Abstract P364: Recent Trends In Mortality From Coronary Heart Disease Mortality And Its Risk Factors In Selected Developed Countries
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.
Author Disclosures: A. Sekikawa: None. K. Miura: None. B. Willcox: None. K.H. Masaki: None. R.P. Tracy: None. Y. Miyamoto: None. H. Ueshima: None. L.H. Kuller: None.
- © 2014 by American Heart Association, Inc.