Secular trends in deaths from cardiovascular diseases: A 25-year community study

Yariv Gerber, Steven J. Jacobsen, Robert L. Frye, Susan A. Weston, Jill M. Killian, Véronique L. Roger

Research output: Contribution to journalArticle

105 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)2285-2292
Number of pages8
JournalCirculation
Volume113
Issue number19
DOIs
StatePublished - May 1 2006

Keywords

  • Cardiovascular diseases
  • Epidemiology
  • Mortality
  • Population
  • Prevention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Gerber, Y., Jacobsen, S. J., Frye, R. L., Weston, S. A., Killian, J. M., & Roger, V. L. (2006). Secular trends in deaths from cardiovascular diseases: A 25-year community study. Circulation, 113(19), 2285-2292. https://doi.org/10.1161/CIRCULATIONAHA.105.590463