Trends In Heart Disease Mortality Research Articles

TCT-118 Trends in Congenital Heart Disease Mortality in the USA From 1999 to 2022: Insight From CDC Wonder

TCT-118 Trends in Congenital Heart Disease Mortality in the USA From 1999 to 2022: Insight From CDC Wonder

Trends in statin utilization and ischemic heart disease mortality in Lithuania and Sweden, 2000-2020.

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.

Worldwide trends in mortality for hypertensive heart disease from 1990 to 2019 with projection to 2034: data from the Global Burden of Disease 2019 study.

This study aims to analyse the worldwide trends in hypertensive heart disease (HHD) mortality and associations with age, period, and birth cohort and predict the future burden of HHD deaths. Mortality estimates were obtained from Global Burden of Disease 2019 study. We used age-period-cohort (APC) model to examine the age, period, and cohort effects on HHD mortality between 1990 and 2019. Bayesian APC model was utilized to predict HHD deaths to 2034. The global HHD deaths were 1.16 million in 2019 and were projected to increase to 1.57 million in 2034, with the largest increment in low- and middle-income countries (LMICs). Between 1990 and 2019, middle/high-middle socio-demographic index (SDI) countries had the largest mortality reductions (annual percentage change = -2.06%), whereas low SDI countries saw a lagging performance (annual percentage change = -1.09%). There was a prominent transition in the age distribution of deaths towards old-age population in middle/high-middle SDI countries, while the proportion of premature deaths (aged under 60 years) remained at 24% in low SDI countries in 2019. Amongst LMICs, Brazil, China, and Ethiopia showed typically improving trends both over time and in recent birth cohorts, whereas 63 countries including Indonesia, the Philippines, and Pakistan had unfavourable or worsening risks for recent periods and birth cohorts. The HHD death burden in 2019 is vast and is expected to increase rapidly in the next decade, particularly for LMICs. Limited progress in HHD management together with high premature mortality would exact huge human and medical costs in low SDI countries. The examples from Brazil, China, and Ethiopia suggest that efficient health systems with action on improving hypertension care can reduce HHD mortality effectively in LMICs.

Abstract 562: Ischemic Heart Disease Mortality And Systemic Lupus Erythematosus

Introduction: Systematic lupus erythematosus (SLE) is associated with significant morbidity and mortality, contributing to accelerated atherosclerotic disease. We sought to quantify ischemic heart disease (IHD) mortality trends in individuals with SLE in the United States (U.S.). Hypothesis: Disparities related to IHD mortality in individuals with SLE exist. Methods: Cross-sectional analyses were conducted using the CDC Wide-ranging Online Data for Epidemiologic Research database to capture all mortality data in the U.S. using death certificate information from 1999 to 2020. We identified individuals with IHD (ICD10: I20-I25) as the underlying cause of death and SLE (ICD10: M32) as the multiple causes of death. Underlying cause of death was defined as the diagnosis that led to mortality and multiple causes of death were defined as the diagnoses that contributed to mortality. Quantified measures included age-adjusted mortality rate (AAMR) per 100,000 population and corresponding 95% confidence intervals. AAMR was adjusted to the U.S. population in the year 2000. Results: We identified 2,733 deaths from 1999 to 2020. AAMR decreased from 0.055 (95% CI, 0.046 - 0.064) in 1999 to 0.027 (95% CI, 0.023 - 0.032) in 2020. Females were disproportionately affected by higher AAMR compared to males (0.054 [95% CI, 0.051 - 0.056] and 0.013 [95% CI, 0.011 - 0.014], respectively). Black populations had the highest AAMR (0.084 [95% CI, 0.077 - 0.090]), with no significant differences among other racial groups such as White (0.029 [95% CI, 0.028 - 0.030], American Indian/Alaska Native (0.041 [95% CI, 0.025 - 0.063]), and Asian/Pacific Islander (0.023 [95% CI, 0.017 - 0.030]) populations. No differences in AAMR were observed between metropolitan and non-metropolitan regions (0.027 [95% CI, 0.026 - 0.029] and 0.029 [95% CI, 0.026 - 0.032], respectively). The West had the highest AAMR (0.036 [95% CI, 0.033 - 0.039]), with no significant differences among the Northeastern (0.027 [95% CI, 0.024 - 0.030]), Midwestern (0.027 [95% CI, 0.025 - 0.030]), and Southern regions (0.029 [95% CI, 0.027 - 0.031]). Conclusion: IHD mortality in individuals with SLE remains disproportionately concentrated in females, Black populations, and Western regions.

Mortality Trends in Heart Disease in Mississippi, 2010-2021

Background Due to the lack of studies examining heart disease mortality trends and its implications on health in populations significantly affected by heart disease, this study aimed to address the gap in research and to identify the magnitude and the impact of heart disease mortality by exploring trends in heart disease mortality among Mississippians from 2010 to 2021. Methods The study uses data from the Mississippi Statistically Automated Health Resource System, which is an online database with data collected from vital statistics. Standard Error for the data was calculated using SAS. Overall and age adjusted mortality rates were calculated by gender, race, and age. Joinpoint regression models were used to calculate Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC) as an indicator of trends. The Joinpoint regression models were generated using independent and dependent variables, and standard error for gender, race, and age. Results The overall age-adjusted mortality rate increased from 251.4 deaths per 100,000 in 2010 to 255.3 deaths per 100,000 in 2021 (1.5% increase). Comparisons between genders reveal an upward trend of heart disease mortality (AAPC, 0.71%- Males and AAPC, 0.08%- Females), and an upward trend of heart disease mortality among races (AAPC, 0.43%-blacks, AAPC, 0.38%- whites, AAPC, 3.68% -other). However, there was a declining trend in adults 65 years and older (AAPC, -0.16%). Conclusion This study identified an overall increase in heart disease mortality. However, trends varied by gender, race, and age. Based on study findings, Mississippi needs more initiatives aimed towards reducing heart disease mortality, specifically targeting blacks, males, and individuals under 65 years of age. This finding also demonstrates the effectiveness of other initiatives, within the state, such as the American Heart Association’s Go Red Campaign for women but reveals the need for more focus on the most at-risk groups identified within the study.

Abstract 9853: Trends in National Death Rates From Heart Disease in the United States, 2010–2020

Introduction: Heart disease (HD) death rates have been declining for decades. Updated trend data for 2010–2020 are needed to inform clinical and public health practice. Methods: We obtained age-standardized death rates per 100,000 population from the US Centers for Disease Control and Prevention’s WONDER database, which aggregates death certificate data from the National Vital Statistics System. Among adults aged ≥35 years, HD deaths were defined by underlying cause of death International Classification of Diseases, 10th revision codes. We calculated percent change between 2010, 2019, and 2020 death rates overall and by HD subtypes and demographic subgroups. Results: HD death rates declined during 2010-2019 and increased in 2020 across age, sex, and race and ethnicity groups. The national HD death rate declined by 9.8% from 2010 to 2019 (347.3 vs. 313.0 per 100,000) and increased by 4.1% in 2020 to 325.9 per 100,000, which approximated the 2015 rate (326.5 per 100,000). Coronary heart disease accounted for 55% of total HD deaths in 2020. Among non-Hispanic Black adults, the HD death rate declined by 10.4% during from 2010 to 2019 and increased by 11.2% in 2020, returning the 2020 HD death rate (440.7 per 100,000) to approximately the 2010 rate (442.4 per 100,000). Among adults aged 35–54 and 55–74 years, HD death rates declined from 2010 to 2019 (35–54: 5.5%, 55–74: 2.3% decline) and increased in 2020 (35–54: 12.0%, 55–74: 7.8% increase), resulting in a higher HD death rate in 2020 (35–54: 54.1, 55–74: 297.3 per 100,000) than in 2010 (35–54: 51.1, 55–74: 282.5 per 100,000). Conclusions: National declines in HD death rates had reversed by 2020 during the Coronavirus Disease-2019 pandemic. Setbacks represented approximately 5 years of lost progress among all adults and ≥10 years of lost progress among non-Hispanic Black adults and younger adults. Clinical and public health efforts may need to be modified to reverse negative trends in HD mortality.

An observational analysis of trends in rheumatic heart disease incidence and mortality in EU15+ countries over 29 years

Abstract Background Rheumatic heart disease (RHD) is a debilitating sequela of acute rheumatic fever (ARF), caused by Group A streptococcus (GAS) infection. Repeated episodes of ARF results in valvular damage over time. As a preventable disorder which was once common worldwide, RHD has largely been eradicated in affluent nations due to widespread availability of penicillin, improvement in socioeconomic standards and advancements in health and social infrastructures. However, it has been speculated that the global refugee crisis, especially in Europe, might contribute to a resurgence of RHD cases in these regions. Purpose This observational study aimed to analyse trends in RHD incidence and mortality rates in European Union 15+ (EU15+) over a 29-year period. Methods Data was obtained from the Global Burden of Disease database. Age-standardised mortality and incidence rates for RHD were extracted for the EU15+ countries for the years 1990–2019. Trends were subsequently analysed using Joinpoint regression analysis. Results Over the 29-year period, an overall declining trend in RHD incidence and mortality across EU 15+ nations was observed. The United Kingdom demonstrated the largest decrease in RHD incidence amongst females (−54.9%) and Finland amongst males (−55.3%). Both RHD incidence and mortality were higher among females compared to males across EU15+ countries over the observed period. The most recent incidence trends, starting predominantly after 2014, demonstrated a rise in RHD incidence in most countries. For both sexes, increases were seen in Australia, Belgium, Ireland, Italy, Netherlands, Norway, Sweden and USA. For males specifically, increase in RHD incidence was seen in Spain, and Finland, and for females only in Canada and Ireland. The recent increasing RHD incidence rates ranged from +0.4% to + 24.7% for males and +0.6% to +11.4% for females. Conclusion Whilst overall there are decreases in incidence and mortality from RHD, we observe more than half of EU15+ countries have increasing incidence trends in RHD in recent years. This increasing trend primarily started after 2014, overlapping with the start of the European migration crisis. Although speculative, disparities in access to healthcare for migrants, amongst other socioeconomic factors, may be potential causes; subsequently, further efforts by governments and public health officials are required to recognise and control the resurgence of RHD in high income nations. Funding Acknowledgement Type of funding sources: None.

A Dynamic Visualization Tool of Local Trends in Heart Disease and Stroke Mortality in the United States.

Efforts in the US to prevent and treat cardiovascular disease (CVD) contributed to large decreases in death rates for decades; however, in the last decade, progress has stalled, and in many counties, CVD death rates have increased. Because of these increases, there is heightened urgency to disseminate high-quality data on the temporal trends in CVD mortality. The Local Trends in Heart Disease and Stroke Mortality Dashboard is an online, interactive visualization of US county-level death rates and trends for several CVD outcomes across stratifications of age, race and ethnicity, and sex. This powerful visualization tool generates national maps of death rates and trends, state maps of death rates and trends, county-level line plots of annual death rates, and bar charts of percentage changes. County-level death rates and trends were estimated by applying a Bayesian spatiotemporal model to data obtained from the National Vital Statistics System of the National Center for Health Statistics and US Census bridged-race intercensal estimates for the years 1999 through 2019. The Local Trends in Heart Disease and Stroke Mortality Dashboard makes it easy for public health practitioners, health care providers, and community leaders to monitor county-level spatiotemporal trends in CVD mortality by age group, race and ethnicity, and sex and provides key information for identifying and addressing local health inequities in CVD mortality trends.

Analysis of Rheumatic Heart Disease Mortality in the Chinese Population: A JoinPoint and Age-Period-Cohort Study.

(1) Background: We aimed to analyze rheumatic heart disease (RHD) mortality trends in China’s urban and rural areas and to determine the roles of age, period, and cohort effects. (2) Methods: Based on mortality data extracted from the China Health Statistics Yearbook, we calculated the crude mortality rate of RHD. Age–adjusted rates were computed by the direct method using the 2020 census as the standard population. The annual percentage change (APC) and average annual percentage change (AAPC) were determined by the JoinPoint regression model. The age–period–cohort model was used to estimate the effects of age, period, and cohort. (3) Results: From 2006 to 2020, the general trend in RHD standardized mortality declined. The RHD mortality rate was higher in rural than in urban areas and among females than males. The elderly (over 60 years old) were at high risk for RHD deaths in China. The age effect increased with age, and the cohort effect showed a declining trend as chronology grew, but the period effect was not significant. (4) Conclusions: China has achieved great success in RHD, but RHD mortality may increase with age. Compared with the period effect, age and cohort effects dominated the risk of RHD deaths.

Mortality Trends from Ischemic Heart Disease in Turkey: 2009-2019.

Cardiovascular diseases still play an important role in public health and epidemiol- ogy as the leading cause of death worldwide. Ischemic heart disease is the most common reason in this group. This study aims to analyze the latest trends in ischemic heart disease mor- tality rates in Turkey by age, gender, and region using the Turkish Statistical Institute mortality data and evaluate the results. We have obtained ischemic heart disease mortality data (2009-2019, in 12 regions) for Turkey from the mortality database of the Turkish Statistical Institute. Joinpoint analysis was used to estimate the annual percentage change and average annual percentage change to identify significant changes in trends. The mean mortality rate for ischemic heart disease in Turkey was in an increasing trend from 2009 to 2019 (annual percentage change=1.7 (-0.8; 4.3), P=.166). This increase was more pronounced in women (annual percentage change=2.2 (-0.7; 5.2), P=.121) compared to men (annual percentage change=1.4 (-1.1; 3.9), P=.235). When the period between 2015 and 2019 was evaluated, it was determined that ischemic heart disease mortality was in a decreasing trend in the groups over 65 years of age. The death rate due to ischemic heart disease is almost 2 times higher in men than in women in Turkey, and this rate ratio is highest in the Istanbul region. Although ischemic heart disease mortality trends have decreased globally, our country's average is still on an increasing trend. However, significant decreases have been observed in ischemic heart disease mortality rates, especially in the group over 65 years of age, in the last 5 years.

Trends in heart disease mortality among breast cancer survivors in the US, 1975\u20132017

PurposeHeart disease is a significant concern among breast cancer survivors, in part due to cardiotoxic treatments including chemotherapy and radiotherapy. Long-term trends in heart disease mortality have not been well characterized. We examined heart disease mortality trends among US breast cancer survivors by treatment type.MethodsWe included first primary invasive breast cancer survivors diagnosed between 1975 and 2016 (aged 18–84; survived 12 + months; received initial chemotherapy, radiotherapy, or surgery) in the SEER-9 Database. Standardized mortality ratios (SMRs) and 10-year cumulative heart disease mortality estimates accounting for competing events were calculated by calendar year of diagnosis and initial treatment regimen. Ptrends were assessed using Poisson regression. All statistical tests were 2-sided.ResultsOf 516,916 breast cancer survivors, 40,812 died of heart disease through 2017. Heart disease SMRs declined overall from 1975–1979 to 2010–2016 (SMR 1.01 [95%CI: 0.98, 1.03] to 0.74 [0.69, 0.79], ptrend < 0.001). This decline was also observed for survivors treated with radiotherapy alone and chemotherapy plus radiotherapy. A sharper decline in heart disease SMRs was observed from 1975 to 1989 for left-sided radiotherapy, compared to right-sided. In contrast, there was a non-significant increasing trend in SMRs for chemotherapy alone, and significant by regional stage (ptrend = 0.036). Largest declines in 10-year cumulative mortality were observed from 1975–1984 to 2005–2016 among surgery only: 7.02% (95%CI: 6.80%, 7.23%) to 4.68% (95%CI: 4.39%, 4.99%) and radiotherapy alone: 6.35% (95%CI: 5.95%, 6.77%) to 2.94% (95%CI: 2.73%, 3.16%).ConclusionsWe observed declining heart disease mortality trends by most treatment types yet increasing for regional stage patients treated with chemotherapy alone, highlighting a need for additional studies with detailed treatment data and cardiovascular management throughout cancer survivorship.

Time trends in ischaemic heart disease incidence and mortality over three decades (1990-2019) in 20 Western European countries: systematic analysis of the Global Burden of Disease Study 2019.

To investigate and compare changes in the rates of ischaemic heart disease (IHD) incidence and mortality between 1990 and 2019 in 20 high-income Western European countries with similar public health systems and low cardiovascular risk. The 2020 updated version of the Global Burden of Disease database was searched. Variability and differences in IHD incidence and mortality rates (per 100 000) between countries over time, were calculated. A piecewise linear (join point) regression model was used to identify the slopes of these trends and the points in time at which significant changes in the trends occur. Ischaemic heart disease incidence and mortality rates varied widely between countries but decreased for all between 1990 and 2019. The relative change was greater for mortality than for incidence. Ischaemic heart disease incidence rates declined by approximately 36% between 1990 and 2019, while mortality declined by approximately 60%. Breakpoint analysis showed that the largest decreases in incidence and mortality occurred between 1990 and 2009 (-32%, -52%, respectively), with a much slower decrease after that (-5.9%, -17.6%, respectively), and even a slight increase for some countries in recent years. The decline in both incidence and mortality was lower in the Mediterranean European countries compared to the Nordic and Central European regions. In the Western European countries studied, the decline in age-standardized IHD incidence over three decades was slower than the decline in age-standardized IHD mortality. Decreasing trends of both IHD incidence and mortality has substantially slowed, and for some countries flattened, in more recent years.

Coronary heart disease and stroke mortality trends in Brazil 2000-2018.

To analyse the mortality rate trend due to coronary heart disease (CHD) and stroke in the adult population in Brazil. From 2000 to 2018, a time trend study with joinpoint regression was conducted among Brazilian men and women aged 35 years and over. Age-adjusted and age, sex specific CHD and stroke trend rate mortality were measured. Crude mortality rates from CHD decreased in both sexes and in all age groups, except for males over 85 years old with an increase of 1.78%. The most accentuated declining occurred for age range 35 to 44 years for both men (52.1%) and women (53.2%) due to stroke and in men (33%) due to CHD, and among women (32%) aged 65 to 74 years due to CHD. Age-adjusted mortality rates for CHD and stroke decreased in both sexes, in the period from 2000 to 2018. The average annual rate for CHD went from 97.09 during 2000-2008 to 78.75 during 2016-2018, whereas the highest percentage of change was observed during 2008 to 2013 (APC -2.5%; 95% CI). The average annual rate for stroke decreased from 104.96 to 69.93, between 2000-2008 and 2016-2018, and the highest percentage of change occurred during the periods from 2008 to 2013 and 2016 to 2018 (APC 4.7%; 95% CI). The downward trend CHD and stroke mortality rates is continuing. Policy intervention directed to strengthen care provision and improve population diets and lifestyles might explain the continued progress, but there is no room for complacency.

Comparison of 20-Year Obesity-Associated Cancer Mortality Trends With Heart Disease Mortality Trends in the US

Heart disease and cancer are the 2 major diseases associated with mortality risk in the United States. Four decades of improvements in heart disease mortality slowed after 2011; this slowing has been associated with the obesity epidemic. The same pattern has not been observed for total cancer mortality. However, trends in total cancer mortality may obscure patterns specific to obesity-associated cancers. To investigate whether trends in obesity-associated cancer mortality mirror the slowed mortality improvements observed for heart disease associated with the obesity epidemic. This cross-sectional study compared US mortality trends for International Statistical Classification of Diseases and Related Health Problems, Tenth Revision-defined cancer (total cancer, obesity-associated cancer, and cancer not associated with obesity) and heart disease deaths from January 1, 1999, to December 31, 2018. Data were included on decedents with complete information on the underlying cause of death, age, sex, race, and ethnicity. Changes in age-adjusted cause-specific mortality rates between 1999-2011 and 2011-2018 were compared. Annual relative rates of change in age-adjusted mortality rates (AAMRs) in the overall population and stratified by sex, race, and ethnicity were estimated using Poisson regression. Differences in AAMR annual relative rates of change before and after 2011 were evaluated using Wald tests. A total of 50 163 483 decedents met the inclusion criteria (50.1% female decedents, 79.9% non-Hispanic White decedents, and 11.7% non-Hispanic Black decedents; mean [SD] age, 72.8 [18.5] years). In contrast with heart disease mortality, for which improvements slowed between 1999-2011 and 2011-2018, decreases in total cancer AAMR relative change accelerated between 1999-2011 (-1.48 [95% CI, -1.43 to -1.52]) and 2011-2018 (-1.77 [95% CI, -1.67 to -1.86]) (P < .001). For obesity-associated cancer mortality, which accounted for approximately 33% of total cancer deaths annually, decreases in annual AAMR relative change decelerated from -1.19 (95% CI, -1.13 to -1.26) in 1999-2011 to -0.83 (95% CI, -0.70 to -0.96) in 2011-2018 (P < .001). The largest decelerations in obesity-associated cancer mortality were observed for female decedents (-1.45 [95% CI, -1.36 to -1.53] in 1999-2011 and -0.91 [95% CI, -0.75 to -1.07] in 2011-2018; P < .001) and non-Hispanic White individuals (-1.16 [95% CI, -1.09 to -1.22] in 1999-2011 and -0.68 [95% CI, -0.55 to -0.81] in 2011-2018; P < .001). Slowing improvements in obesity-associated cancer mortality were obscured when considering total cancer mortality. These findings potentially signal a changing profile of cancer-associated mortality that may parallel trends previously observed for heart disease as the consequences of the obesity epidemic are understood.

Comparison of trends in congenital heart disease mortality from 1990 to 2017 between China and North America

Objective: To compare trends in congenital heart disease (CHD) mortality between China and North America from 1990 to 2017. Methods: Using the data from the Global Burden Of Disease (GBD) study 2017, we analyzed the related indicators of CHD mortality in China and North America from 1990 to 2017, including standardized mortality, number of deaths, age distribution of death population and age-specific mortality of CHD in each birth cohort. Age-period-cohort model was used to calculate the annual percent change of age-standardized and age-specific mortality rates of CHD (% per year), period effect-adjusted age-specific mortality rates, and the relative risk of death among CHD population at different time periods (2000－2004 as reference period) and different birth cohorts (1970 as reference cohort). Results: In 2017, the age-standardized mortality rates for CHD in China and North America were 2.63/100 000 and 1.13/100 000 respectively, a decrease of 50.4% and 49.4% compared to 1990. Of all deaths from CHD in China, 76.8% were found in children under 5 years, which was higher than that in North America (51.7%). For population under 40 years, the period effect-adjusted age-specific mortality was higher in China (0.46-167.94 per 100 000 person-years) than in North America (0.68-22.47 per 100 000 person-years); whereas for population over 40 years, mortality was lower in China (0.13-0.34/100 000 person years) than in North America (0.43-0.72/100 000 person-years).From 1990 to 2017, CHD mortality in China decreased by 1.95% per year. The annual decrease of mortality ranged from 1.95% to 3.64% per year in population under 45 years, but the mortality showed increasing trends among those over 50 years. In 2015－2019, the relative risk of death from CHD decreased by 31% in China and 24% in North America. For 2015 birth cohort, the relative risk of death decreased by 84% in China and by 64% in North America. Conclusions: In the past 30 years, the risk of death from CHD in China has significantly decreased, and the survival gap with North America is dramatically narrowed. However, mortality is higher among younger populations in China than in North America, and the mortality in the elders shows increasing trends each year in China.

Comparison of 20-Year Obesity-Associated Cancer Mortality Trends with Heart Disease Mortality Trends in the US

Comparison of 20-Year Obesity-Associated Cancer Mortality Trends with Heart Disease Mortality Trends in the US

Trends in US Cancer and Heart Disease Mortality, 1999-2018

Trends in US Cancer and Heart Disease Mortality, 1999-2018

Trends in ischaemic heart disease and cerebrovascular disease mortality in Europe: an observational study from 1990–2017

Abstract Background Cardiovascular disease remains the leading cause of death worldwide. Previously, we identified a growing disparity between Western and Eastern European countries for mortality from ischaemic heart disease (IHD) and cerebrovascular disease (CVD). Purpose To describe current trends in mortality from IHD and CVD. Methods IHD and CVD age-standardized death rates (ASDR) for European countries between 1990–2017 were extracted from the World Health Organization mortality database using the International Classification of Diseases 9th and 10th Edition codes. Jointpoint regression analysis was used to describe trends over this period. Results Between 1990–2017, IHD mortality declined in all included countries except Croatia (+3% in males and +23% in females). Largest mortality improvements were generally seen in Western European countries, including the Netherlands, UK and Sweden, which saw greater than 65% improvements for both sexes. Estonia was a notable exception, which, after the Netherlands, demonstrated the second highest improvement in mortality (−69% in males, −74% in females). Hungary and Greece saw the smallest improvements in IHD mortality (approximately −12% to −27%). Results of jointpoint regression analysis for selected European countries are shown in Figure 1. In 2017 Lithuania had the highest mortality rate in both males and females (279.4/100,000 and 261.3/100,000, respectively) whilst the Netherlands had the lowest mortality in males and females (32.6/100,00 and 15.3/100,000, respectively). This represents an approximately 8.5-fold difference in IHD mortality in males and a 10.5-fold difference in females between these two countries. CVD mortality declined in all included countries between 1990–2017. Estonia saw the greatest improvements in both males and females (−80.8% and −84.9%, respectively), followed by Austria, Portugal and the Czech Republic (over 70% reductions in both sexes). Bulgaria, Romania and Lithuania saw the smallest reductions (approximately −17% to −33%). In 2017, Bulgaria had the highest CVD mortality rate in both males and females (149.9/100,000 and 113.1/100,000, respectively), whilst the lowest mortality rate was observed in Austria (21.8/100,000 and 19.5/100,000 for males and females, respectively). This represents an approximately 7-fold difference in CVD mortality in males and a 6-fold difference in females between these two countries. Conclusions IHD and CVD mortality rates continue to decrease for men and women across Europe. While certain Eastern European countries have demonstrated considerable mortality improvements over this observation period, in general the disparity between Eastern and Western Europe persists, with further work required to understand and address these inequalities. Squares: male. Circles: female Funding Acknowledgement Type of funding source: None

Escalating ischemic heart disease burden among women in India: Insights from GBD, NCDRisC and NFHS reports

ObjectiveTo determine trends in ischemic heart disease (IHD) mortality and burden among women in India we performed a study. MethodsData were obtained from three publicly available resources. Cardiovascular disease (CVD) and IHD mortality were obtained from 2017 Global Burden of Diseases (GBD) Study. Metabolic risk factor data (body-mass index, blood pressure and diabetes) were obtained from Non-Communicable Disease Risk Factor Collaboration (NCDRiSC) and lifestyle factors were obtained from National Family Health Surveys (NFHS). Descriptive statistics are reported. ResultsGBD study reported that in year 2017 in India CVD caused 2.64 million deaths (women 1.18, men 1.45 million) and IHD 1.54 million (women 0.62, men 0.92 million). Burden of IHD related disability adjusted life years (DALYs) was 36.99 million (women 13.80, men 23.19 million). From 2000 to 2017 annual IHD mortality increased from 0.85 to 1.54 million (+81.1%) with greater increase in women 0.32 to 0.62 million (+93.7%) compared to men (0.53–0.92 million, +73.6%). Increase in age-adjusted IHD mortality rate/100,000 was also more in women (62.9–92.7, +47.4%) than men (97.5–129.5, +32.8%). Trends in cardiometabolic risk factors from 2000 to 2015 showed greater increase in body-mass index, diabetes, tobacco-use and periodontal infections among women than men. ConclusionIHD is increasing more rapidly among women than men in India and there is sex-associated convergence. This is associated with greater increase in overweight, diabetes, tobacco use and periodontal infections in women.

Rheumatic heart disease burden, trends, and inequalities in the Americas, 1990–2017: a population-based study

The World Health Assembly 2018 approved a resolution on rheumatic heart disease to strengthen programmes in countries where this condition remains a substantial public health problem. We aimed to describe the regional burden, trends, and inequalities of rheumatic heart disease in the Americas. In this secondary analysis of the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2017, we extracted data for deaths, prevalence of cases, disability-adjusted life-years (DALYs), years lived with disability, and years of life lost (YLL) as measures of rheumatic heart disease burden using the GBD Results Tool. We analysed 1990-2017 trends in rheumatic heart disease mortality and prevalence, quantified cross-country inequalities in rheumatic heart disease mortality, and classified countries according to rheumatic heart disease mortality in 2017 and 1990-2017. GBD 2017 estimated that 3 604 800 cases of rheumatic heart disease occurred overall in the Americas in 2017, with 22 437 deaths. We showed that in 2017 rheumatic heart disease mortality in the Americas was 51% (95% UI 44-59) lower (1·8 deaths per 100 000 population [95% uncertainty interval 1·7-1·9] vs 3·7 deaths per 100 000 population [3·4-3·9]) and prevalence was 30% (29-33) lower (346·4 cases per 100 000 [334·1-359·2] vs 500·6 cases per 100 000 [482·9-519·7]) than the corresponding global estimates. DALYs were half of those globally (55·7 per 100 000 [49·8-63·5] vs 118·7 per 100 000 [108·5 to 130·7]), with a 70% contribution from YLL (39·1 out of 55·7 per 100 000). A significant reduction in rheumatic heart disease mortality occurred, from a regional average of 88·4 YLL per 100 000 (95% uncertainty interval 88·2-88·6) in 1990 to 38·2 (38·1-38·4) in 2017, and a significant reduction in income-related inequality, from an excess of 191·7 YLL per 100 000 (68·6-314·8) between the poorest and richest countries in 1990 to 66·8 YLL per 100 000 (6·4-127·2) in 2017. Of the 37 countries studied, eight (22%) had both the highest level of premature rheumatic heart disease mortality in 2017 and the smallest reduction in this mortality between 1990 and 2017. The Americas have greatly reduced premature mortality due to rheumatic heart disease since 1990. These health gains were paired with a substantial reduction in the magnitude of income-related inequalities across countries, which is consistent with overall socioeconomic and health improvements observed in the Region. Countries with less favourable rheumatic heart disease situations should be targeted for strengthening of their national programmes. None.