Zhang Yuehan, Joshy Grace, Bishop Karen, Adair Tim, Ho Wendy, Sheehan Katrina, Gourley Michelle, Jackson Rod, Nguyen Mai, Banks Emily, Paige Ellie
National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Canberra, Australia.
Int J Epidemiol. 2025 Jun 11;54(4). doi: 10.1093/ije/dyaf112.
Recent Global Burden of Disease (GBD) estimates show increasing cardiovascular disease (CVD) mortality in Australia and New Zealand, prompting concern. This study investigates whether such increases are observed in official national data.
Annual age-standardized coronary heart disease (CHD) and stroke mortality rates for ages 35-84 years in Australia/New Zealand from 2008 to 2018/19 were calculated using official national data and published GBD estimates. Differences in annual mortality rate percentage changes between official data and GBD estimates were calculated separately for each country. Joinpoint regression identified temporal trend changes.
Official data showed annual decreases in CHD mortality of 4.9% (95% CI: 4.4%-5.5%) for Australia and 4.2% (3.7%-4.7%) for New Zealand on average; corresponding annual stroke mortality reductions were 4.3% (3.2%-5.3%) for Australia and 3.7% (2.9%-4.5%) for New Zealand. Absolute CHD mortality rates from GBD were substantively higher than from official data (e.g. 104.7 [103.0-106.5] vs 99.0 [97.3-100.7] per 100 000 people, respectively, Australia, 2008). Contrasting with ongoing declining rates using official data, GBD estimates showed slower overall mortality rate declines, recent increases in CHD mortality (e.g. 1.2% [0.2%-2.2%] annual increases from 2016 to 2019 for Australia), and stagnating stroke mortality. Differences are likely explained by GBD's redistribution of ill-defined causes of death and use of projected data after 2016, when national mortality data were unavailable for GBD estimates.
CHD and stroke mortality in Australia/New Zealand continue to decline, according to gold-standard official data. Disparities with GBD estimates highlight the need for transparency in reporting GBD methods and care in interpretation and application.
近期全球疾病负担（GBD）估计显示，澳大利亚和新西兰的心血管疾病（CVD）死亡率呈上升趋势，令人担忧。本研究调查了官方国家数据中是否也观察到这种上升情况。
利用官方国家数据和已公布的GBD估计值，计算了2008年至2018/19年澳大利亚/新西兰35 - 84岁人群的年度年龄标准化冠心病（CHD）和中风死亡率。分别计算每个国家官方数据和GBD估计值之间年度死亡率百分比变化的差异。连接点回归确定时间趋势变化。
官方数据显示，澳大利亚冠心病死亡率平均每年下降4.9%（95%置信区间：4.4% - 5.5%），新西兰为4.2%（3.7% - 4.7%）；澳大利亚相应的年度中风死亡率下降4.3%（3.2% - 5.3%），新西兰为3.7%（2.9% - 4.5%）。GBD的冠心病绝对死亡率实质上高于官方数据（例如，澳大利亚2008年每10万人分别为104.7[103.0 - 106.5]和99.0[97.3 - 100.7]）。与官方数据显示的持续下降率形成对比，GBD估计显示总体死亡率下降较慢，近期冠心病死亡率有所上升（例如，澳大利亚2016年至2019年每年上升1.2%[0.2% - 2.2%]），中风死亡率停滞不前。差异可能是由于GBD对死因不明的重新分配以及在2016年后使用预测数据，当时GBD估计无法获得国家死亡率数据。
根据金标准官方数据，澳大利亚/新西兰的冠心病和中风死亡率继续下降。与GBD估计值的差异凸显了在报告GBD方法以及解释和应用时保持透明度的必要性。
