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
Comparative Study
. 2017 Jul 18;17(1):192.
doi: 10.1186/s12872-017-0630-2.

Heterogeneity in national U.S. mortality trends within heart disease subgroups, 2000-2015

Stephen Sidney  1 , Charles P Quesenberry Jr  2 , Marc G Jaffe  3 , Michael Sorel  2 , Alan S Go  2   4   5 , Jamal S Rana  2   6   7
Affiliations
Comparative Study

Heterogeneity in national U.S. mortality trends within heart disease subgroups, 2000-2015

Stephen Sidney et al. BMC Cardiovasc Disord. .

Abstract

Background: The long-term downward national U.S. trend in heart disease-related mortality slowed substantially during 2011-2014 before turning upward in 2015. Examining mortality trends in the major subgroups of heart disease may provide insight into potentially more targeted and effective prevention and treatment approaches to promote favorable trajectories. We examined national trends between 2000 and 2015 in mortality attributed to major heart disease subgroups including ischemic heart disease, heart failure, and all other types of heart disease.

Methods: Using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (WONDER) data system, we determined national trends in age-standardized mortality rates attributed to ischemic heart disease, heart failure, and other heart diseases from January 1, 2000, to December 31, 2011, and from January 1, 2011, to December 31, 2015. Annual rate of changes in mortality attributed to ischemic heart disease, heart failure, and other heart diseases for 2000-2011 and 2011-2015 were compared.

Results: Death attributed to ischemic heart disease declined from 2000 to 2015, but the rate of decline slowed from 4.96% (95% confidence interval 4.77%-5.15%) for 2000-2011 to 2.66% (2.00%-3.31%) for 2011-2015. In contrast, death attributed to heart failure and all other causes of heart disease declined from 2000 to 2011 at annual rates of 1.94% (1.77%-2.11%) and 0.64% (0.44%-0.82%) respectively, but increased from 2011 to 2015 at annual rates of 3.73% (3.21% 4.26%) and 1.89% (1.33-2.46%). Differences in 2000-2011 and 2011-2015 decline rates were statistically significant for all 3 endpoints overall, by sex, and all race/ethnicity groups except Asian/Pacific Islanders (heart failure only significant) and American Indian/Alaskan Natives.

Conclusions: While the long-term decline in death attributed to heart disease slowed between 2011 and 2014 nationally before turning upward in 2015, heterogeneity existed in the trajectories attributed to heart disease subgroups, with ischemic heart disease mortality continuing to decline while death attributed to heart failure and other heart diseases switched from a downward to upward trend. While systematic efforts to prevent and treat ischemic heart disease continue to be effective, urgent attention is needed to address the challenge of heart failure.

Keywords: Coronary heart disease; Epidemiology; Heart disease; Heart failure; Mortality rate.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

Relevant financial activities outside the submitted work included research grant support related to cardiovascular disease for Dr. Go from Astra-Zeneca, Sanofi, and CSL Behring. Dr. Rana reports receiving grant funding from Regeneron and Sanofi to his institution.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Age-adjusted mortality in U.S., 2000–2015 by sex and race-ethnicity. Legend: Total, Male, Female, NH White, NH Asian/Pacific Islander, Hispanic, NH Black, NH American Indian/Alaskan Native (NH – Non-Hispanic)
See this image and copyright information in PMC

References

    1. Sidney S, Quesenberry CP, Jr, Jaffe MG, Sorel M, Nguyen-Huynh MN, Kushi LH, Go AS, Rana JS. Recent trends in cardiovascular mortality in the United States and public health goals. JAMA Cardiol. 2016. doi:10.1001/jamacardio.2016.1326. - PubMed
    1. Xu JQ, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2015. NCHS data brief, no 267. Hyattsville, MD: National Center for Health Statistics. 2016. - PubMed
    1. Center for Disease Control and Prevention. Underlying cause of death, 1999–2014 request. http://wonder.cdc.gov/ucd-icd10.html. Accessed 4 Aug 2016.
    1. Klein RJ, Schoenberg CA. Age adjustment using the 2000 projected U.S. population. Healthy People Statistical Notes, no. 20. Hyattsville, Maryland: National Center for Health Statistics. January 2001. https://www.cdc.gov/nchs/data/statnt/statnt20.pdf. - PubMed
    1. Navar AM, Peterson ED, Wojdyla D, Sanchez RJ, Sniderman AD, D'Agostino RB, Sr, Pencina MJ. Temporal changes in the association between modifiable risk factors and coronary heart disease incidence. JAMA. 2016;316(19):2041–2043. doi: 10.1001/jama.2016.13614. - DOI - PMC - PubMed

Publication types