12 August 2019

Downwards trend in CVD deaths is slowing

Cardio Clinical

The large gains made over the last 50 years in cardiovascular disease prevention may be becoming a thing of the past.

Between 1965 and 1998, cardiovascular disease deaths dropped 40 to 80% in countries around the world. But a study by University of Melbourne epidemiologists Professor Alan Lopez and Dr Tim Adair looking at CVD deaths over the last 20 years reveals this public health success story has seemingly reached its end. 

The study shows CVD death rates are now barely declining, and have even started to rise in some countries.

Between 2000 and 2010, CVD deaths were declining around 3 to 7% a year in high-income countries. But since then those rates have dropped to around 1 to 2% a year in the majority of countries.

The US and Canada became the first countries to start recording a slight increase in CVD deaths from 2016 onwards.

In Australia, the decline in CVD deaths went from around 7% in 2000-2010, to around just 0.5% currently.

“For most high-income countries, CVD-mortality rates have either increased or are now declining by  less than 2% per year,” the authors wrote.

The authors offered two potential explanations for the trend.

Firstly, the high rates of change seen in the 20th century might not have been sustainable. Countries have made great strides in reducing smoking, encouraging exercise and ensuring early diagnosis, so it might be that there’s not much more we could do.

A second, more sinister explanation, was that the steep rise in obesity rates were leading to a rise in CVD mortality.

“For the US, at least, this claim is consistent with recent findings on the impact of obesity on reducing life expectancy,” the authors said.

International Journal of Epidemiology 2019, 5 August