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CHD-related mortality declining overall, relatively unchanged among young patients, women
Although deaths related to CHD have declined sharply in the United States since 1979, the decrease is most pronounced among older patients; the mortality rate among younger patients — particularly women — has changed only slightly since 1990, according to recent results.
The researchers evaluated age-specific data on CHD-related mortality among adults in the United States aged 25 years or older between 1979 and 2011. Changes to mortality rates were assessed between 1979-1989, 1990-1999 and 2000-2011. Patients were stratified according to age as younger than 55 years, 55-64 years and 65 years or older.
Overall, CHD-related mortality declined by 68% among both men and women from 1979 to 2011. However, the observed decrease in mortality rate was less pronounced among younger people, particularly women aged younger than 55 years, who exhibited an estimated annual percent decrease of 1.9%.
CHD-related mortality declined significantly among patients aged 65 years or older. The researchers calculated an estimated annual percent decrease in mortality of 2.6% for men and 1.7% for women until 2000, at which point the decline grew more pronounced (estimated annual percentage decrease of 5% in women and of 4.4% among men after 2000).
A similar decline in CHD-related mortality was observed from 1979-1989 among patients aged younger than 55 years, with an annual percentage decrease of 5.5% among men and 4.6% among women until 1990. However, the decline in mortality rate stopped in subsequent years in this population. Younger women in particular exhibited an estimated annual percentage increase of 0.1% between 1990 and 1999, followed by a 1% estimated annual decrease after 2000.
Viola Vaccarino
Joinpoint regression modeling (National Cancer Institute) also indicated a less pronounced decline in CHD-related mortality among patients aged younger than 55 years compared with older patients after 1989. Younger women had a poorer annual decrease in mortality compared with younger men until 2004, after which point there was no significant difference according to gender.
“We think that these trends are not related to differences in treatment and hospitalization, but rather to a lack of effective preventive strategies for young people, particularly women,” Viola Vaccarino, MD, PhD, professor and chair of epidemiology at Emory University Rollins School of Public Health in Atlanta, said in a press release. “This population has not been studied as much as older groups, partially because they are generally considered to be at low risk. There is an urgent need for more research.” – by Adam Taliercio
Disclosure: The researchers report no relevant financial disclosures.