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Explaining the fall in Coronary Heart Disease mortality in the Republic of Ireland between 2000 and 2015 - IMPACT modelling study.
International Journal of Cardiology ( IF 3.2 ) Pub Date : 2020-03-31 , DOI: 10.1016/j.ijcard.2020.03.067
Vivien Marasigan 1 , Ivan Perry 2 , Kathleen Bennett 3 , Kevin Balanda 4 , Simon Capewell 5 , Martin O' Flaherty 5 , Zubair Kabir 2
Affiliation  

BACKGROUND To investigate the contribution of individual and population factors to Coronary Heart Disease (CHD) mortality rates in Ireland between 2000 and 2015. METHODS The Irish IMPACT CHD model was utilized with CHD Deaths Prevented or Postponed (DPPs) as outcome. RESULTS CHD mortality rates in Ireland in those aged 25-84 years fell by 56% (63% in women vs. men 53%), with 4060 fewer deaths than expected in 2015. Improvements in CHD risk factors explained ~30% of the decline (785 DPPs in men; 425 in women): [population systolic blood pressure (+25% DPPs), mean cholesterol serum levels (+11%) and smoking prevalence (+5%)]. Additional deaths attributable to rises in diabetes prevalence (-6%), BMI (-4%) and physical inactivity (-2%) negatively impacted DPPs. Increased uptake of cardiology treatments explained ~60% of the decline (1620 DPPs in men; 825 in women), particularly secondary prevention and heart failure treatments. Some 10% was unexplained. CONCLUSION CHD mortality declined in Ireland between 2000 and 2015, with two-thirds attributable to increased uptake in cardiology treatments and only one-third to improvements in population risk factors, partly reflecting adverse trends in obesity, diabetes and physical inactivity. Additional investments in prevention policies and treatments will be necessary to reduce future CHD deaths.

中文翻译:

说明爱尔兰共和国2000至2015年间冠心病死亡率的下降-IMPACT模型研究。

背景技术为了调查2000年至2015年爱尔兰个人和人口因素对冠心病(CHD)死亡率的贡献。方法将爱尔兰IMPACT CHD模型与预防或推迟CHD死亡(DPP)结合使用。结果爱尔兰的25-84岁人群冠心病死亡率下降了56%(女性为63%,男性为53%),死亡人数比2015年减少了4060人。冠心病危险因素的改善解释了下降的30% (男性785 DPPs;女性425 DPP):[收缩压人群(+ 25%DPPs),平均胆固醇血清水平(+ 11%)和吸烟率(+ 5%)]。由于糖尿病患病率上升(-6%),BMI(-4%)和缺乏身体活动(-2%)而导致的额外死亡对DPP产生了负面影响。心脏病治疗的摄取增加解释了下降的约60%(男性1620 DPP;女性为825),尤其是二级预防和心力衰竭治疗。约有10%无法解释。结论爱尔兰的CHD死亡率在2000年至2015年期间有所下降,其中三分之二归因于心脏病治疗的摄取增加,而只有三分之一归因于人口风险因素的改善,部分反映了肥胖,糖尿病和缺乏运动能力的不利趋势。为减少将来的冠心病死亡,有必要对预防政策和治疗进行额外的投资。糖尿病和缺乏运动。为减少将来的冠心病死亡,有必要对预防政策和治疗进行额外的投资。糖尿病和缺乏运动。为减少将来的冠心病死亡,有必要对预防政策和治疗进行额外的投资。
更新日期:2020-03-31
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