The Australian epidemic of cardiovascular mortality 1935-2005: Effects of period and birth cohort

Taylor, Richard, Page, Andrew and Danquah, Jessica (2011) The Australian epidemic of cardiovascular mortality 1935-2005: Effects of period and birth cohort. Journal of Epidemiology and Community Health, 66 7: e18-1-e18-7. doi:10.1136/jech.2010.109538


Author Taylor, Richard
Page, Andrew
Danquah, Jessica
Title The Australian epidemic of cardiovascular mortality 1935-2005: Effects of period and birth cohort
Journal name Journal of Epidemiology and Community Health   Check publisher's open access policy
ISSN 0143-005X
1470-2738
Publication date 2011-01-30
Sub-type Article (original research)
DOI 10.1136/jech.2010.109538
Volume 66
Issue 7
Start page e18-1
End page e18-7
Total pages 7
Place of publication London, United Kingdom
Publisher BMJ Group
Collection year 2012
Language eng
Formatted abstract
Background This study investigates the period and birth cohort effects in cardiovascular disease (CVD) mortality in Australia, and assesses explanations related to contemporaneous effects of changes in risk factors (period effects) and influences of exposures earlier in life (cohort effects).

Methods
Australian mortality from diseases of the circulatory system (DoCS; International Classification of Diseases (ICD) 9th revision, chapter 7), were investigated by sex and 5-year age group (35-79 years) from 1935 to 2005 for: all DoCS, all DoCS less rheumatic heart disease (RHD) and stroke. Ischaemic heart disease (IHD; ICD9 410-4) trends from 1968 were also examined. The extent to which the Australian CVD epidemic was characterised by period effects or birth cohort effects was investigated by age and cohort-specific analyses of secular trends, and age-period-cohort (APC) models.


Results
The CVD epidemic increased into the 1960s, with men one third higher than women, predominantly due to IHD. A sustained decline occurred in both sexes from 1970. Deduction of RHD from CVD steepened the ascent of the epidemic. Age-specific analyses of CVD mortality (less RHD) by period and cohort, and APC modelling, indicate that the rise and fall of the epidemic are period effects.

Conclusion The period epidemic of CVD mortality in Australia 1935e2005, consistent with international reports, supports the concurrent effects of changes in risk factors in adults on CVD mortality, and does not support effects of differential exposures by birth cohort, as would occur with changes in perinatal influences such as birth weight. Prevention of CVD mortality should focus on lowering risk factors in adults.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published Online First 30 January 2011

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
 
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Created: Thu, 22 Mar 2012, 15:56:37 EST by Geraldine Fitzgerald on behalf of School of Public Health