Mortality From Ischemic Heart Disease

Abstract

Background Ischemic heart disease (IHD) has been considered the top cause of mortality globally. However, countries differ in their rates and there have been changes over time. Methods and Results We analyzed mortality data submitted to the World Health Organization from 2005 to 2015 by individual countries. We explored patterns in relationships with age, sex, and income and calculated age-standardized mortality rates for each country in addition to crude death rates. In 5 illustrative countries which provided detailed data, we analyzed trends of mortality from IHD and 3 noncommunicable diseases (lung cancer, stroke, and chronic lower respiratory tract diseases) and examined the simultaneous trends in important cardiovascular risk factors. Russia, United States, and Ukraine had the largest absolute numbers of deaths among the countries that provided data. Among 5 illustrative countries (United Kingdom, United States, Brazil, Kazakhstan, and Ukraine), IHD was the top cause of death, but mortality from IHD has progressively decreased from 2005 to 2015. Age-standardized IHD mortality rates per 100 000 people per year were much higher in Ukraine (324) and Kazakhstan (97) than in United States (60), Brazil (54), and the United Kingdom (46), with much less difference in other causes of death. All 5 countries showed a progressive decline in IHD mortality, with a decline in smoking and hypertension and in all cases a rise in obesity and type II diabetes mellitus. Conclusions IHD remains the single largest cause of death in countries of all income groups. Rates are different between countries and are falling in most countries, indicating great potential for further gains. On the horizon, future improvements may become curtailed by increasing hypertension in some developing countries and more importantly global growth in obesity.

Keywords: coronary artery disease; epidemiology; heart diseases; mortality; noncommunicable diseases; risk factors; statistics.

Figure 1.

Changes in (A) crude death rates and (B) age-standardized mortality rates between 2005 and 2015. These are the 16 countries who provided longitudinal mortality data.

Figure 2.

Variation in age- and sex-specific mortality in (A) United Kingdom, (B) Brazil, (C) United States, (D) Kazakhstan, and (E) Ukraine. All data are from 2015 except Kazakhstan which is from 2012.

Figure 3.

Mortality trends from major causes of death from 2005 to 2015 in (A) United Kingdom, (B) Brazil, (C) United States, (D) Kazakhstan, and (E) Ukraine. Age-standardized mortality rates per 100 000 people from ischemic heart disease (red line), stroke (light blue line), cirrhosis and other liver diseases (green line), chronic lower respiratory tract diseases (yellow line), lung cancer (blue line), transport accidents (orange line), and infectious diseases (purple line).

Figure 4.

Mortality trends from ischemic heart disease (IHD) compared with variations in Gross National Income (GNI) and prevalence of cardiovascular risk factors from 2005 to 2015 in (A) United Kingdom, (B) Brazil, (C) United States, (D) Kazakhstan, and (E) Ukraine. The red line and right axis represent the IHD mortality trend. Behind this are a family of area charts showing trends of GNI (yellow), age-standardized mean body mass index (BMI; purple), age-standardized prevalence of smoking (green), type II diabetes mellitus (DM II; light blue), and hypertension (HTN; orange).

Figure 5.

Statin prescription rates in the United Kingdom from 2005 to 2013. Rates of prescription in the population over 18 y old.