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. 2019 Dec 1;4(12):1280-1286.
doi: 10.1001/jamacardio.2019.4187.

Association Between Aging of the US Population and Heart Disease Mortality From 2011 to 2017

Stephen Sidney  1 , Alan S Go  1   2   3   4   5 , Marc G Jaffe  6 , Matthew D Solomon  7 , Andrew P Ambrosy  8 , Jamal S Rana  1   7   5
Affiliations

Association Between Aging of the US Population and Heart Disease Mortality From 2011 to 2017

Stephen Sidney et al. JAMA Cardiol. .

Abstract

Importance: A deceleration in the rate of decrease of heart disease (HD) mortality between 2011 and 2014 has been reported. In the context of the rapid increase in the population of adults aged 65 years and older, extending the examination of HD mortality through 2017 has potentially important implications for public health and medical care.

Objective: To examine changes in the age-adjusted mortality rate and the number of deaths within subcategories of HD from 2011 to 2017 in conjunction with the change in the size of the US population during the same period.

Design, setting, and participants: In this quality improvement study, the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) data set was used to identify national changes in the US population aged 65 years and older and in the age-adjusted mortality rates and number of deaths that were listed with an underlying cause of HD, coronary heart disease (CHD), heart failure, and other HDs from January 1, 2011, to December 31, 2017.

Main outcomes and measures: Changes from 2011 to 2017 in the US population and in age-adjusted mortality rates and number of deaths that were listed with an underlying cause of HD, CHD, heart failure (both as an underlying and a contributing cause), and other HDs overall, by sex and race/ethnicity.

Results: The total size of this population of US adults aged 65 years and older increased 22.9% from 41.4 million to 50.9 million between January 1, 2011, and December 31, 2017, while the population of adults younger than 65 years increased by only 1.7%. During this period, the age-adjusted mortality rate decreased 5.0% for HD and 14.9% for CHD while increasing 20.7% for heart failure and 8.4% for other HDs. The number of deaths increased 8.5% for HD, 38.0% for heart failure, and 23.4% for other HDs while decreasing 2.5% for CHD. A total of 80% of HD deaths occurred in the group of adults aged 65 years and older.

Conclusions and relevance: The substantial increase in the growth rate of the group of adults aged 65 years and older who have the highest risk of HD was associated with an increase in the number of HD deaths in this group despite a slowly declining HD mortality rate in the general population. With the number of adults aged 65 years and older projected to increase an additional 44% from 2017 to 2030, innovative and effective approaches to prevent and treat HD, particularly the substantially increasing rates of heart failure, are needed.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Sidney reported receiving grants from the National Heart, Lung, and Blood Institute outside the submitted work. Dr Go reported receiving grants from the National Institute on Aging and the National Heart, Lung, and Blood Institute during the conduct of the study. No other disclosures were reported.

Figures

Figure.
Figure.. Total Mortality Rates and Number of Deaths, 2000 to 2017
A, Heart disease. B, Coronary heart disease. C, Heart failure as underlying cause. D, Heart failure as contributing cause. E, All other heart disease.
See this image and copyright information in PMC

Comment in

References

    1. Sidney S, Quesenberry CP Jr, Jaffe MG, et al. . Recent trends in cardiovascular mortality in the United States and public health goals. JAMA Cardiol. 2016;1(5):594-599. doi:10.1001/jamacardio.2016.1326 - DOI - PubMed
    1. Sidney S, Quesenberry CP Jr, Jaffe MG, Sorel M, Go AS, Rana JS. Heterogeneity in national U.S. mortality trends within heart disease subgroups, 2000-2015. BMC Cardiovasc Disord. 2017;17(1):192. doi:10.1186/s12872-017-0630-2 - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention, National Center for Health Statistics Underlying cause of death, 1999-2017. CDC WONDER [database online]. Atlanta, GA: Centers for Disease Control and Prevention; 2018. https://wonder.cdc.gov/ucd-icd10.html. Accessed April 4, 2019.
    1. Centers for Disease Control and Prevention, National Center for Health Statistics Multiple cause of death, 1999-2017. CDC WONDER [database online]. Atlanta, GA: Centers for Disease Control and Prevention; 2018. https://wonder.cdc.gov/mcd-icd10.html. Accessed August 8, 2019.
    1. US Census Bureau Projected age groups and sex composition of the population: main projections series for the United States, 2017-2060. Washington, DC: US Census Bureau, Population Division; 2018. https://www2.census.gov/programs-surveys/popproj/tables/2017/2017-summar.... Updated September 2018. Accessed April 4, 2019.