

Ischaemic heart disease (IHD) is the leading cause of death worldwide [1,2,3,4], placing a major economic and resource burden on health and public health systems. In this article we provide an overview of the global epidemiology of IHD mortality using data submitted by individual member states to the World Health Organisation. Ischaemic heart disease (IHD) is the leading cause of death worldwide. For the working-age population, IHD mortality rates are markedly higher in low-and-middle income countries than in high income countries. Over the last 25 years, age-standardised IHD mortality has fallen by more than half in high income countries, but the trend is flat or increasing in some low-and-middle income countries. Low-and-middle income countries account for more than 80% of global IHD deaths. Conclusions: The global burden of IHD deaths has shifted to low-and-middle income countries as lifestyles approach those of high income countries. Population ageing maintains IHD as the leading cause of death. The 20-fold mortality difference between countries, and the temporal trends, may hold vital clues for handling IHD epidemic which is migratory, and still burgeoning

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