CDC: CVD mortality declining, but still too high

Azithromycin not linked to CV risk in Danish study
Azithromycin not linked to CV risk in Danish study

HealthDay News -- Despite declining overall, about 200,000 preventable U.S. deaths were attributable to cardiovascular disease in 2010, with deaths occurring disproportionately among those younger than 65 years, males, blacks and those in the South, according to the CDC.

The overall rate of preventable deaths before the age of 75 years due to heart disease, stroke and hypertensive disease declined 29% from 2001 to 2010, Linda J. Schieb, MSPH, from the CDC in Atlanta, and colleagues reported in Morbidity and Mortality Weekly Report.

However, 56% of these deaths occurred in people younger than 65 years, an age group for whom the number of preventable CVD deaths did not change over time.

Although blacks saw similar percentage declines as the general population during the study period, this group still had twice the rate of avoidable cardiovascular deaths as whites, the researchers noted.

In order to quantify the number of avoidable deaths from cardiovascular disease in the United States, Schieb and colleagues analyzed mortality data from the National Vital Statistics System and population estimates from the Census Bureau from 2001 to 2010.

Only deaths that occurred before the age of 75 years were included, based on the average U.S. life expectancy of 78 years. Any deaths coded with an underlying cause of ischemic heart disease, stroke, hypertension or chronic rheumatic heart disease -- all of which are potentially avoidable by addressing risk factors or through treatment -- were included.

In 2010 alone, 200,070 deaths from heart disease, stroke and hypertensive disease were deemed avoidable. Men were twice as likely to experience an avoidable cardiovascular death than women (83.7 vs. 39.6 per 100,000), the researchers found.

The avoidable death rate among blacks was 1.9-fold higher than for whites at 107.3 deaths per 100,000. And risk for preventable CVD mortality was also elevated 20% in Alaska Natives compared with whites.

In terms of geographic location, avoidable death rates were highest in the South census region, specifically in  southern Appalachia, Tennessee, Arkansas, Mississippi, Louisiana and Oklahoma.

The oldest age group, those aged 65 to 75 years, experienced the biggest drop in avoidable CVD deaths, 5.1% per year compared with 3.3% per year among those aged 55 to 64 years, and just 0.8% per year in 35- to 54-year-olds. There was no change over time in the 35 and younger age group. 

"Nearly one-fourth of all cardiovascular disease deaths are avoidable," Schieb and colleagues concluded. "National, state, and local initiatives aimed at improving health-care systems and supporting healthy behaviors are essential to reducing avoidable heart disease, stroke and hypertensive disease deaths."

They made several recommendations for such initiatives, including using electronic health records to identify patients who need help quitting smoking or controlling BP and cholesterol, referring these patients to community resources, connecting uninsured patients to health insurance marketplaces in their states and using national quality indicators to monitor progress and clinical improvements on these measures. 

Study limitations include reliance on administrative codes to determine cause of death, which may have misclassified some of the deaths, and the lack of a universal definition for an avoidable cardiovascular death.


References

  1. Scheib LJ et al. MMWR 2013;62:1-7.
Loading links....
You must be a registered member of Clinical Advisor to post a comment.

Sign Up for Free e-newsletters