Minhas Abdul Mannan Khan, Al-Kindi Sadeer, Van Spall Harriette G C, Abramov Dmitry
Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine Houston, TX (A.M.K.M.).
Division of Cardiology, Houston Methodist, Houston, TX (S.A.-K.).
Circ Cardiovasc Qual Outcomes. 2025 May;18(5):e011459. doi: 10.1161/CIRCOUTCOMES.124.011459. Epub 2025 Apr 4.
Several sources of data, including the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research (CDC WONDER) and the Global Burden of Disease (GBD) data set, report causes of mortality in the United States. While CDC WONDER contains data based on death certificate codes, the GBD mortality data undergo additional processing, such as cause-of-death reassignment before reporting. Potential differences in reported mortality from cardiovascular disease in the United States between these 2 data sources have not been characterized.
US nationwide cardiovascular cause-of-death data for each year between 2000 and 2019 were obtained from the GBD and the Multiple Cause-of-Death files using CDC WONDER in this longitudinal study. In addition to mortality from cardiovascular disease, mortality from key components of cardiovascular disease, including ischemic heart disease, stroke, and atrial fibrillation/flutter, was determined from each data set. Absolute and crude mortality rates per 100 000 are reported for each data set. Percent differences in cardiovascular mortality from GBD and CDC WONDER and percent changes in cardiovascular mortality across years were calculated.
In 2019, GBD reported 957 455 (95% uncertainty interval, 855 065-1 013 175) cardiovascular deaths, while CDC WONDER reported 859 290 cardiovascular deaths in the United States. Between 2000 and 2019, the reported crude mortality rates from cardiovascular causes in GBD decreased from 327 (297-341) to 292 (261-309), a reduction of 10.7%, and decreased in CDC WONDER from 335 (334-335) to 267 (266-267), a reduction of 20.3%. In 2019, the reported mortality rates for components of cardiovascular disease were higher in GBD compared with CDC WONDER for ischemic heart disease (percent difference, 54.5%), stroke (percent difference, 26.1%), and atrial fibrillation/flutter (percent difference, 25.0%).
There are prominent differences in reported cardiovascular mortality between GBD and CDC WONDER data.
包括美国疾病控制与预防中心的广泛流行病学研究在线数据(CDC WONDER)和全球疾病负担(GBD)数据集在内的多个数据来源报告了美国的死亡原因。虽然CDC WONDER包含基于死亡证明编码的数据,但GBD死亡率数据会经过额外处理,例如在报告前重新分配死因。这两个数据来源在美国心血管疾病报告死亡率方面的潜在差异尚未得到描述。
在这项纵向研究中,使用CDC WONDER从GBD和多死因文件中获取了2000年至2019年每年美国全国范围的心血管死因数据。除了心血管疾病死亡率外,还从每个数据集中确定了心血管疾病关键组成部分的死亡率,包括缺血性心脏病、中风和心房颤动/扑动。报告了每个数据集每10万人的绝对和粗死亡率。计算了GBD和CDC WONDER心血管死亡率的百分比差异以及多年来心血管死亡率的百分比变化。
2019年,GBD报告美国有957455例(95%不确定区间,855065 - 1013175)心血管死亡,而CDC WONDER报告的心血管死亡病例为859290例。2000年至2019年期间,GBD报告的心血管疾病粗死亡率从327(297 - 341)降至292(261 - 309),下降了10.7%,CDC WONDER则从335(334 - 335)降至267(266 - 267),下降了20.3%。2019年,GBD报告的心血管疾病组成部分的死亡率在缺血性心脏病(百分比差异,54.5%)、中风(百分比差异,26.1%)和心房颤动/扑动(百分比差异,25.0%)方面高于CDC WONDER。
GBD和CDC WONDER数据在报告的心血管死亡率方面存在显著差异。