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

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.

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Paraoxonase 1 (Q192R) gene polymorphism, coronary heart disease and the risk of a new acute coronary event

Clínica e Investigación en Arteriosclerosis (English Edition) ◽

10.1016/j.artere.2017.01.001 ◽

2017 ◽

Vol 29 (1) ◽

pp. 1-6

Author(s):

Efrén Martínez-Quintana ◽

Fayna Rodríguez-González ◽

José María Medina-Gil ◽

Paloma Garay-Sánchez ◽

Antonio Tugores

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Gene Polymorphism ◽

Coronary Event ◽

Paraoxonase 1 ◽

Acute Coronary Event

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Accelerated melanoma mortality rates among middle-aged white males with tumors of all thicknesses.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e21029 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e21029-e21029

Author(s):

Juliana Berk-Krauss ◽

David Polsky ◽

Jennifer Stein ◽

Alan Geller

Keyword(s):

White Women ◽

Age Groups ◽

White Men ◽

Mortality Rates ◽

Age Group ◽

Middle Aged ◽

Mortality Trends ◽

Men And Women ◽

And Gender ◽

Melanoma Mortality

e21029 Background: Effective early detection of melanoma remains one of the most crucial strategies in improving patient prognosis, due to the inverse relationship between primary tumor thickness and survival time. However, recent studies have demonstrated the mortality burden of thin melanomas is at least as severe as that of thicker melanomas. Recognizing specific mortality trends among men and women by age and thickness is essential for establishing targeted melanoma screening efforts. Methods: We evaluated Surveillance, Epidemiology and End Results (SEER) data from 2009-2013. Melanoma thickness was divided into four standard categories: 0.01-1.00mm, 1.01-2.00mm, 2.01-4.00mm and > 4.01 mm. Melanoma mortalities were calculated among white men and women by age and thickness. We used a Bayesian analysis to calculate the probability of an individual dying from a melanoma of a given gender, age, and thickness. We then compared these probabilities between men and women. Results: Among white men, the largest increases in mortality rates occurred in the jump from the 45-49 to 50-54 age group at an increase of 68% for 0.01-1.00mm tumors, and from the 50-54 to 55-59 age group at an increase of 91% for 1.01-2.00mm tumors, 71% 2.01-4.00mm tumors and 80% for > 4.01mm tumors. In white women, mortality rates regardless of thickness increased at a slow incremental pace, across all age groups at an average overall rate of 36%. Mortality rates for white men with < 1mm and 1.01-2mm melanomas were comparable within the age groups less than 64 years, as was the case for white women with tumors of these thicknesses. The probability of a man dying was greater than of a woman for any age or thickness category. Conclusions: Melanoma mortality rate trends are nuanced and can vary significantly by age, thickness, and gender. In white men, mortality rates begin to accelerate sharply around the mid-50s age group. Screening efforts should therefore target detecting melanoma in middle-aged males in the in situ or earliest stage.

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

Circulation ◽

10.1161/circ.131.suppl_1.p052 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Kobina A Wilmot ◽

Martin O’Flaherty ◽

Simon Capewell ◽

Earl S Ford ◽

Viola Vaccarino

Keyword(s):

Coronary Heart Disease ◽

Young Adults ◽

Heart Disease ◽

Young Women ◽

Cardiovascular Mortality ◽

Young Men ◽

Mortality Rates ◽

Men And Women ◽

The Us ◽

Age And Sex

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.

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Abstract P365: Turning in the Mortality Trends from Coronary Heart Disease in Japan: Age-Specific Analysis of the Regional Difference in Japan from 1969 to 2007

Circulation ◽

10.1161/circ.129.suppl_1.p365 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Akira Okayama ◽

Nagako Okuda ◽

Hirotsugu Ueshima

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Mortality Rate ◽

Old Age ◽

Urban Population ◽

Mortality Rates ◽

Vital Statistics ◽

Age Group ◽

Mortality Trends ◽

Younger Generation

Objective: To examine the recent mortality trends of coronary heart disease (CHD), we compared the age specific CHD mortality trends in Japan and in urban and in the rest of Japan, respectively using Vital Statistics. Methods and Results: We compared CHD mortality rates in all Japan, the urban population (20 million) and in the rest of Japan (100 million) from 1969 to 2007 for 30 to 69 years of age. In 1969 [[Unable to Display Character: ‑]] 1970, the age[[Unable to Display Character: ‑]]adjusted CHD mortality rate was 57.7 per 100,000 for men and 25.9 for women in Japan, and was the same as those of the urban population (59.2 for men and 26.8 for women) and the rest of Japan (57.3 for men and 25.9 for women). The CHD mortality rate in the rest of Japan decreased to 28.4 for men and 7.6 for women in 2006-2007. Although CHD mortality rate in the urban population also decreased to 39.9 for men and 10.1 for women in 2006 - 2007, the decline was much smaller. Trends in age-specific CHD mortality rates was compared between Period I (1969 - 1978), Period II (1981- 1994) and period III (1996 - 2007). Among men in Japan and in the rest of Japan, the decline in the mortality rate for the 30 to 49[[Unable to Display Character: ‑]]year[[Unable to Display Character: ‑]]old[[Unable to Display Character: ‑]]age group was initially observed in Period I and II, and has turned to increase significantly (p<0.001) in the Period III while continuous declining trends in 50-59 and 60-69 year old-age-group. Trends in urban population went ahead, changes in the declining trends was observed both the Period II and III among 30-49 year-old-age group and period III among 50-59 year-old-age group while continuous decline was observed among 60-69 year-old-age group. Similar trends were observed among women. These trends coincide with the increase in the fat intake mainly among younger generation. Conclusions: Observed increase in CHD mortality of men in Japan among younger generation proceeded by those in the urban population may predict the future increase in CHD mortality in Japan.

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Abstract 15749: Sex-differences in Coronary Heart Disease Between Individuals With Familial Hypercholesterolemia and Controls in Norway During 1992-2017

Circulation ◽

10.1161/circ.142.suppl_3.15749 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Karianne Svendsen ◽

Jannicke Igland ◽

Henriette W Krogh ◽

Grethe S Tell ◽

Liv J Mundal ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Familial Hypercholesterolemia ◽

Sex Difference ◽

Cumulative Incidence ◽

Age Groups ◽

Excess Risk ◽

Control Population ◽

Men And Women ◽

Increased Risk

Introduction: During the last 30 years, treatment of familial hypercholesterolemia (FH) has been revolutionized, but it is not known if both sexes equally benefit in these advances, and whether this could have affected the sex difference in risk of coronary heart disease (CHD). We aimed to study sex difference in the risk of CHD between men and women with FH compared to non-FH men and women. Methods: We obtained data on CHD hospitalization and death from Norwegian health registries in 4,525 individuals diagnosed with FH between 1992 and 2014 and an age and sex matched control population of 88,892. The sex distribution was about 50/50 between women and men, and the mean age at start of follow-up was 36 years. Results: The cumulative incidence of CHD (FH vs. non-FH controls) in women and men are shown in Figure 1 with a clear increased risk in FH compared to controls. The cumulative incidence starts to increase at a younger age in men compared with women, both in FH and non-FH controls. This corresponds to an age adjusted 2.6-fold higher risk of CHD in men compared with women in both the FH and control population. In the FH population, men aged 20-39 years had a hazard ratio (HR) of 5.3 (95% CI: 2.6-10.9) compared with women, whereas the corresponding HR between women and men in non-FH controls was 3.7 (95% CI: 2.6-5.3). There was no significant interaction between sex and FH status, indicating that the excess risk in men was similar in FH and non-FH controls. Stratified by sex and adjusted for age, we found that both men and women with FH had a 2-fold higher risk of CHD than controls. The highest excess risk was observed in ages 20-30 years with a of HR= 4.5 (95% CI: 2.2-9.2) and a HR of= 5.5 (95%CI: 4.60-9.34) in women and men, respectively. Conclusions: The risk of CHD among individuals with FH was higher in men than in women in all age groups presented, with no differences between the FH sample and the non-FH controls. However, the relative risk in FH compared with controls was similar for both sexes.

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Heterogeneous trends in burden of heart disease mortality by subtypes in the United States, 1999-2018: observational analysis of vital statistics

BMJ ◽

10.1136/bmj.m2688 ◽

2020 ◽

pp. m2688 ◽

Cited By ~ 1

Author(s):

Nilay S Shah ◽

Rebecca Molsberry ◽

Jamal S Rana ◽

Stephen Sidney ◽

Simon Capewell ◽

...

Keyword(s):

United States ◽

Heart Failure ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Hypertensive Heart Disease ◽

Mortality Rates ◽

Ischemic Heart ◽

Percentage Change ◽

Annual Percentage Change ◽

Disease Mortality

Abstract Objective To describe trends in the burden of mortality due to subtypes of heart disease from 1999 to 2018 to inform targeted prevention strategies and reduce disparities. Design Serial cross sectional analysis of cause specific heart disease mortality rates using national death certificate data in the overall population as well as stratified by race-sex, age, and geography. Setting United States, 1999-2018. Participants 12.9 million decedents from total heart disease (49% women, 12% black, and 19% <65 years old). Main outcome measures Age adjusted mortality rates (AAMR) and years of potential life lost (YPLL) for each heart disease subtype, and respective mean annual percentage change. Results Deaths from total heart disease fell from 752 192 to 596 577 between 1999 and 2011, and then increased to 655 381 in 2018. From 1999 to 2018, the proportion of total deaths from heart disease attributed to ischemic heart disease decreased from 73% to 56%, while the proportion attributed to heart failure increased from 8% to 13% and the proportion attributed to hypertensive heart disease increased from 4% to 9%. Among heart disease subtypes, AAMR was consistently highest for ischemic heart disease in all subgroups (race-sex, age, and region). After 2011, AAMR for heart failure and hypertensive heart disease increased at a faster rate than for other subtypes. The fastest increases in heart failure mortality were in black men (mean annual percentage change 4.9%, 95% confidence interval 4.0% to 5.8%), whereas the fastest increases in hypertensive heart disease occurred in white men (6.3%, 4.9% to 9.4%). The burden of years of potential life lost was greatest from ischemic heart disease, but black-white disparities were driven by heart failure and hypertensive heart disease. Deaths from heart disease in 2018 resulted in approximately 3.8 million potential years of life lost. Conclusions Trends in AAMR and years of potential life lost for ischemic heart disease have decelerated since 2011. For almost all other subtypes of heart disease, AAMR and years of potential life lost became stagnant or increased. Heart failure and hypertensive heart disease account for the greatest increases in premature deaths and the largest black-white disparities and have offset declines in ischemic heart disease. Early and targeted primary and secondary prevention and control of risk factors for heart disease, with a focus on groups at high risk, are needed to avoid these suboptimal trends beginning earlier in life.

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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.

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Temporal trend in adolescent mortality from aggression in Brazil, 2000 to 2017

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1112 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

V O M Pereira ◽

E C Aquino ◽

R B Corassa ◽

M D M Mascarenhas ◽

W M Ramalho ◽

...

Keyword(s):

Mortality Rate ◽

Temporal Trend ◽

Age Groups ◽

Population Group ◽

Social Situation ◽

Mortality Rates ◽

Percentage Change ◽

Ecological Design ◽

Annual Percentage Change ◽

Upward Trend

Abstract Background Mortality from aggression in adolescents reflects one of the symptoms of the Brazilian social situation, which makes this population group vulnerable, exposing them to situations that determine their death in an early and violent way. This work contributes to the analysis of the temporal trend of adolescent mortality due to aggression throughout Brazil from 2000 to 2017. Methods A ecological design time series was carried out on the mortality rate of adolescents due to aggression in Brazil, from 2000 to 2017. Data from the Mortality Information System (SIM) of the Ministry of Health of Brazil was used. Mortality rates were analyzed according to sex and age groups (10-14 and 15-19 years). The joinpoint regression method was used to calculate the annual trend in mortality rates. Results The mortality rate among female adolescents aged 10 to 14 years decreased from 1.81 to 1.74 deaths/100 thousand inhab., and in the group aged 15 to 19, increased from 6.64 to 7.87 deaths/100.000 inhab., from 2000 to 2017. The Average Annual Percentage Change (AAPC) of the rates showed a steady trend of mortality in the groups from 10 to 14 years (AAPC = -0.4; 95% CI -1.4-0.7) and 15 to 19 years (AAPC = 0.7; 95% CI -2.3-3.9). In males, the rate for the 10 to 14-year-old group increased from 4.56 to 6.64 deaths/100.000 inhab., and in the 15 to 19 year old group, increased from 73.06 to 122.78 deaths/100.000 inhab., from 2000 to 2017. The AAPC showed an upward trend in the groups between 10 and 14 years old (AAPC = 2.3; 95% CI % 0.2-4.4) and 15 to 19 years (AAPC = 2.8; 95% CI 2.1-3.5). In the 15 to 19-year-old group, the upward trend of the period between 2009 and 2017 stood out [Annual Percentage Change (APC) = 5.1; 95% CI 4.0-6.3)]. Conclusions This analysis can contribute with subsidies for the improvement of public policies and intersectoral actions that act on the vulnerabilities to which adolescents are exposed and that reduce the mortality rates due to aggressions. Key messages Mortality from aggression in adolescents aged 15-19 showed, in the female sex, an increase from 6.64 to 7.87 deaths/100.000 inhab., and in males, an increase from 73.06 to 122.78 deaths/100.000 inhab. The upward trend in the mortality rate in male adolescents aged 15 to 19 was highlighted in the period from 2009 to 2017 [Annual Percentage Variation (APC) = 5.1; 95% CI 4.0–6.3).

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Paraoxonase 1 (Q192R) gene polymorphism, coronary heart disease and the risk of a new acute coronary event

Clínica e Investigación en Arteriosclerosis ◽

10.1016/j.arteri.2016.07.005 ◽

2017 ◽

Vol 29 (1) ◽

pp. 1-6

Author(s):

Efrén Martínez-Quintana ◽

Fayna Rodríguez-González ◽

José María Medina-Gil ◽

Paloma Garay-Sánchez ◽

Antonio Tugores

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Gene Polymorphism ◽

Coronary Event ◽

Paraoxonase 1 ◽

Acute Coronary Event

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Yoga and Cardiovascular Health Trial (YACHT): a UK-based randomized mechanistic study of a yoga intervention plus usual care versus usual care alone following an acute coronary event, BMJ Open 2019;9:e030119

Integrative Medicine Case Reports ◽

10.38205/imcr.010245 ◽

2020 ◽

Vol 1 (2) ◽

pp. 45

Author(s):

Saras Jyoti

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Usual Care ◽

Cardiovascular Health ◽

Coronary Event ◽

Mechanistic Study ◽

Acute Coronary Event ◽

Body Postures ◽

The World

Over the years Yoga has gained popularity throughout the world because of its various health benefits. Yoga is mind-body intervention which includes breathing, body postures and meditation (1). The studies on Yoga have documented to lower the stress and depression and are believed to improve biological cardiovascular risk factors (2–4). Cardiac rehabilitation (CR) is a program designed to strengthen cardiovascular health if you have experienced the heart related problems, and it has been shown to improve cardiovascular mortality and hospital re-admissions in patients with coronary heart disease (CHD). Yoga could, therefore, be a useful addition to CR. In this UK-based randomized report (Yoga and Cardiovascular Health Trial (YACHT), the hypothesis was that Yoga could be related to primarily with improvements in cardiovascular function in patients suitable for CR.

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