Cardiology Department, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
Biostatistics and Fundamentals of Scientific Research, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
Vasc Health Risk Manag. 2023 Aug 23;19:519-526. doi: 10.2147/VHRM.S417693. eCollection 2023.
Cardiovascular diseases (CVD) are the leading cause of mortality in Kazakhstan. In the last decade, Kazakhstan has carried out a number of reforms in the healthcare sector, in particular, to reduce mortality from significant diseases, including CVD. This study aimed to provide the trend of avoidable mortality from CVD in Kazakhstan.
We extracted data from the Bureau of National Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan on population by age; mortality rates from chronic rheumatic heart disease (I05-I09); hypertensive diseases (I10-I15); ischaemic heart disease (I20-I25); cerebrovascular diseases (I60-I69) from 2011 to 2021, by gender and 5-year age group (0, 1-4, 5-9, 74). We applied join point regression to calculate the average annual percentage change (AAPC). In addition, crude mortality and trends were calculated per 100,000 population.
The avoidable mortality rates, including treatable and preventable mortality decreased between 2011 and 2019 and then increased in the last two years (2020 and 2021) in all four studied disease groups. The AAPC showed that total avoidable mortality rates decreased between 2011 and 2021-6.0 points (-10.6 to - 1.1) (p = 0.017), whereas in males -4.2 (-8.3 to 0.1) and females - 5.1 (-8.8 to -1.3) (p = 0.009). Avoidable mortality rates from ischemic heart disease, cerebrovascular and hypertensive disease has been reduced stronger in male compared to female. The crude mortality declined over the period given; however, among young people mortality is still high.
Our findings showed that avoidable mortality from CVD decreased over the last years, which could be related to the policy on strengthening the primary care on early diagnosis and detection of CVD and its risk factors. However, primary healthcare facilities need to improve activities on health literacy (drug adherence, risk factors) of the population, including the prevention of CVD.
心血管疾病（CVD）是哈萨克斯坦的主要死亡原因。在过去的十年中，哈萨克斯坦在医疗保健领域进行了多项改革，特别是为了降低包括 CVD 在内的重大疾病的死亡率。本研究旨在提供哈萨克斯坦可避免的 CVD 死亡率趋势。
我们从哈萨克斯坦战略规划和改革机构国家统计局提取了按年龄划分的人口数据；2011 年至 2021 年，按性别和 5 岁年龄组（0、1-4、5-9、74）划分的慢性风湿性心脏病（I05-I09）、高血压疾病（I10-I15）、缺血性心脏病（I20-I25）、脑血管疾病（I60-I69）的死亡率数据。我们应用连接点回归计算平均年百分比变化（AAPC）。此外，按每 10 万人计算了粗死亡率和趋势。
在所有四个研究疾病组中，2011 年至 2019 年期间，可避免死亡率（包括可治疗和可预防的死亡率）下降，然后在过去两年（2020 年和 2021 年）上升。AAPC 显示，2011 年至 2021 年期间，总可避免死亡率下降了 6.0 个百分点（-10.6 至-1.1）（p = 0.017），而男性下降了 4.2 个百分点（-8.3 至 0.1），女性下降了 5.1 个百分点（-8.8 至-1.3）（p = 0.009）。与女性相比，男性缺血性心脏病、脑血管疾病和高血压疾病的可避免死亡率下降幅度更大。在研究期间，粗死亡率有所下降；然而，年轻人的死亡率仍然很高。
我们的研究结果表明，近年来 CVD 的可避免死亡率有所下降，这可能与加强初级保健以早期诊断和检测 CVD 及其危险因素的政策有关。然而，初级保健设施需要改善人口健康素养（药物依从性、危险因素）活动，包括预防 CVD。
