Abstract P052: Coronary Heart Disease Mortality Declines in the United States From 1980 through 2011: Evidence for Stagnation in Young Adults, Especially Women

Background: Cardiovascular mortality rates have fallen dramatically over the past four decades. However, recent unfavorable trends in coronary heart disease (CHD) risk factors among young adults (obesity, diabetes, and tobacco use) raise concerns about their subsequent impact on CHD mortality. Furthermore, recent data from the US and other countries suggest a worsening of CHD incidence and mortality among young women. We therefore examined recent trends in CHD mortality rates in the US according to age and sex. Methods: We used mortality data between 1980 and 2011 from US adults ≥ 25 years. We calculated age-specific CHD mortality rates and estimated annual percentage change (EAPC) for US adults, and compared three decades of data (1980-1989, 1990-1999, and 2000-2011). We also used Joinpoint regression modeling to assess changes in trends over time, based on inflection points of the mortality distribution. Results: Young men and women (aged<55 years) showed a robust decline in CHD mortality from 1980 until 1989 (EAPC -5.5% in men and -4.6% in women). However, the two subsequent decades saw stagnation with minimal improvement (Table). This was particularly true for young women who had no improvements between 1990 and 1999 (EAPC +0.1%), and only -1% EAPC since 2000. In contrast, older adults (65+years) showed steep annual declines since 2000, approximately doubled compared with the previous period (women, -5.0% and men, -4.4%). Jointpoint analyses provided consistent results. Conclusions: The dramatic declines in cardiovascular mortality since 1980 conceals major heterogeneities. CHD death rates in older groups are now falling steeply. However, young men and women have enjoyed small decreases in CHD mortality rates since 1990. The drivers of these major differences in CHD mortality trends by age and sex needs urgent study.

Download Full-text

Coronary heart disease trends in England and Wales from 1984 to 2004: concealed levelling of mortality rates among young adults

Heart ◽

10.1136/hrt.2007.118323 ◽

2008 ◽

Vol 94 (2) ◽

pp. 178-181 ◽

Cited By ~ 93

Author(s):

M O'Flaherty ◽

E Ford ◽

S Allender ◽

P Scarborough ◽

S Capewell

Keyword(s):

Coronary Heart Disease ◽

Young Adults ◽

Heart Disease ◽

Mortality Rates ◽

England And Wales

Download Full-text

Coronary heart disease incidence still decreased between 2006 and 2014 in France, except in young age groups: Results from the French MONICA registries

European Journal of Preventive Cardiology ◽

10.1177/2047487319899193 ◽

2020 ◽

Vol 27 (11) ◽

pp. 1178-1186 ◽

Cited By ~ 1

Author(s):

Aline Meirhaeghe ◽

Michèle Montaye ◽

Katia Biasch ◽

Samantha Huo Yung Kai ◽

Marie Moitry ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Age Groups ◽

Coronary Event ◽

Mortality Rates ◽

Percentage Change ◽

Age Group ◽

Acute Coronary Event ◽

Annual Percentage Change ◽

Men And Women

Background Over the past few decades decreases in coronary heart disease morbidity and mortality rates have been observed throughout the western world. We sought to determine whether the acute coronary event rates had decreased between 2006 and 2014 among French adults, and whether there were sex and age-specific differences. Methods We examined the French MONICA population-based registries monitoring the Lille urban area in northern France, the Bas-Rhin county in north-eastern France and the Haute Garonne county in south-western France. All acute coronary events among men and women aged 35–74 were collected. Results Over the study period, the age-standardised attack rates decreased in both men (annual percentage change −1.5%, P = 0.0006) and women (annual percentage change −2.1%, P = 0.002). Also, the age-standardised incidence rates decreased in both men (annual percentage change −0.9%, P = 0.03) and women (annual percentage change −1.8%, P = 0.002) due to decreases in the 65–74 year age group. In men, age-standardised mortality rates decreased by 3.5% per year ( P = 0.0004), especially in the 55–64 and 65–74 year age groups. In women, these rates decreased by 4.3% per year ( P = 0.0009), particularly in the 35–44 and 65–74 year age groups. We also observed significant decreases in case fatality among both men (annual percentage change −1.7%, P < 0.0001) and women (annual percentage change −1.9%, P = 0.009). Conclusions Downward trends in acute coronary event attack, incidence and mortality rates were observed between 2006 and 2014 in men and women. This effect was age dependent and was primarily due to decreases in the 65–74 year age group. There were no substantial declines in the younger age groups except for mortality in young women. Prevention measures still need to be strengthened, particularly in young adults.

Download Full-text

Coronary heart disease mortality is decreasing in Argentina, and Colombia, but keeps increasing in Mexico: a time trend study

10.21203/rs.2.15227/v4 ◽

2020 ◽

Author(s):

Carmen Arroyo-Quiroz ◽

Tonatiuh Barrientos-Gutierrez ◽

Martin O'Flaherty ◽

Maria Guzman-Castillo ◽

Lina Sofia Palacio Mejia ◽

...

Keyword(s):

Coronary Heart Disease ◽

Young Adults ◽

Heart Disease ◽

Latin American ◽

Coronary Heart Disease Mortality ◽

Mortality Rates ◽

Mortality Trends ◽

Middle Income ◽

Disease Mortality ◽

Garbage Code

Abstract Background: Mortality rates due to coronary heart disease (CHD) have decreased in most countries, but increased in low and middle-income countries. Few studies have analyzed the trends of coronary heart disease mortality in Latin America, specifically the trends in young-adults and the effect of correcting these comparisons for nonspecific causes of death (garbage codes). The objective of this study was to describe and compare standardized, age-specific, and garbage-code corrected mortality trends for coronary heart disease from 1985 to 2015 in Argentina, Colombia, and Mexico. Methods: Deaths from coronary heart disease were grouped by country, year of registration, sex, and 10-year age bands to calculate age-adjusted and age and sex-specific rates for adults aged ≥25. We corrected for garbage-codes using the methodology proposed by the Global Burden of Disease. Finally, we fitted Joinpoint regression models.Results: In 1985, age-standardized mortality rates per 100,000 population were 136.6 in Argentina, 160.6 in Colombia, and 87.51 in Mexico; by 2015 rates decreased 51% in Argentina and 6.5% in Colombia, yet increased by 61% in Mexico, where an upward trend in mortality was observed in young adults. Garbage-code corrections produced increases in mortality rates, particularly in Argentina with approximately 80 additional deaths per 100,000, 14 in Colombia and 13 in Mexico.Conclusions: Latin American countries are at different stages of the cardiovascular disease epidemic. Garbage code correction produce large changes in the mortality rates in Argentina, yet smaller in Mexico and Colombia, suggesting garbage code corrections may be needed for specific countries. While coronary heart disease (CHD) mortality is falling in Argentina, modest falls in Colombia and substantial increases in Mexico highlight the need for the region to propose and implement population-wide prevention policies.

Download Full-text

The Effect Of Marital Status On The Standard Of Living Of Young Men And Women

Journal of Business & Economics Research (JBER) ◽

10.19030/jber.v2i1.2848 ◽

2011 ◽

Vol 2 (1) ◽

Author(s):

Michael C. Seeborg

Keyword(s):

Young Adults ◽

Regression Analysis ◽

Marital Status ◽

Young Women ◽

Young Men ◽

Longitudinal Survey ◽

The Other ◽

Standard Of Living ◽

Font Size ◽

Men And Women

The National Longitudinal Survey of Youth data base is used to explore the effects of changes in marital status on the standard of living of a sample of young adults. OLS regression analysis indicates that changes in marital status have very different effects on young women and young men.  Women receive large increases in their income-to-needs ratios when they marry, and they incur large declines in their income-to-needs ratios after experiencing a divorce or separation.  Men, on the other hand, do not experience significant changes in their income-to-needs ratios when their marital status changes.

Download Full-text

Risk Factors for Cardiorespiratory and All Cause Mortality in Men and Women in Urban Scotland: 15 Year Follow Up

Scottish Medical Journal ◽

10.1177/003693309504000403 ◽

1995 ◽

Vol 40 (4) ◽

pp. 108-112 ◽

Cited By ~ 28

Author(s):

G.C.M. Watt ◽

C.L. Hart ◽

D.J. Hole ◽

G.D. Smith ◽

C.R. Gillis ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Risk Factor ◽

Heart Disease ◽

Respiratory Disease ◽

Mortality Rates ◽

Respiratory Impairment ◽

Study Objective ◽

Men And Women ◽

All Cause Mortality

Study objective: To describe the relationship between risk factors, risk behaviours, symptoms and mortality from cardiorespiratory diseases in an urban area with high levels of socioeconomic deprivation. A cohort study of 15,411 men and women aged 45–64, comprising 80% of the general population of Paisley and Renfrew, Scotland. Outcomes: Mortality after 15 years from coronary heart disease(ICD 410–4), stroke(ICD 430–8), respiratory disease(ICD 460–519) and all causes. Main results: Mortality rates from all causes were 19% in men aged 45–49, 31% in men aged 50–54, 42% in men aged 55–59 and 57% in men aged 60–64. The rates are considerably higher than those reported in previous UK prospective studies. For women the rates were 12%, 18%, 25% and 38% respectively. In general men and women showed similar relationships between risk factor levels and mortality rates. People in manual occupations had higher mortality rates. Raised levels of systolic and diastolic blood pressure were associated with increased coronary, stroke and all cause mortality rates. Plasma cholesterol had no such association with all cause mortality rates. High and low levels of body mass index were associated with higher mortality rates than intermediate levels. A relationship between short stature and increased mortality rates was observed in men and women. FEV1 expressed as a percentage of the expected value showed the strongest relationship with mortality rates, particularly for respiratory disease, but also for deaths from coronary heart disease, stroke and all causes. Conclusions A similar pattern of relationship between risk factor levels and mortality rates exists in men and women in Renfrew and Paisley. Respiratory impairment as measured by FEV 1% predicted appears to be the most likely explanation of the observed high all cause mortality rates in this population.

Download Full-text

Coronary heart disease mortality is decreasing in Argentina and Colombia, but keeps increasing in Mexico: a time trend study

10.21203/rs.2.15227/v3 ◽

2020 ◽

Author(s):

Carmen Arroyo-Quiroz ◽

Tonatiuh Barrientos-Gutierrez ◽

Martin O'Flaherty ◽

Maria Guzman-Castillo ◽

Lina Sofia Palacio Mejia ◽

...

Keyword(s):

Coronary Heart Disease ◽

Young Adults ◽

Heart Disease ◽

Latin American ◽

Coronary Heart Disease Mortality ◽

Mortality Rates ◽

Mortality Trends ◽

Middle Income ◽

Disease Mortality ◽

Garbage Code

Abstract Background: Mortality rates due to coronary heart disease (CHD) have decreased in most countries, but increased in low and middle-income countries. Few studies have analyzed the trends of coronary heart disease mortality in Latin America, specifically the trends in young-adults and the effect of correcting these comparisons for nonspecific causes of death (garbage codes). Objective: To describe and compare standardized, age-specific, and garbage-code corrected mortality trends for coronary heart disease from 1985 to 2015 in Argentina, Colombia, and Mexico. Methods: Deaths from coronary heart disease were grouped by country, year of registration, sex, and 10-year age bands to calculate age-adjusted and age and sex-specific rates for adults aged ≥25. We corrected for garbage-codes using the methodology proposed by the Global Burden of Disease. Finally, we fitted Joinpoint regression models. Results: In 1985, age-standardized mortality rates per 100,000 population were 136.6 in Argentina, 160.6 in Colombia, and 87.51 in Mexico; by 2015 rates decreased 51% in Argentina and 6.5% in Colombia, yet increased by 61% in Mexico, where an upward trend in mortality was observed in young adults. Garbage-code corrections produced increases in mortality rates, particularly in Argentina with approximately 80 additional deaths per 100,000, 14 in Colombia and 13 in Mexico. Conclusions: Latin American countries are at different stages of the cardiovascular disease epidemic. Garbage code correction produce large changes in the mortality rates in Argentina, yet smaller in Mexico and Colombia, suggesting garbage code corrections may be needed for specific countries. While coronary heart disease (CHD) mortality is falling in Argentina, modest falls in Colombia and substantial increases in Mexico highlight the need for the region to propose and implement population-wide prevention policies.

Download Full-text

Abstract P115: Better Methodologies to Compare Coronary Heart Disease Mortality Trends in Latin American Countries: Argentina, Colombia and Mexico From 1985 to 2012

Circulation ◽

10.1161/circ.135.suppl_1.p115 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Maria C Arroyo Quiroz ◽

Martin O’Flaherty ◽

Hector Lamadrid-Figueroa ◽

Maria L Guzman-Castillo ◽

Simon Capewell ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Latin American ◽

Mortality Rates ◽

P Value ◽

Mortality Trends ◽

Annual Percent Change ◽

Latin American Countries ◽

Garbage Code ◽

Age And Sex

Introduction: Coronary heart disease (CHD) is the leading cause of death worldwide. CHD mortality rates have decreased in most high-income countries, but increased in some Latin-American countries. CHD mortality rates have plateaued among young adults (<55 years) in the US, UK and Australia, but trends in Latin-America are largely unknown. Few studies have analyzed trends in age and sex-specific CHD mortality rates in this region, and almost none has assured data quality by correcting for garbage codes (ICD codes for nonspecific causes of death) as recommended by WHO. Objective: To describe and compare standardized, age-specific and garbage-code corrected mortality trends for coronary heart disease (CHD) from 1985 to 2012 in three contrasting Latin American countries. Methods: CHD deaths (1985-2012) in Argentina, Colombia and Mexico were grouped by calendar year, sex and 10-year age bands to calculate the overall age-adjusted and age and sex specific mortality rates for adults aged ≥25 years. We corrected for garbage-codes for the three countries (1997-2012) using the Global Burden of Disease (GBD) methodology. We then fitted Joinpoint regression models, using the original and garbage code corrected rates, to estimate the annual percent change (APC) and detect points in time when significant changes in the trends occurred. Results: In 2012, age-standardised mortality rates per 100,000 were 65.3 in Argentina, 132.4 in Colombia and 130.3 in Mexico. Compared to 1985, by 2012 mortality fell by 17.5% in Colombia and 52.5% in Argentina. The largest annual decreases in mortality rates were observed in Argentina from 1988-1994 (APC=-5.7 p-value<0.01). The declines in Colombia were constant and smaller for the full period (APC=-0.4 p-value<0.01). CHD mortality rose by 48.9% in Mexico, particularly after 2000. Mortality rates increased in both men and women, particularly in younger men (<39 years) and older women (>60 years). Application of the garbage code corrections produced dramatic increases in mortality rates, more in women than men, and particularly in Argentina: approximately 80 additional deaths per 100,000 (compared with just 14 additional deaths per 10 5 in Colombia and 13 per 10 5 in Mexico). Conclusions: Different Latin American countries demonstrate dramatically different CHD epidemiology. Mortality rates increased after correcting for garbage code misclassification. Although CHD mortality is falling in Argentina, the modest falls in Colombia and substantial rises in Mexico highlight the region’s urgent need for effective, population-wide prevention policies.

Download Full-text

Abstract P364: Recent Trends In Mortality From Coronary Heart Disease Mortality And Its Risk Factors In Selected Developed Countries

Circulation ◽

10.1161/circ.129.suppl_1.p364 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Akira Sekikawa ◽

Katsuyuki Miura ◽

Bradley Willcox ◽

Kamal H Masaki ◽

Russell P Tracy ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Coronary Heart Disease ◽

Heart Disease ◽

Total Cholesterol ◽

Developed Countries ◽

Men And Women ◽

The Us ◽

Recent Trends ◽

The Uk

Objectives: Mortality from coronary heart disease (CHD) in developed countries started to decline in the late 1960’s and early 1970’s and age-adjusted CHD mortality fell about 50%. This decline is attributed to favorable changes in risk factors in the general population, i.e., total cholesterol, blood pressure, smoking, etc., and improved treatment of CHD. We examined recent trends in CHD mortality and its risk factors in selected developed countries. Methods: We selected Australia, Canada, France, Italy, Japan, Spain, Sweden, the UK, and the US. Data on CHD mortality between 1980 and 2005-08 were obtained from the WHO Statistical Information System. To define CHD mortality, codes I20-25 in ICD-10 and corresponding codes in ICDs 8 and 9 were used. Data on risk factors, primarily total cholesterol and systolic blood pressure during the same period were obtained from national surveys as well as literature. Results: in 1980, there was a 2 to 3-fold difference in age-adjusted CHD mortality among these countries both in men and women, with the UK, the US and Canada being high and Japan and France being low. Although between 1980 and 2005-08, age-adjusted CHD mortality continuously declined in all these countries, a 2 to 3-fold difference in the mortality remained with the similar order among these countries. Between 1980 and 2008, age-adjusted mean levels of total cholesterol fell by 21 to 31 mg/dl in men and by 8 to 31 mg/dl in women in these countries except for Japan. Age-adjusted levels of total cholesterol in Japan have continuously increased by 16 mg/dl for both men and women during this period. Meanwhile, between 1980 and 2008 age-adjusted levels of systolic blood pressure fell by 5 to 8 mmHg in men and 6 to 13 mmHg in women in these countries without exception. In 1980, the rate of cigarette smoking in men in Japan was the highest among these countries. Although the rate of smoking in men fell in all these countries, the rates remained the higher in Japan. Conclusions: Age [[Unable to Display Character: –]]adjusted CHD mortality has continuously declined between 1980 and 2005-08 in these developed countries. The decline was accompanied by a constant decrease in population-levels of total cholesterol by 20 to 30 mg/dl except for Japan where levels of total cholesterol have increased by 16 mg/dl. The reasons for persistently low CHD mortality and its downward trend in Japan are unexplained by traditional risk factors. Identifying preventive factors that determine low CHD rates in the Japanese and implementing such factors to the US would eliminate most of CHD epidemics in the US.

Download Full-text