Comparing the decline in coronary heart disease and stroke mortality in neighbouring countries with different healthcare systems.

Hdl Handle:
http://hdl.handle.net/10147/294122
Title:
Comparing the decline in coronary heart disease and stroke mortality in neighbouring countries with different healthcare systems.
Authors:
Bennett, K; Hughes, J; Jennings, S; Kee, F; Shelley, E
Affiliation:
Trinity Centre for Health Sciences, St James's Hospital, , Dublin, Ireland.
Citation:
Comparing the decline in coronary heart disease and stroke mortality in neighbouring countries with different healthcare systems. 2013: Heart
Publisher:
Heart
Journal:
Heart (British Cardiac Society)
Issue Date:
4-Jun-2013
URI:
http://hdl.handle.net/10147/294122
DOI:
10.1136/heartjnl-2013-303921
PubMed ID:
23735936
Additional Links:
http://www.ncbi.nlm.nih.gov/pubmed/23735936
Abstract:
OBJECTIVE: To examine age and gender specific trends in coronary heart disease (CHD) and stroke mortality in two neighbouring countries, the Republic of Ireland (ROI) and Northern Ireland (NI). DESIGN: Epidemiological study of time trends in CHD and stroke mortality. SETTING/PATIENTS: The populations of the ROI and NI, 1985-2010. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Directly age standardised CHD and stroke mortality rates were calculated and analysed using joinpoint regression to identify years where the slope of the linear trend changed significantly. This was performed separately for specific age groups (25-54, 55-64, 65-74 and 75-84 years) and by gender. Annual percentage change (APC) and 95% CIs are presented. RESULTS: There was a striking similarity between the two countries, with percentage change between 1985 and 1989 and between 2006 and 2010 of 67% and 69% in CHD mortality, and 64% and 62% in stroke mortality for the ROI and NI, respectively. However, joinpoint analysis identified differences in the pace of change between the two countries. There was an accelerated pace of decline (negative APC) in mortality for both CHD and stroke in both countries from the mid-1990s (APC ROI -8% (95% CI -9.5 to 6.5) and NI -6.6% (-6.9 to -6.3)), but the accelerated decrease started later for CHD mortality in the ROI. In recent years, a levelling off in CHD mortality was observed in the 25-54 year age group in NI and in stroke mortality for men and women in the ROI. CONCLUSIONS: While differences in the pace of change in mortality were observed at different time points, similar, substantial decreases in CHD and stroke mortality were achieved between 1985 and 1989 and between 2006 and 2010 in the ROI and NI despite important differences in health service structures. There is evidence of a levelling in mortality rates in some groups in recent years.
Item Type:
Article
Language:
en
Keywords:
HEART DISEASE
ISSN:
1468-201X

Full metadata record

DC FieldValue Language
dc.contributor.authorBennett, Ken_GB
dc.contributor.authorHughes, Jen_GB
dc.contributor.authorJennings, Sen_GB
dc.contributor.authorKee, Fen_GB
dc.contributor.authorShelley, Een_GB
dc.date.accessioned2013-06-17T11:43:23Z-
dc.date.available2013-06-17T11:43:23Z-
dc.date.issued2013-06-04-
dc.identifier.citationComparing the decline in coronary heart disease and stroke mortality in neighbouring countries with different healthcare systems. 2013: Hearten_GB
dc.identifier.issn1468-201X-
dc.identifier.pmid23735936-
dc.identifier.doi10.1136/heartjnl-2013-303921-
dc.identifier.urihttp://hdl.handle.net/10147/294122-
dc.description.abstractOBJECTIVE: To examine age and gender specific trends in coronary heart disease (CHD) and stroke mortality in two neighbouring countries, the Republic of Ireland (ROI) and Northern Ireland (NI). DESIGN: Epidemiological study of time trends in CHD and stroke mortality. SETTING/PATIENTS: The populations of the ROI and NI, 1985-2010. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Directly age standardised CHD and stroke mortality rates were calculated and analysed using joinpoint regression to identify years where the slope of the linear trend changed significantly. This was performed separately for specific age groups (25-54, 55-64, 65-74 and 75-84 years) and by gender. Annual percentage change (APC) and 95% CIs are presented. RESULTS: There was a striking similarity between the two countries, with percentage change between 1985 and 1989 and between 2006 and 2010 of 67% and 69% in CHD mortality, and 64% and 62% in stroke mortality for the ROI and NI, respectively. However, joinpoint analysis identified differences in the pace of change between the two countries. There was an accelerated pace of decline (negative APC) in mortality for both CHD and stroke in both countries from the mid-1990s (APC ROI -8% (95% CI -9.5 to 6.5) and NI -6.6% (-6.9 to -6.3)), but the accelerated decrease started later for CHD mortality in the ROI. In recent years, a levelling off in CHD mortality was observed in the 25-54 year age group in NI and in stroke mortality for men and women in the ROI. CONCLUSIONS: While differences in the pace of change in mortality were observed at different time points, similar, substantial decreases in CHD and stroke mortality were achieved between 1985 and 1989 and between 2006 and 2010 in the ROI and NI despite important differences in health service structures. There is evidence of a levelling in mortality rates in some groups in recent years.en_GB
dc.languageENG-
dc.language.isoenen
dc.publisherHearten_GB
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/23735936en_GB
dc.rightsArchived with thanks to Heart (British Cardiac Society)en_GB
dc.subjectHEART DISEASE-
dc.titleComparing the decline in coronary heart disease and stroke mortality in neighbouring countries with different healthcare systems.en_GB
dc.typeArticleen
dc.contributor.departmentTrinity Centre for Health Sciences, St James's Hospital, , Dublin, Ireland.en_GB
dc.identifier.journalHeart (British Cardiac Society)en_GB
dc.description.provinceLeinsteren

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