TY - JOUR
T1 - Secular trends in deaths from cardiovascular diseases
T2 - A 25-year community study
AU - Gerber, Yariv
AU - Jacobsen, Steven J.
AU - Frye, Robert L.
AU - Weston, Susan A.
AU - Killian, Jill M.
AU - Roger, Véronique L.
PY - 2006/5
Y1 - 2006/5
N2 - BACKGROUND - Although age-adjusted cardiovascular disease (CVD) mortality has declined over the past decades, controversies remain about whether this trend was similar across locations of death and disease categories and about the existence of age and sex disparities. METHODS AND RESULTS - We examined CVD mortality trends in Olmsted County, Minnesota, between 1979 and 2003 using the categories defined by the American Heart Association, including coronary heart disease (CHD), non-CHD diseases of the heart, and noncardiac circulatory diseases. Data on demographics, cause, and location of death of all 6378 residents who died of CVD were analyzed. Although decreases in the age-adjusted rates occurred in all groups, the magnitude of the decline varied widely. Lesser annual declines were noted in out-of-hospital than in-hospital deaths (1.8% versus 4.8%; P<0.001), in older than in younger persons (1.5% at age ≥85 years versus 3.9% for those ≤74 years of age; P<0.001), and in women relative to men (2.5% versus 3.3%; P=0.007). Furthermore, although CHD showed a marked annual decrease (3.3%), more modest decrements were found for non-CHD diseases of the heart (2.1%) and noncardiac circulatory diseases (2.4%) (P=0.02 and P=0.04 for the comparison with CHD decline, respectively). CONCLUSIONS - Over the past 25 years, CVD mortality declined markedly in the community, but there were large disparities in the magnitude of the decline, resulting in a shift in the distribution toward out-of-hospital and non-CHD deaths. Further reduction in CVD mortality will require strategies directed at elderly persons and women, in whom out-of-hospital rates have improved only minimally.
AB - BACKGROUND - Although age-adjusted cardiovascular disease (CVD) mortality has declined over the past decades, controversies remain about whether this trend was similar across locations of death and disease categories and about the existence of age and sex disparities. METHODS AND RESULTS - We examined CVD mortality trends in Olmsted County, Minnesota, between 1979 and 2003 using the categories defined by the American Heart Association, including coronary heart disease (CHD), non-CHD diseases of the heart, and noncardiac circulatory diseases. Data on demographics, cause, and location of death of all 6378 residents who died of CVD were analyzed. Although decreases in the age-adjusted rates occurred in all groups, the magnitude of the decline varied widely. Lesser annual declines were noted in out-of-hospital than in-hospital deaths (1.8% versus 4.8%; P<0.001), in older than in younger persons (1.5% at age ≥85 years versus 3.9% for those ≤74 years of age; P<0.001), and in women relative to men (2.5% versus 3.3%; P=0.007). Furthermore, although CHD showed a marked annual decrease (3.3%), more modest decrements were found for non-CHD diseases of the heart (2.1%) and noncardiac circulatory diseases (2.4%) (P=0.02 and P=0.04 for the comparison with CHD decline, respectively). CONCLUSIONS - Over the past 25 years, CVD mortality declined markedly in the community, but there were large disparities in the magnitude of the decline, resulting in a shift in the distribution toward out-of-hospital and non-CHD deaths. Further reduction in CVD mortality will require strategies directed at elderly persons and women, in whom out-of-hospital rates have improved only minimally.
KW - Cardiovascular diseases
KW - Epidemiology
KW - Mortality
KW - Population
KW - Prevention
UR - http://www.scopus.com/inward/record.url?scp=33745009714&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33745009714&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.105.590463
DO - 10.1161/CIRCULATIONAHA.105.590463
M3 - Article
C2 - 16682616
AN - SCOPUS:33745009714
SN - 0009-7322
VL - 113
SP - 2285
EP - 2292
JO - Circulation
JF - Circulation
IS - 19
ER -