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Demographic and Epidemiologic Drivers of Global Cardiovascular Mortality | Journal Scan
Study Questions:
Can the effects of population growth, aging of the population, and epidemiologic changes in disease on trends in mortality be disentangled so as to allow for planning the future of the health care system and benchmarking progress toward the reduction of cardiovascular disease (CVD)?
Methods:
The authors used mortality data from the Global Burden of Disease Study 2013, which includes data on 188 countries grouped into 21 world regions. They developed three counterfactual scenarios to represent the principal drivers of change in CV deaths (population growth alone, population growth and aging, and epidemiologic changes in disease) from 1990 to 2013. Secular trends and correlations with changes in national income were examined.
Results:
Global deaths from CVD increased by 41% between 1990 and 2013 despite a 39% decrease in age-specific death rates; this increase was driven by a 55% increase in mortality due to the aging of populations and a 25% increase due to population growth. The relative contributions of these drivers varied by region; only in Central Europe and Western Europe did the annual number of deaths from CVD actually decline. Change in gross domestic product per capita was correlated with change in age-specific death rates only among upper-middle income countries, and this correlation was weak; there was no significant correlation elsewhere.
Conclusions:
The aging and growth of the population resulted in an increase in global CV deaths between 1990 and 2013, despite a decrease in age-specific death rates in most regions. Only Central and Western Europe had gains in CV health that were sufficient to offset these demographic forces.
Perspective:
An example of the need for this type of analysis is how to plan to accomplish the United Nations goal for a 25% reduction in premature mortality from CVD by the year 2025.
Keywords: Mortality, Aging, Benchmarking, Cardiovascular Diseases, Cost of Illness, Demography, Gross Domestic Product, Mortality, Premature, Population, Population Growth, Primary Prevention
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