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Global heart disease, mortality rates declined over last 32 years

Between 1980 and 2012, global mortality rates for heart disease, stomach and cervical cancers declined, according to recent worldwide mortality data on noncommunicable diseases. Over the same time period, however, mortality rates increased for diabetes, liver and lung cancers, and chronic respiratory disease in women.

“Noncommunicable diseases are the leading health concerns of the modern era, accounting for two-thirds of global deaths, half of all disability, and rapidly growing costs,” Mohammed K. Ali, PhD, associate professor of global health and epidemiology at Emory University, and colleagues, wrote. “To provide a contemporary overview of the burdens caused by noncommunicable diseases, we compiled mortality data reported by authorities in 49 countries for atherosclerotic cardiovascular diseases; diabetes; chronic respiratory diseases; and lung, colon, breast, cervical, liver and stomach cancers.”

Mohammed K. Ali

Researchers used data from the WHO Mortality Database for males and females aged 0 to 85 years from 1980 to 2012 and included data from 49 countries with good national registration system coverage.

Ali and colleagues reported cardiovascular disease mortality rates were lowest among high-income Asia-Pacific countries like Japan and Hong Kong, as well as Mediterranean countries like Spain, Italy, Greece and Portugal. However, Asia-Pacific countries had the highest mortality rate for stroke. Overall, compared with low- and middle-income countries, cardiovascular disease mortality rates were lower in high-income countries.

Depending on the organ involved, mortality rates for cancer varied according to sex and country income level, according to Ali and colleagues. Cervical and stomach cancer mortality rates declined across the world, while liver and lung cancer mortality rates increased.

The mortality rate for diabetes fell sharply in Greece in the 1980s. However, the rest of the world experienced either flat (North and South Americas, Western Europe and the Mediterranean) or increased (Mexico, Australia, New Zealand, Trinidad and Tobago) rates during the study period.

In an interview with Healio.com/Family Medicine, Ali said the reduced mortality rates for conditions like heart disease and stroke, as well as some cancers, “suggest clinicians are doing a great job in terms of preventive care — lowering blood pressure and cholesterol levels, screening and encouraging self-screening, and possibly, that reductions in tobacco use are also contributing.”

Increases in mortality rates for diabetes, however, suggest diabetes and obesity are two conditions currently not being managed well, and that the non-cardiovascular effects of diabetes — including kidney disease — deserve more attention, he said.

“Lastly, while much of this is good news in high-income countries like the U.S., our data show two important take-home messages. No. 1: More needs to be done in low- and middle-income countries in terms of preventive care, reductions in tobacco exposure and also better documentation of causes of death. No. 2: Even here in the U.S., while death rates are declining, that doesn’t mean we have less of these diseases. In fact, with population growth and lower deaths, it means that clinicians have and will increasingly face higher numbers of people with chronic conditions (cancers, diabetes, etc.) and we have to figure out how to handle the higher volume of patients clinicians will have to manage.”– by Will Offit

Disclosures: Healio.com/Family Medicine was unable to confirm relevant financial disclosures at the time of publication.