Explaining the recent decrease in coronary heart disease mortality rates in Ireland, 1985-2000

Journal of Epidemiology and Community Health
Kathleen BennettS Capewell

Abstract

To examine the proportion of the recent decline in coronary heart disease (CHD) deaths in Ireland attributable to (a) "evidence based" medical and surgical treatments, and (b) changes in major cardiovascular risk factors. IMPACT, a previously validated model, was used to combine and analyse data on the use and effectiveness of specific cardiology treatments and risk factor trends, stratified by age and sex. The main data sources were published trials and meta-analyses, official statistics, clinical audits, and observational studies. Between 1985 and 2000, CHD mortality rates in Ireland fell by 47% in those aged 25-84. Some 43.6% of the observed decrease in mortality was attributed to treatment effects and 48.1% to favourable population risk factor trends; specifically declining smoking prevalence (25.6%), mean cholesterol concentrations (30.2%), and blood pressure levels (6.0%), but offset by increases in adverse population trends related to obesity, diabetes, and inactivity (-13.8%). The results emphasise the importance of a comprehensive strategy that maximises population coverage of effective treatments, and that actively promotes primary prevention, particularly tobacco control and a cardioprotective diet.

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Citations

Nov 28, 2012·Irish Journal of Medical Science·V O AlongeM Codd
Jan 15, 2009·European Heart Journal·Lena BjörckSimon Capewell
Oct 18, 2008·European Journal of Public Health·Tom O'HaraSiobhan Jennings
Aug 6, 2010·European Journal of Public Health·Richard LayteKathleen Bennett
Sep 18, 2012·International Journal of Epidemiology·Patricia M KearneyIvan J Perry
Mar 23, 2013·Clinical and Experimental Pharmacology & Physiology·Anne-Marie WatersLynelle Moon
Aug 28, 2012·BMJ Open·Niveen M E Abu-RmeilehAbdullatif Husseini
Aug 13, 2011·BMC Public Health·Simon Capewell, Earl S Ford
Apr 27, 2012·Globalization and Health·Michael M EngelgauAjay Mahal
Jan 28, 2014·PloS One·Rosa Björk ThorolfsdottirKarl Andersen
Nov 10, 2013·European Heart Journal·Ian M Graham, Marie-Therese Cooney
Jan 12, 2011·Annual Review of Public Health·Sam HarperGeorge Davey Smith
Aug 15, 2014·Preventing Chronic Disease·Jennifer GanderSteven N Blair
Sep 21, 2010·The European Journal of General Practice·Patricia FitzpatrickLeslie Daly
Jan 27, 2016·International Journal of Cardiology·M O'FlahertyUNKNOWN Euroheart II Steering Group
Jun 23, 2009·The American Journal of Cardiology·Simon CapewellJulia A Critchley
Aug 22, 2009·The Journal of Clinical Hypertension·Brendan BuckleyIvan J Perry
Dec 3, 2013·International Journal of Cardiology·Cláudia GouvinhasNuno Lunet
Apr 2, 2013·International Journal of Cardiology·Zubair KabirKathleen Bennett
Nov 11, 2011·International Journal of Cardiology·Nguyen Dang ThangJohan Herlitz
Dec 2, 2008·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Kathleen BennettSimon Capewell
Nov 28, 2012·European Journal of Preventive Cardiology·Jan BruthansSimon Capewell
Jul 3, 2013·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Gabrielle McKeeDebra K Moser
Mar 10, 2012·European Journal of Preventive Cardiology·John HughesKathleen Bennett
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Jul 8, 2010·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Patricia FitzpatrickLeslie Daly
Aug 22, 2017·Journal of Aging and Health·Sharon M CruiseFrank Kee
Jan 22, 2010·Circulation·Donald M Lloyd-JonesUNKNOWN American Heart Association Strategic Planning Task Force and Statistics Committee

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