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HealthDay News — Coronary heart disease (CHD) mortality declined from 1990 to 2019, although the decline is slowing among younger cohorts, according to a study published in the September issue of the American Heart Journal.
Cande V. Ananth, Ph.D., M.P.H., from the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues conducted a sequential time-series analysis from 1990 to 2019 to examine mortality trends among men and women aged 25 to 84 years in the United States with CHD recorded as the underlying cause of death. The preventable fraction of CHD death attributable to alcohol, smoking, and high body mass index was estimated through the Global Burden of Disease.
The researchers found that the age-standardized CHD mortality rate declined from 210.5 per 100,000 in 1990 to 66.8 in 2019 (annual change, −4.04 percent; incidence rate ratio, 0.32) among women and from 442.4 to 156.7 per 100,000, respectively (annual change, −3.74 percent; incidence rate ratio, 0.36) among men. Among younger cohorts, a slowing of the decline in CHD mortality rates was seen. The decline was slightly attenuated with correction for unmeasured confounders through a quantitative bias analysis. With elimination of smoking, alcohol, and obesity, half of all CHD deaths could have been prevented, including 1,726,022 female and 2,897,767 male CHD deaths between 1990 and 2019.
“The ultimate goal is to help inform standards of care and public health priorities by determining which patients face the highest level of risk for cardiovascular events,” Ananth said in a statement. “Although increased screening and population-wide interventions are possible, the returns are likely to be minimal, at best, while costs will be prohibitively high. We need to maximize returns from our limited resources by identifying high-risk subsets of patients and targeting intervention to them.”
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