Trends in Cardiovascular Mortality and Public Health Goals
Have national trends in cardiovascular disease (CVD) mortality changed in recent years?
Data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research data system were used for the present analysis. National trends in age-adjusted mortality rates for CVD, heart disease (HD), stroke, and cancer between January 2000, to December 2011, and January 2011, to December 2014 were determined. Sex and race/ethnicity trends were also examined. The primary outcome measures were the annual rates of change and trend in gap between HD and cancer mortality rates.
The decline in CVD, HD, and stroke mortality has decelerated since 2011. In the meantime, rates of decline for cancer mortality have remained stable. The percentage (95% confidence interval), the annual rates of decline for 2000-2011, were 3.79% (3.61% to 3.97%) for CVD, 3.69% (3.51% to 3.87%) for HD, 4.53% (4.34% to 4.72%) for stroke, and 1.49% (1.37% to 1.60%) for cancer mortality. The rates for 2011-2014 were 0.65% (−0.18% to 1.47%) for CVD, 0.76% (−0.06% to 1.58%) for HD, 0.37% (−0.53% to 1.27%) for stroke, and 1.55% (1.07% to 2.04%) for cancer mortality. Deceleration of the decline in all CVD mortality rates occurred in males, females, and all race/ethnicity groups. For example, the annual rates of decline for total CVD mortality for 2000-2011 were 3.69% (3.48% to 3.89%) for males and 3.98% (3.81% to 4.14%) for females; for 2011-2014, the rates were 0.23% (−0.71% to 1.16%) and 1.17% (0.41% to 1.93%), respectively. The gap between HD and cancer mortality persisted.
The investigators concluded that deceleration in the decline of all CVD, HD, and stroke mortality rates has occurred since 2011. If this trend continues, strategic goals for lowering the burden of CVD set by the American Heart Association and the Million Hearts Initiative may not be reached.
These data are concerning and may be affected by significant numbers of adults who have CVD risk factors such as diabetes in addition to sedentary behaviors. All key stakeholders including employers, patients, and governments need to be actively involved in creating healthy environments and improved access to health care.
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