Changing Trends In Coronary Heart Disease Mortality
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Changing Trends In Coronary Heart Disease Mortality
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Author :
language : en
Publisher:
Release Date : 1985
Changing Trends In Coronary Heart Disease Mortality written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1985 with categories.
Proceedings Of The Conference On The Decline In Coronary Heart Disease Mortality
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Author :
language : en
Publisher:
Release Date : 1979
Proceedings Of The Conference On The Decline In Coronary Heart Disease Mortality written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1979 with Coronary heart disease categories.
Abstract: Data on the decrease in coronary heart disease in the US are presented in a collection of papers. Change, and trends in the US are compared to international trends (based on mortality and hospital data). Possible causes for the decline, including pathophysiological bases, coronary care, and artery bypass grafts are covered. Finally, changes in risk factors are described: trends in smoking and hypertension; food consumption patterns; changes in blood cholesterol; relation of physical activity, and environmental and social variables. A summary strategy for quantifying and studying coronary heart disease change is included. (rkm).
A Better Understanding Of Recent Coronary Heart Disease Mortality Trends And Determinants
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Author : Martin O'Flaherty
language : en
Publisher:
Release Date : 2011
A Better Understanding Of Recent Coronary Heart Disease Mortality Trends And Determinants written by Martin O'Flaherty and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011 with categories.
Introduction Coronary heart disease (CHD) is one of the leading global causes of morbidity and mortality. The underlying biological mechanisms are well understood, and a host of causal risk factors for the disease have been identified, mainly related to diet, smoking and physical activity. Evidence-based treatments for the disease are also available, reducing mortality and improving quality of life. The decline in CHD mortality rates observed in most developed countries since the 1960s represents a most remarkable epidemiological phenomenon. However, this decline is not universal, and may now be in jeopardy. Thus, the mortality decline has recently plateaued in young adults in the United States. Furthermore, the absolute burden of disease is set to increase mainly because of an increasingly ageing population, and will represent a heavy burden to high, middle and low income countries alike. Furthermore, CHD incidence may rise in future because of recent adverse trends in major CHD risk factors, namely the worldwide increases in obesity and diabetes prevalence observed since the 1980s. Moreover, new technology and improved treatments are decreasing case fatality in CHD patients, increasing life expectancy and thus expanding the pool of patients surviving with clinically apparent disease. Finally, and crucially, important socioeconomic inequalities persist, perhaps reflecting disease determinants. The complex interplay of these factors and potential changes over time together suggest that the CHD epidemic may still be evolving. Further attention is therefore essential. The analysis of time trends in disease specific mortality can thus potentially help us to understand the population dynamic of diseases such as CHD, warn about key changes and perhaps offer some novel insights for better prevention and control. However, most previous analyses have been focused on age-adjusted rates that might conceal important differences by age or by socioeconomic status, which might provide further understanding of trend drivers. Aims and objectives: My aim is to study recent coronary heart disease mortality time trends in different countries, in order to better understand the current state of the CHD epidemic. Furthermore, I will analyze the relative importance of CHD treatments and risk factors as drivers of the mortality trends. Finally, I will consider the Public Health implications of my findings. My objectives therefore are: 1. To summarize our current understanding of Coronary Heart Disease (CHD) causation 2. To describe recent CHD mortality time trends focusing on age and gender specific trends by identifying periods with similar rate of change in diverse populations (England & Wales, the Netherlands, Poland and Australia). 3. To describe recent CHD mortality time trends by Socio-Economic Status in England and Scotland. 4. To quantify the role of risk factors and evidence-based treatments as drivers of the CHD mortality trends, first using a modelling approach in Poland, and then in England while also considering socioeconomic factors. 5. To consider the public health policy implications of dynamic trends in coronary heart disease mortality. Methods CHD mortality trends were analysed using the joinpoint regression approach. Widely used in cancer epidemiology, but rarely in CHD, this method explores trend data to find points in time ("joinpoints") that define segments where the trend has a constant pace of change. The key strength of this technique is objectivity- (it avoids the detection of potentially biased patterns when trends are described using time intervals defined subjectively by the researcher). Joinpoint avoids this potential bias by essentially removing the observer from the selection process, instead using a formal and objective exploration of the time-series data. My analysis therefore focused on age-adjusted rates, then age and gender specific rates. The analysis for Scotland and England also considered socio-economic status (using area-based measures of material deprivation). The contributions of risk factors and treatments to the observed CHJD mortality trends in Poland were studied using the IMPACT model, a comprehensive, population-based model of CHD epidemiology. The model goal is to quantify the decline in coronary heart disease deaths in the Polish population between 1991 and 2005 which might be explained by risk factor changes and by treatments. The model is comprehensive, incorporating all usual treatments for coronary heart disease and heart failure plus all major cardiovascular risk factors, including smoking, blood pressure, cholesterol, diabetes, obesity and physical activity. Similar analyses but also exploring the socio-economic differences were conducted in England, using a modified IMPACT model (IMPACTsec). That was used to estimate the contribution of risk factors and evidence based treatments to the observed decline in mortality in England between 2000 and 2007, for each quintile of the index of multiple deprivation. Results Age-adjusted trends in England and Wales, Scotland, Australia and the Netherlands conceal important recent age specific patterns. In these countries, the age-adjusted rates show continuing declines; however, among young adults a recent period of slowing down of the rate of decline in CHD mortality has been observed. Furthermore, trends are very dynamic, and the patterns can change surprisingly quickly. In the Netherlands, the sustained period of minimal change in young adults was followed by a period of further decline. Poland offers a strikingly different example of trend dynamism. After a period of constant increase, Poland showed a sudden, sharp decline in CHD mortality rates within a period of a very few years. This decline occurred in all age and gender groups, and still continues. The recent mortality trends are probably attributable more to changes in risk factors rather than medical treatments. For example, using the IMPACT model to study the decline phase of the Polish CHD epidemic, approximately 55% of the observed fall in mortality might be attributed to changes in risk factors, and only about a third to evidence based therapies. Because of the social patterning of risk factors levels, further insights on the role of risk factors as major contributors to trend changes can be obtained by studying trends in levels stratified by socioeconomic circumstances. Scotland and England offer particular opportunities for detailed studies of trends in CHD mortality using high quality data including socioeconomic status. The resulting picture is complex. The recent flattening in CHD mortality trends observed in young adults was confined to the most deprived groups in Scotland, but was more uniform in England. A marked deterioration of medical care is implausible, meaning that the most likely explanation for this recent flattening of CHD mortality must be adverse trends in major cardiovascular risk factors. The CHD mortality modelling in England produced intriguing results. As expected, socio-economic patterning of risk factor changes were observed. For example, decline in smoking levels contributed more to the observed decline amongst the more deprived groups. Social patterning was less clear among young adults in England. Moreover, the IMPACT SEC model analysis suggested that approximately half the CHD mortality fall was attributable to improved treatment uptake, with benefits occurring surprisingly equitably across all social groups. A similar analysis of the Scottish trends is therefore urgently needed to gain better insights on the drivers of the socioeconomic patterning underlying the observed trends. Conclusions The recent flattening in CHD mortality in young adults seen in many countries experiencing an overall decline in deaths strongly suggests that favourable trends can reverse.
Heart Disease
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Author : Gerdi Weidner
language : en
Publisher: IOS Press
Release Date : 2002
Heart Disease written by Gerdi Weidner and has been published by IOS Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2002 with Medical categories.
Annotation This book addresses one major question: Why do men get more heart disease than women? Recent global trends in heart disease show that traditional coronary risk factors, such as elevated blood pressure and cholesterol are poor candidates in explaining the gender gap in heart disease. Changes in these risk factors also cannot explain the recent cardiovascular disease epidemic among middle-aged men in Eastern Europe. This book will focus on environmental, behavioral, and psychosocial variables, as well as new risk factors of a biological nature in an attempt to understand the gender gap in heart disease. It combines perspectives from numerous disciplines, such as demography, epidemiology, medicine, sociology, and psychology. This book features the work of a distinguished group of international researchers appearing in Richard Stone's report on "Stress: the invisible hand in Eastern Europe's death rates" (Science, vol. 288, June 9, 2000, pp. 1732-33). It combines perspectives from numerous disciplines, such as demography, epidemiology, medicine, nutrition, sociology, and psychology to explore the environmental, behavioral, and psychosocial influences on men's greater susceptibility to heart disease
Proceedings Of The Conference On The Decline In Coronary Heart Disease Mortality
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Author :
language : en
Publisher:
Release Date : 1979
Proceedings Of The Conference On The Decline In Coronary Heart Disease Mortality written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1979 with categories.
Trends And Determinants Of Coronary Heart Disease Mortality
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Author : Millicent Higgins
language : en
Publisher:
Release Date : 1989
Trends And Determinants Of Coronary Heart Disease Mortality written by Millicent Higgins and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1989 with Coronary heart disease categories.
The Coronary Heart Disease Pandemic In The Twentieth Century
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Author : William G. Rothstein
language : en
Publisher: CRC Press
Release Date : 2017-12-14
The Coronary Heart Disease Pandemic In The Twentieth Century written by William G. Rothstein and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-12-14 with Medical categories.
This book demonstrates that a pandemic of coronary heart disease occurred in North America, western and northern Europe, and Australia and New Zealand from the 1930s to about 2000. At its peak it caused more deaths than any other disease. The book examines and compares trends in coronary heart disease mortality rates for individual countries. The most detailed analyses are for the United States, where mortality rates are examined for race, sex, and age groups and for geographic regions. Popular explanations for the rise and fall of coronary heart disease mortality rates are examined.
Lessons For Science From The Seven Countries Study
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Author : Hironori Toshima
language : en
Publisher: Springer Science & Business Media
Release Date : 2012-12-06
Lessons For Science From The Seven Countries Study written by Hironori Toshima and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-12-06 with Medical categories.
The Seven Countries Study has made central contributions to the under standing of the socio-cultural influences on population rates of cardiovascular diseases (CVD). It has pointed the way to preventive strategies for whole populations. The Study is unique as a long-term investigation, now in its 35th year. This pioneering work arose in part from a meeting between Professors Ancel Keys and Noboru Kimura to discuss differences observed in clinical mani festations and pathology of coronary disease in the U.S. and Japan. Professor Keys started explorations of the importance in these differences of dietary fat and serum cholesterol when he visited Japan in 1954, and thereafter initiated the Seven Countries Study to test these hypotheses. In the Japanese cohorts of the Study, it became evident from the outset that coronary artery disease was extremely rare, but its incidence has since increased along with dramatic lifestyle changes from traditional Japanese to western styles. The Japanese experience contrasts with a reduction in coronary artery disease in many western countries along with establishment of major preventive efforts in risk factor reduction and cardiac care.
Coronary Heart Disease Epidemiology
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Author : Michael Marmot
language : en
Publisher: Oxford Medical Publications
Release Date : 2005
Coronary Heart Disease Epidemiology written by Michael Marmot and has been published by Oxford Medical Publications this book supported file pdf, txt, epub, kindle and other format this book has been release on 2005 with Medical categories.
Heart attack (ischaemic heart disease or coronary heart disease) as one of a group of cardiovascular diseases, is one of the main causes of death (over 30 million/year) in the developed and developing world. The dual aim of this book is to review the well-established risk factors in CHD and to look forward to disease prevention, equipped with lessons from the past. The book covers etiology to public health, including studies within a single population and international studies, important areas of methodological development, trials to test preventive strategies, and the application of epidemiological and other knowledge to the development of public health policy for the prevention of widespread disease. It is an all-encompassing work containing contributions from the world authorities in the field.
Cardiovascular Diseases In The United States
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Author : Iwao Milton Moriyama
language : en
Publisher: Harvard University Press
Release Date : 1971
Cardiovascular Diseases In The United States written by Iwao Milton Moriyama and has been published by Harvard University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 1971 with Cardiovascular system categories.
Cardiovascular diseases kill and disable more than a million Americans each year. The major types of this complex of diseases are coronary heart disease, hypertensive disease, cerebrovascular diseases, rheumatic heart disease, and congenital malformations of the circulatory system. Authors Moriyama, Krueger, and Stamler relate each of these types to etiology, age of patient at onset, clinical course, and socioeconomic impact on the population. For each type of cardiovascular disease they analyze the quantitative data on the incidence, prevalence, and levels and time trends of mortality and on the demographic characteristics of person affected. They also examine international differences in levels and trends in mortality and point out areas for further research. More than thirty-five figures as well as extensive tables document their text.