Abstract 14679: Demographic and Epidemiologic Drivers of Cardiovascular Mortality: Findings from the Global Burden of Disease, Injuries and Risk Factors Study, 1990-2010
Introduction: Global cardiovascular disease (CVD) deaths are increasing due to the combined effects of three factors: population growth, population ageing, and changes in disease epidemiology. Disentangling the impact of these three drivers on trends in mortality is important for health system planning and benchmarking progress towards the reduction in CVD. We hypothesized large regional variation in these demographic forces.
Methods: We used all available CVD mortality data, as estimated for the Global Burden of Disease, Risk Factors,and Injuries Study 2010 (GBD 2010) in 187 countries. Three counterfactual scenarios were computed representing drivers of change in CVD deaths from 1990 to 2010 (population growth alone, growth and ageing, and change in disease epidemiology) in 21 world regions. We repeated our analysis 1000 times for each 5-year age-sex-country-specific death rate, separately for 10 sub-causes of CVD, using the complete set of model draws from GBD 2010 and report the mean and 95% uncertainty interval of the resulting distribution.
Results: There was a 34.1% (95% UI 31.2-38.9) decrease in age-specific CVD death rates between 1990-2010 but the number of global deaths continued to rise. The increase was due to a 44.7% (95% UI 44.4-45.1) increase in CVD deaths due to population ageing and a 20.5% (95% UI 20.0-20.9) increase due to population growth. Population ageing and growth led to a significant increase in CVD deaths in most regions. Ageing and growth drove increases in deaths with smaller or no improvement in age-specific CVD mortality in S Asia, C Asia, SE Asia, E Asia, Oceania, and the Caribbean. Ageing alone drove the increase in E Europe. Improvements in health balanced ageing in the high income Asia Pacific. For Southern Latin America, C Europe, Australasia, high income N America, and W Europe, improvements in health led to stable or decreased deaths despite ageing and growth. Only atrial fibrillation and PVD, as sub-causes of CVD, saw increases in all three drivers of change.
Conclusions: Population ageing and growth account for a large part of the increasing number of global deaths due to CVD. Only a few regions have experienced gains in cardiovascular health large enough to offset these demographic trends.
Author Disclosures: G.A. Roth: None. M.H. Forouzanfar: None. A. Moran: None. R.M. Barber: None. G. Nguyen: None. V. Feigin: None. M. Naghavi: None. G. Mensah: None. C.J. Murray: None.
This research has received full or partial funding support from the American Heart Association.
- © 2014 by American Heart Association, Inc.