Kesteloot Hugo, Sans Susana, Kromhout Daan
Department of Epidemiology, Kapucijnenvoer 35, 3000 Leuven, Belgium.
Eur Heart J. 2006 Jan;27(1):107-13. doi: 10.1093/eurheartj/ehi511. Epub 2005 Oct 4.
Important changes in cardiovascular and all-cause mortality rates are occurring in Western and Eastern Europe, each with their own dynamics. Differences in trends will be analysed and possible causes are discussed.
Mortality data for cardiovascular and all-cause mortality rates from different countries were obtained from WHO and were analysed for the period 1970-2000. The annual changes in cause-specific mortality rates were calculated using linear and polynomial regression models. Mortality rates declined almost linearly for ischaemic heart disease, stroke, and total cardiovascular diseases between 1970 and 2000 in Western Europe. In both men and women, the decline for these diseases varied between 50 and 65% or approximately 2%/year in this period. In contrast, in Eastern Europe cardiovascular mortality rates reached a maximum in the period 1990-94, followed by a decline of approximately 3%/year in Poland, 2%/year in Hungary, and 5%/year in the Baltic states. The changes in cardiovascular mortality rates were reflected in all-cause mortality rates in both Western and Eastern Europe.
Over the past 30 years, mortality rates in cardiovascular diseases increased or decreased very rapidly. The causes are complex but changes in diet appear to play a major role. The more recent declines in Western Europe also reflect improvements in modern cardiovascular treatment.
西欧和东欧的心血管疾病死亡率及全因死亡率都出现了重要变化,且各有其动态变化情况。本文将分析趋势差异并探讨可能的原因。
从世界卫生组织获取不同国家心血管疾病死亡率及全因死亡率数据,并对1970 - 2000年期间的数据进行分析。使用线性和多项式回归模型计算特定病因死亡率的年度变化。1970年至2000年期间,西欧的缺血性心脏病、中风和心血管疾病总死亡率几乎呈线性下降。在此期间,男性和女性的这些疾病死亡率下降幅度在50%至65%之间,或每年约2%。相比之下,东欧的心血管疾病死亡率在1990 - 1994年期间达到最高值,随后波兰每年下降约3%,匈牙利每年下降2%,波罗的海国家每年下降5%。西欧和东欧的心血管疾病死亡率变化均反映在全因死亡率中。
在过去30年里,心血管疾病死亡率的上升或下降速度非常快。原因很复杂,但饮食变化似乎起主要作用。西欧近期的死亡率下降也反映出现代心血管治疗的改善。