Ischemic Heart Disease Mortality Trends Research Articles

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 Mortality from Ischemic Heart Disease in Peru, 2005 to 2017

The highest proportion of deaths among patients with cardiovascular diseases is due to ischemic heart disease (IHD), which is the second most common cause of death in Peru. This study aims to measure and identify changes in the temporal trend in mortality from ischemic heart disease in the Peruvian population. An ecological study was carried out with data from individual death records from the Ministry of Health between 2005 and 2017. A death was considered attributable to IHD if it was registered with the codes I20 to I25 of the ICD-10. Crude and adjusted mortality rates for IHD were calculated for the general population by age and according to sex. A joinpoint regression analysis was performed to assess trends in IHD mortality. There were 61,524 deaths due to IHD (55.69% men) from 2005 to 2017. According to the ICD-10, acute myocardial infarction (I21) accounted for the highest proportion of deaths (88.16%), followed by chronic IHD (I25), with 6.53%. In general, a decrease in adjusted IHD mortality rates was found in the general population over time (45.34 in 2005; 22.18 in 2017). By sex, men possessed a 1.5-fold higher rate than women. The highest mortality rates from IHD were found in the natural coastal region (68.55%) and in urban areas (86.43%). A joinpoint regression analysis showed a reduction in the mortality trend over time due to IHD for both the general population and the population when grouped by sex. In conclusion, there was a continuous decrease in mortality rates due to IHD in the Peruvian population between 2005 and 2017. Strategies focused on mitigating the impact of this disease are required and should emphasize the subgroups most likely to die from this cause.

Abstract 14113: Age-Related Demographic Trends in Mortality Due to Ischemic Heart Disease in the United States From 1999 to 2019

Introduction: United States Ischemic heart disease (IHD) mortality has decreased recently. mortality trends for demographic groups across different ages have not been well described. Hypothesis: Different age groups have different IHD mortality trends Methods: WWe performed a nationwide analysis using the CDC WONDER database to evaluate IHD mortality trends from 1999 to 2019. Crude mortality rates per 100,000 were evaluated by sex, race, ethnicity and ten-year age groups. We used Joinpoint linear regression to assess average annual percentage change (AAPC) in IHD-related mortality. Results: From 1999 to 2019, IHD mortality decreased from 189.8 to 110.0/100,000 (AAPC -2.9%, 95% CI -3.3 to -2.6%) nationally. Compared to the 65-74 year age group (AAPC -1.7%, 95% CI -1.9 to -1.4%), decline in IHD-related mortality was lower for 35-44 year (-0.4%, 95% CI -0.4 - 0.0%; p < 0.001), 45-54 year (-0.4%, 95% CI -0.5 to -0.3%; p < 0.001), and 55-64 year (-0.5%, 95% CI -0.8% to -0.2%; p < 0.001) age groups but similar for the 75-84 year group and higher for ≥85 year age group. Black populations had the highest mortality rates among men and women across all age groups except men ≥85 years old. All the studied groups had significant decreases in mortality between 2002 and 2010. From 2010 to 2019, all groups had significant decreases in mortality except for 35-44 year-old minority groups (black women AAPC -0.7%, 95% CI -2.3% to 1.0%; black men -0.6%, 95% CI -1.7% to 0.6%; Hispanic women 0.9, 95% CI -1.7% to 3.6%; Hispanic men 0.3%, 95% CI -0.9% to 1.5%) (Figure). Conclusions: U.S. populations <65 years old have had slower declines in IHD-related mortality than those ≥65 years, and black populations continue to have the highest IHD-related mortality across almost all age groups. Since 2010, black and Hispanic populations between 35 and 44 years old have not had significant decreases in IHD-related mortality. Greater focus on prevention and treatment of IHD in younger and minority populations is needed.

Abstract 12079: Demographic and State-Level Trends in Mortality Due to Ischemic Heart Disease in the United States From 1999 to 2019

Introduction: Mortality from ischemic heart disease (IHD) in the United States (U.S.) has decreased recently, yet variation in IHD-related mortality trends for different demographic across U.S. states is not well described. Hypothesis: IHD mortality differs based on geography, gender, ethnicity, and race. Methods: We performed analysis using CDC WONDER database to evaluate IHD mortality trends in the U.S. between 1999 and 2019. Age-adjusted mortality rates (AAMR) per 100,000 people were evaluated and stratified by sex, race, and state. Joinpoint regression was used to assess annual rates of change in IHD-related mortality. Results: From 1999 to 2019, AAMR due to IHD decreased from 194.6/100,000 to 88.0/100,000 nationally. Black men had the highest AAMR, and Hispanic white women had the lowest AAMR throughout this period. AAMR for white men decreased nationally by 51.4% from 251.2 to 122.1; 59.1% for white women from 150.5 to 61.5; 51.8% for black men from 278.7 to 134.2; 59.9% for black women from 188 to 75.4; 54.3% for Hispanic men from 200.1 to 91.4; and 63.1% for Hispanic women from 133.1 to 49.0 (Figure). Relative decreases in AAMR across states ranged from 27.0%-70.9% for white men, 30.9%-68.9% for white women, 7.3%-80.9% for black men, 27.2%-74.7% for black women, 30.5%-79.8% for Hispanic men, and 35.8%-76.8% for Hispanic women. Based on the regression model, the annual average percent decline in IHD-related AAMR for all groups has decreased since 2011 (Figure). Conclusions: AAMR due to IHD in the U.S. has decreased from 1999 to 2019 for all demographic groups, though the rate of decline has lessened since 2011. There is significant geographic variation in reductions of IHD-related AAMR across U.S. states. These findings indicate that race, ethnicity, and geography are strongly associated with trends in mortality due to IHD. Given the ongoing disparities in mortality, further investigation into geographic differences in prevention and treatment of IHD is needed.

Ischemic heart disease mortality trends in Croatia between 1995 and 2011: a joinpoint regression analyisis

Cardiologia CROATICA Aim: In the last few decades, mortality from ischemic heart disease has been decreasing in many countries. The aim of this study was to analyze trends in ischemic heart disease mortality rates in Croatia between 1995 and 2011. Materials and methods: The data on deaths from ischemic heart diseases in Croatia were extracted from the WHO mortality database, and estimates of the Croatian population were derived from the Population Division of the Department of Economic and Social Affairs of the United Nations. Ischaemic heart diseases were defined as I20-I25 diagnoses in ICD-10. We used Joinpoint Regression analysis to describe mortality time trends, with up to 4 joinpoints and a Monte Carlo simulation to calculate p-values for a series of permutation tests. The joinpoint analysis was applied to the age-standardised rates (world population) and their standard errors, separately for each sex. Results: There were 165,432 deaths due to ischemic heart disease in Croatia in this 17-year period (51.2% females). The age-standardized ischemic heart disease mortality rates declined from 139.9/100,000 in men and 79.4/100,000 in women in 1995 to 118.9/100,000 and 67.6/100,000 in 2011, respectively. The trends showed a constant decrease, without any joinpoints in both men and women. In men, the best fitting model showed that in the period from 1995-2011 mortality rates significantly decreased (annual percent change (APC) of -1.0%; 95% CI -1.4 to -0.6), while in women trends were also decreasing (APC of -0.8%;95% CI -1.3 to -0.3) throughout the entire study period. Conclusion: Mortality rates for ischaemic heart disease showed a continuous decrease during this period, especially in men. However, it is still the leading cause of death, and it is important to monitor trends and focus on reduction of preventable risk factors.

Circulation : Clinical Summaries

<i>Circulation</i> : Clinical Summaries

Trends in age-standardised and age-specific mortality from ischaemic heart disease in Germany

Research from some industrialised countries indicated a flattening of the declining ischaemic heart disease (IHD) mortality trends in certain population groups. This study aims to investigate age-standardised, as well as sex- and age-specific time trends in IHD mortality in Germany. Using German vital statistics between 1980 and 2007, age-standardised and age-specific IHD mortality rates for men and women were calculated. Joinpoint software was used to estimate average annual percentage changes (AAPC) together with 95% confidence intervals and to identify changing trends in mortality. To account for the reunification in 1990 trends for West Germany alone were investigated in sensitivity analysis. Since 1980, marked decreases in mortality of 50% in men and 39% in women were observed, with AAPC of 2.4 and 1.5%, respectively. While moderate declines in mortality were observed since the early 1980s in men, significant decreases in women were only found after 1995. Trends in mortality varied substantially across age groups, showing decreases in older age (75+ years) only during the last 5-10 years. A flattening of mortality declines was not observed. In West Germany, overall decreases and AAPC were larger and differences between men and women were somewhat smaller. German IHD mortality trends present a complex picture with profound decreases since 1980. However, declines were smaller and delayed compared to other industrialised countries. Also, time trends were not homogeneous in men and women, as well as across age groups. Preventive measures need to be strengthened to account for failures in the past and to counter the increasing burden of modifiable risk factors.

Stroke and Ischemic Heart Disease Mortality Trends in Brazil from 1979 to 1996

Stroke and ischemic heart disease (IHD) mortality rates were analyzed in Brazilian subjects older than 30 years of age from 1979 to 1996. Population estimates were based on census surveys. Mortality data were obtained from the Ministry of Health. For stroke, the age-adjusted death rate (ADR) dropped from 200 to 164 and from 168 to 130 deaths/100,000 population in men and women, respectively (p < 0.001), in the interval study. For IHD, the ADR dropped from 194 to 164 and from 119 to 105 deaths/100,000 population in men and women, respectively (p < 0.001), in the same time period. Mortality from stroke and IHD combined was greater in men for all age groups (p < 0.001). Stroke was the most frequent cause of death in both women and men except for men aged between 40 and 69 years, in whom IHD was more common. Stroke and IHD were the main causes of death in the Brazilian population.

Poland and U.S. Collaborative Study on Cardiovascular Epidemiology Hypertension in the Community: Prevalence, Awareness, Treatment, and Control of Hypertension in the Pol-MONICA Project and the U.S. Atherosclerosis Risk in Communities Study

PURPOSE: The objectives of this manuscript are to assess differences in blood pressure levels and in hypertension prevalence, awareness, treatment, and control for selected rural and urban areas in the U.S. and Poland, where ischemic heart disease mortality trends are different.METHODS: Included are white persons aged 45–64 selected in Minneapolis, MN suburbs [urban] and Washington County, MD [semi-rural] from the U.S. Atherosclerosis Risk in Communities Study (ARIC) surveyed in 1987–89, and in Warsaw [urban] and Tarnobrzeg Province [semi-rural] from Poland's Pol-MONICA Project surveyed in 1987–88. Sample sizes were: U.S.—3,696 men, 3,801 women; Poland—875 men, 960 women.RESULTS: Mean blood pressures were > 15% higher for Polish samples than for the U.S. (p < 0.01). In multivariable analysis, hypertension was significantly positively related to age and body mass index (BMI) in both U.S. and Polish samples (except age in Polish men), and to heart rate in Polish samples and U.S. rural women. Smoking was significantly negatively related to hypertension in urban Polish and rural U.S. men. Hypertension awareness, treatment, and control were better in U.S. than in Polish samples. In the U.S. > 80% of subjects with hypertension (systolic blood pressure (SBP) ⩾ 160 mmHg or diastolic blood pressure (DBP) ⩾ 95 mmHg or on treatment) were controlled whereas in Polish samples ⩽ 17% of hypertensive men and 16% of hypertensive women were controlled. When SBP ⩾ 140 mmHg or DBP ⩾ 90 mmHg or on treatment defined hypertension, control was about 55% in U.S. samples and about 2% in Polish samples.CONCLUSIONS: Hypertension prevalence is higher and blood pressure levels are less well controlled in Polish than in U.S. samples. These striking differences can be expected to contribute to opposing trends in coronary heart disease (CHD) mortality in the two countries. Hypertension control programs in the U.S. are almost certainly responsible for much of the observed differences. There is a clear need for similar programs in Poland.

Trends in Ischemic Heart Disease Deaths— United States, 1990-1994

In 1994, a total of 481,458 persons died as a result of ischemic heart disease (IHD), which comprises two thirds of all heart diseases--the leading cause of death in the United States. This report presents trends in IHD mortality in the United States for 1990-1994 (the latest year for which data are available) and compares these trends by race, sex, and state. These findings indicate IHD death rates decreased from 1990 through 1994; however, the rate of decline was slower than rates of previously observed declines.

Trends in Ischemic Heart Disease Mortality—United States, 1980-1988

In 1989, approximately 500,000 persons died from ischemic heart disease (IHD), the leading cause of death in the United States (1). This report summarizes an analysis by CDC to characterize trends in IHD mortality in the United States from 1980 through 1988 (the latest year for which data are available), and emphasizes comparisons by race and sex, region, and state.

Deaths in early phase of acute myocardial infarction and approaches for reducing the in-hospital and out-hospital case-fatality rates of the disease.

Shiritsu Asahikawa Hospital received a total of 922 patients with acute myocardial infarction (AMI) from 1961 through 1985. The numbers of AMI patients and deaths during 1981-1985 were 2.8 times and 2.3 times, respectively, those observed during 1971-1975. However, decreasing trends were noted in the overall and age-adjusted mortality due to ischemic heart disease (IHD) per population of 100,000 Asahikawa residents between 1975 and 1984, suggesting a discrepancy between our CCU data and the city's records. We investigated the prehospital condition, out-of-hospital cardiac arrest, and the mechanism of early deaths in patients hospitalized with AMI. It was found that the increase of AMI patients admitted to our hospital was due to an increase in the hospitalization rate of AMI patients and the establishment of the coronary care unit (CCU) which allowed the admittance of patients who might have been declared dead out-of-hospital in the past. On the other hand, the declining trends in IHD mortality in the entire city of Asahikawa were attributable to reductions in the in-hospital and out-of-hospital fatality rates of patients with AMI, to improved hospital fatality rates of patients with AMI, and to improved survival rates in AMI patients who developed ventricular fibrillation (Vf) or who experienced out-of-hospital cardiac arrest episode. In order to further decrease the case-fatality rate of patients with AMI, it is essential to continuously educate residents on emergency treatment to be given at the onset of AMI.

Estimation of myocardial infarction mortality from routinely collected data in Western Australia

The accuracy of routinely collected mortality data for ischemic heart disease (IHD) as indicators of death from acute myocardial infarction (AMI) was assessed in ages 25–64 years, according to the WHO criteria defined in 1983. Cases were identified from computer records (linked for individuals) of all death certificates and hospital discharges in Western Australia between 1971 and 1982. Where the official cause was IHD about 90% of deaths fulfilled the WHO criteria for definite or possible AMI. Up to 10% of fatal cases of definite or possible AMI were coded to other causes in the official death statistics, however it appeared that variations in this figure with changes in coding practices could cause appreciable bias in the estimation of secular trends in IHD mortality. This problem could largely be overcome by reviewing fatal events where the death certificate was coded to one of a limited number of other ICD rubrics.

The decline of ischemic heart disease mortality in Texas

This is a study of the decline of ischemic heart disease (IHD) mortality in the State ofTexas, from 1970 to 1977. The data were collected and analyzed at three different levels: state, health service area (HSA), and county. The study was designed to test hypotheses pertaining to the role of the medical care system as a possible factor associated with the changing IHD mortality trends. The results suggest that factors such as emergency medical services (EMS), intensive care units (ICU) and coronary care units (CCUs) in hospitals, intensive care and coronary care beds and medical specialists are associated with the observed decline in heart disease mortality in Texas.

Ischaemic heart disease and sudden death, 1901-61.

Several distinguished authorities have recently questioned the widely held belief that death rates from ischaemic heart disease (IHD) have increased during the present century. Robb-Smith (1967) has devoted a monograph to the subject and con cludes that the evidence in favour of any real in crease is very insubstantial. He believes that the apparent increase in IHD mortality in England and Wales can be entirely explained by the ageing of the population and by the changes in medical termino logy which have taken place during the past few decades. Similar conclusions have been reached by Campbell (1963a, b) and Bedford (1968) in Britain, and by Moriyama and Woolsey (1951) and Lew (1957) in the United States. The resolution of this controversy is of more than academic interest, since a substantial part of the current large-scale effort to control IHD through public health education and aetiological research is based on the belief that some modern factors in our way of life are responsible for the present 'epidemic'. We have therefore re-examined the evidence provided by death certificates, taking care to avoid the pitfalls documented by Robb-Smith and the other critics. Our study has been restricted to deaths occurring among men aged 45 to 64 in the Province of Ontario between 1901 and 1961, and we have based our conclusions on information obtained from original death certificates, on the records of the Toronto chief coroner's office, and on the official mortality tabulations of the Registrar General of Ontario. Mortality records based on death certificates have often in the past proved to be an unsatisfactory method of studying trends in IHD mortality, because of the uncertainty surrounding the diagnosis of this condition (particularly in the early years of the century) and because of the frequent changes which have taken place in the international classification of causes of death, on which most official mortality tabulations are based. Blockage of a coronary artery by a thrombosis or an embolus was well recognized as a cause of sudden death by the end of the nine teenth century (Osier, 1895), but it was not until after the reports of Herrick (1912, 1919) that non-fatal coronary thrombosis came to be recognized as the underlying lesion in many cases of 'myocarditis' or 'fatty degeneration of the heart'. In any retrospective study it is therefore necessary to take account of these changes in medical terminology if misleading conclusions are to be avoided (Stewart, 1950; Piatt, 1951). In addition to errors resulting from a lack of knowledge of ischaemic heart disease in the past, errors may also have occurred in the diagnoses appearing on death certificates as a result of the physican's misinterpretation of symptoms and physical signs. Thus dyspnoea of cardiac origin may sometimes have been ascribed to bronchial asthma, ankle oedema to Bright's disease (chronic nephritis), substernal pain to indigestion, and sudden death to apoplexy or cerebral haemorrhage. Rheu matic and syphilitic heart disease may also have been overdiagnosed in the past at the expense of ischaemic heart disease (Campbell, 1963a, b). We have attempted to circumvent some of these problems by using three definitions of ischaemic heart disease. First, a narrow definition of 'pure' IHD in which only terms such as angina pectoris, arteriosclerotic heart disease, and coronary throm bosis were accepted. Second, a somewhat broader definition in which, in addition to the preceding terms, certain non-specific diagnoses were accepted su h as heart failure, myocarditis, cardiac dropsy, and organic heart disease. Third, a very broad definition in which rheumatic heart disease, chronic nephritis, cardio-renal disease, asthma, indigestion, hypertension, and apoplexy were included. It was hoped that the first and third of these definitions would provide a form of lower and upper probability limit for the true rate of IHD mortality, and that over the years there might be common trends in all three definitions which would enable valid con clusions to be drawn. To ensure that the death rates calculated for each of these definitions were undistorted by the periodic variations in the international classification of causes of death, we have worked with original death 1