Trends in age-standardised and age-specific mortality from ischaemic heart disease in Germany
- 140 Downloads
Research from some industrialised countries indicated a flattening of the declining ischaemic heart disease (IHD) mortality trends in certain population groups. This study aims to investigate age-standardised, as well as sex- and age-specific time trends in IHD mortality in Germany.
Using German vital statistics between 1980 and 2007, age-standardised and age-specific IHD mortality rates for men and women were calculated. Joinpoint software was used to estimate average annual percentage changes (AAPC) together with 95% confidence intervals and to identify changing trends in mortality. To account for the reunification in 1990 trends for West Germany alone were investigated in sensitivity analysis.
Since 1980, marked decreases in mortality of 50% in men and 39% in women were observed, with AAPC of 2.4 and 1.5%, respectively. While moderate declines in mortality were observed since the early 1980s in men, significant decreases in women were only found after 1995. Trends in mortality varied substantially across age groups, showing decreases in older age (75+ years) only during the last 5–10 years. A flattening of mortality declines was not observed. In West Germany, overall decreases and AAPC were larger and differences between men and women were somewhat smaller.
German IHD mortality trends present a complex picture with profound decreases since 1980. However, declines were smaller and delayed compared to other industrialised countries. Also, time trends were not homogeneous in men and women, as well as across age groups. Preventive measures need to be strengthened to account for failures in the past and to counter the increasing burden of modifiable risk factors.
KeywordsIschaemic heart disease Mortality Germany Trend
- 2.Sans S, Kesteloot H, Kromhout D (1997) The burden of cardiovascular diseases mortality in Europe Task Force of the European Society of Cardiology on Cardiovascular Mortality and Morbidity Statistics in Europe. Eur Heart J 18:1231–1248Google Scholar
- 7.Passa P (2002) Diabetes trends in Europe. Diabetes Metab Res Rev 18 Suppl 3:S3–S8Google Scholar
- 13.Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet 364:937–952CrossRefPubMedGoogle Scholar
- 14.Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De BG, Ebrahim S, Gjelsvik B, Herrmann-Lingen C, Hoes A, Humphries S, Knapton M, Perk J, Priori SG, Pyorala K, Reiner Z, Ruilope L, Sans-Menendez S, Scholte op RW, Weissberg P, Wood D, Yarnell J, Zamorano JL, Walma E, Fitzgerald T, Cooney MT, Dudina A, Vahanian A, Camm J, De CR, Dean V, Dickstein K, Funck-Brentano C, Filippatos G, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Hellemans I, Altiner A, Bonora E, Durrington PN, Fagard R, Giampaoli S, Hemingway H, Hakansson J, Kjeldsen SE, Larsen ML, Mancia G, Manolis AJ, Orth-Gomer K, Pedersen T, Rayner M, Ryden L, Sammut M, Schneiderman N, Stalenhoef AF, Tokgozoglu L, Wiklund O, Zampelas A (2007) European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur Heart J 28:2375–2414CrossRefPubMedGoogle Scholar
- 17.Critchley J, Capewell S (2004) Smoking cessation for the secondary prevention of coronary heart disease. Cochrane database of systematic reviews (Online) 3041Google Scholar
- 18.Randomised trial of cholesterol lowering in 4,444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S) (1994) Lancet 344:1383–1389Google Scholar
- 19.JBS 2: Joint British Societies’ guidelines on prevention of cardiovascular disease in clinical practice (2005) Heart 91 Suppl 5: v1–52Google Scholar
- 27.Federal Statistical Office (Statistisches Bundesamt). Federal Health Monitoring (Gesundheitsberichterstattung des Bundes), last accessed 4th January 2010. http://www.gbe-bund.de
- 28.Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M, Kastarinen M, Poulter N, Primatesta P, Rodriguez-Artalejo F, Stegmayr B, Thamm M, Tuomilehto J, Vanuzzo D, Vescio F (2003) Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 289:2363–2369CrossRefPubMedGoogle Scholar
- 29.Thefeld W (1999) Prevalence of diabetes mellitus in the adult German population. Gesundheitswesen 61 Spec No:S85–S89Google Scholar
- 30.Muller-Riemenschneider F, Nocon M, Willich SN (2009) Prevalence of modifiable cardiovascular risk factors in German adolescents. Eur J Cardiovasc Prev RehabilGoogle Scholar