Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Mar 8;133(10):967-78.
doi: 10.1161/CIRCULATIONAHA.115.019904. Epub 2016 Feb 4.

Modeling Future Cardiovascular Disease Mortality in the United States: National Trends and Racial and Ethnic Disparities

Jonathan Pearson-Stuttard  1 , Maria Guzman-Castillo  2 , Jose L Penalvo  2 , Colin D Rehm  2 , Ashkan Afshin  2 , Goodarz Danaei  2 , Chris Kypridemos  2 , Tom Gaziano  2 , Dariush Mozaffarian  2 , Simon Capewell  2 , Martin O'Flaherty  2
Affiliations

Modeling Future Cardiovascular Disease Mortality in the United States: National Trends and Racial and Ethnic Disparities

Jonathan Pearson-Stuttard et al. Circulation. .

Abstract

Background: Accurate forecasting of cardiovascular disease mortality is crucial to guide policy and programming efforts. Prior forecasts often have not incorporated past trends in rates of reduction in cardiovascular disease mortality. This creates uncertainties about future trends in cardiovascular disease mortality and disparities.

Methods and results: To forecast US cardiovascular disease mortality and disparities to 2030, we developed a hierarchical bayesian model to determine and incorporate prior age, period, and cohort effects from 1979 to 2012, stratified by age, sex, and race, which we combined with expected demographic shifts to 2030. Data sources included the National Vital Statistics System, Surveillance, Epidemiology, and End Results (SEER) single-year population estimates, and US Bureau of Statistics 2012 national population projections. We projected coronary disease and stroke deaths to 2030, first on the basis of constant age, period, and cohort effects at 2012 values, as is most commonly done (conventional), and then with the use of more rigorous projections incorporating expected trends in age, period, and cohort effects (trend based). We primarily evaluated absolute mortality. The conventional model projected total coronary and stroke deaths by 2030 to increase by ≈18% (67 000 additional coronary deaths per year) and 50% (64 000 additional stroke deaths per year). Conversely, the trend-based model projected that coronary mortality would decrease by 2030 by ≈27% (79 000 fewer deaths per year) and stroke mortality would remain unchanged (200 fewer deaths per year). Health disparities will be improved in stroke deaths but not coronary deaths.

Conclusions: After prior mortality trends and expected demographic shifts are accounted for, total US coronary deaths are expected to decline, whereas stroke mortality will remain relatively constant. Health disparities in stroke but not coronary deaths will be improved but not eliminated. These age, period, and cohort approaches offer more plausible predictions than conventional estimates.

Keywords: cardiovascular diseases; ethnic groups; mortality; population groups; projections and predictions.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Total number of CVD Deaths 1979–2030. Observed deaths 1979–2012, conventional projections and trend-based projections 2013–2030. Crude number of deaths, stratified by CVD subtype.
Figure 2
Figure 2
CHD Mortality: Observed crude deaths 1979–2012 and trend-based projections 2013–2030. 2a Men, 2b Women.
Figure 2
Figure 2
CHD Mortality: Observed crude deaths 1979–2012 and trend-based projections 2013–2030. 2a Men, 2b Women.
Figure 3
Figure 3
Stroke Mortality: Observed crude deaths 1979–2012 and trend-based projections 2013–2030. 3a Men, 3b Women.
Figure 3
Figure 3
Stroke Mortality: Observed crude deaths 1979–2012 and trend-based projections 2013–2030. 3a Men, 3b Women.
Figure 4
Figure 4
Validation of mortality projections 2003–2012: Observed crude deaths, ‘trend-based’ and conventional projections. 4a CHD Men, 4b, CHD Women, 4c Stroke Men, 4d Stroke Women.
Figure 4
Figure 4
Validation of mortality projections 2003–2012: Observed crude deaths, ‘trend-based’ and conventional projections. 4a CHD Men, 4b, CHD Women, 4c Stroke Men, 4d Stroke Women.
Figure 4
Figure 4
Validation of mortality projections 2003–2012: Observed crude deaths, ‘trend-based’ and conventional projections. 4a CHD Men, 4b, CHD Women, 4c Stroke Men, 4d Stroke Women.
Figure 4
Figure 4
Validation of mortality projections 2003–2012: Observed crude deaths, ‘trend-based’ and conventional projections. 4a CHD Men, 4b, CHD Women, 4c Stroke Men, 4d Stroke Women.
See this image and copyright information in PMC

References

    1. Morbidity and Mortality: 2012 Chart Book on Cardiovascular, Lung and Blood Diseases. Bethesda, MD: National Heart, Lung and Blood Institute; 2012.
    1. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Soliman EZ, Sorlie PD, Sotoodehnia N, Turan TN, Virani SS, Wong ND, Woo D, Turner MB Subcommittee AHASCaSS. Heart disease and stroke statistics--2012 update: A report from the american heart association. Circulation. 2012;125:e2–e220. - PMC - PubMed
    1. National Cancer Institute; Surveillance, Epidemiology, and End Results Program. [Accessed 22nd May 2015]; http://seer.Cancer.Gov/popdata/singleages.html.
    1. Lee R. The outlook for population growth. Science. 2011;333:569–573. - PMC - PubMed
    1. Mensah GA, Mokdad AH, Ford ES, Greenlund KJ, Croft JB. State of disparities in cardiovascular health in the united states. Circulation. 2005;111:1233–1241. - PubMed

Publication types