Coronary heart disease epidemics: not all the same

Mirzaei, M., Truswell, A.S., Taylor, R. and Leeder, S.R. (2009) Coronary heart disease epidemics: not all the same. Heart, 95 9: 740-746. doi:10.1136/hrt.2008.154856


Author Mirzaei, M.
Truswell, A.S.
Taylor, R.
Leeder, S.R.
Title Coronary heart disease epidemics: not all the same
Journal name Heart   Check publisher's open access policy
ISSN 1355-6037
Publication date 2009-05-01
Sub-type Article (original research)
DOI 10.1136/hrt.2008.154856
Open Access Status Not yet assessed
Volume 95
Issue 9
Start page 740
End page 746
Total pages 7
Place of publication London, United Kingdom
Publisher B M J Group
Language eng
Subject 2705 Cardiology and Cardiovascular Medicine
Abstract Background: Coronary heart disease (CHD) was an important epidemic in many developed countries in the 20th century and there is concern because the epidemic has affected Eastern Europe, Russia and Central Asia and is starting to affect developing countries. Methods: The epidemic curves of CHD mortality for 55 countries, which had reliable data and met other selection criteria, were examined using age-standardised death rates 35-74 years from the World Health Organization. Annual male mortality rates for individual countries from 1950 to 2003 were plotted and a table and a graph used to classify countries by magnitude, pattern and timing of its CHD epidemic. Results: The natural history of CHD epidemics varies markedly among countries. Different CHD patterns are distinguishable including "rise and fall" (classic epidemic pattern), "rising" (first part of epidemic) and "flat" (no epidemic yet). Furthermore, epidemic peaks were higher in Anglo-Celtic countries first affected by the epidemic, and subsequent peaks were less, except for the recent extraordinary epidemics in Russia and Central Asian republics. There were considerable differences among some continental or regional geographical areas. Eastern European, South American and Asian countries have quite different epidemic characteristics, including shorter epidemic cycles. Conclusions: It cannot be assumed that WHO regions or any other geographical regions will be useful when analysing CHD epidemics or deciding upon strategic policies to reduce CHD in individual countries. The needs for action that are urgent in some countries are less so in others, and even regional country groups can have quite different epidemic characteristics.
Formatted abstract
Background:
Coronary heart disease (CHD) was an important epidemic in many developed countries in the 20th century and there is concern because the epidemic has affected Eastern Europe, Russia and Central Asia and is starting to affect developing countries.

Methods:
The epidemic curves of CHD mortality for 55 countries, which had reliable data and met other selection criteria, were examined using age-standardised death rates 35–74 years from the World Health Organization. Annual male mortality rates for individual countries from 1950 to 2003 were plotted and a table and a graph used to classify countries by magnitude, pattern and timing of its CHD epidemic.

Results:
The natural history of CHD epidemics varies markedly among countries. Different CHD patterns are distinguishable including “rise and fall” (classic epidemic pattern), “rising” (first part of epidemic) and “flat” (no epidemic yet). Furthermore, epidemic peaks were higher in Anglo-Celtic countries first affected by the epidemic, and subsequent peaks were less, except for the recent extraordinary epidemics in Russia and Central Asian republics. There were considerable differences among some continental or regional geographical areas. Eastern European, South American and Asian countries have quite different epidemic characteristics, including shorter epidemic cycles.

Conclusions:
It cannot be assumed that WHO regions or any other geographical regions will be useful when analysing CHD epidemics or deciding upon strategic policies to reduce CHD in individual countries. The needs for action that are urgent in some countries are less so in others, and even regional country groups can have quite different epidemic characteristics.
Keyword Risk-factors
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: ERA 2012 Admin Only
School of Public Health Publications
 
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Created: Thu, 03 Sep 2009, 18:18:43 EST by Mr Andrew Martlew on behalf of School of Public Health