Population assessment of future trajectories in coronary heart disease mortality.

<h4>Background</h4>Coronary heart disease (CHD) mortality rates have been decreasing in Iceland since the 1980s, largely reflecting improvements in cardiovascular risk factors. The purpose of this study was to predict future CHD mortality in Iceland based on potential risk factor trends....

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Autores principales:	Rosa Björk Thorolfsdottir, Thor Aspelund, Simon Capewell, Julia Critchley, Vilmundur Gudnason, Karl Andersen
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1703686e0ef6441db4eaeb59f6148b64
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spelling	oai:doaj.org-article:1703686e0ef6441db4eaeb59f6148b642021-11-18T08:36:57ZPopulation assessment of future trajectories in coronary heart disease mortality.1932-620310.1371/journal.pone.0085800https://doaj.org/article/1703686e0ef6441db4eaeb59f6148b642014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24465713/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Coronary heart disease (CHD) mortality rates have been decreasing in Iceland since the 1980s, largely reflecting improvements in cardiovascular risk factors. The purpose of this study was to predict future CHD mortality in Iceland based on potential risk factor trends.<h4>Methods and findings</h4>The previously validated IMPACT model was used to predict changes in CHD mortality between 2010 and 2040 among the projected population of Iceland aged 25-74. Calculations were based on combining: i) data on population numbers and projections (Statistics Iceland), ii) population risk factor levels and projections (Refine Reykjavik study), and iii) effectiveness of specific risk factor reductions (published meta-analyses). Projections for three contrasting scenarios were compared: (1) If the historical risk factor trends of past 30 years were to continue, the declining death rates of past decades would level off, reflecting population ageing. (2) If recent trends in risk factors (past 5 years) continue, this would result in a death rate increasing from 49 to 70 per 100,000. This would reflect a recent plateau in previously falling cholesterol levels and recent rapid increases in obesity and diabetes prevalence. 3) Assuming that in 2040 the entire population enjoys optimal risk factor levels observed in low risk cohorts, this would prevent almost all premature CHD deaths before 2040.<h4>Conclusions</h4>The potential increase in CHD deaths with recent trends in risk factor levels is alarming both for Iceland and probably for comparable Western populations. However, our results show considerable room for reducing CHD mortality. Achieving the best case scenario could eradicate premature CHD deaths by 2040. Public health policy interventions based on these predictions may provide a cost effective means of reducing CHD mortality in the future.Rosa Björk ThorolfsdottirThor AspelundSimon CapewellJulia CritchleyVilmundur GudnasonKarl AndersenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 1, p e85800 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Rosa Björk Thorolfsdottir Thor Aspelund Simon Capewell Julia Critchley Vilmundur Gudnason Karl Andersen Population assessment of future trajectories in coronary heart disease mortality.
description	<h4>Background</h4>Coronary heart disease (CHD) mortality rates have been decreasing in Iceland since the 1980s, largely reflecting improvements in cardiovascular risk factors. The purpose of this study was to predict future CHD mortality in Iceland based on potential risk factor trends.<h4>Methods and findings</h4>The previously validated IMPACT model was used to predict changes in CHD mortality between 2010 and 2040 among the projected population of Iceland aged 25-74. Calculations were based on combining: i) data on population numbers and projections (Statistics Iceland), ii) population risk factor levels and projections (Refine Reykjavik study), and iii) effectiveness of specific risk factor reductions (published meta-analyses). Projections for three contrasting scenarios were compared: (1) If the historical risk factor trends of past 30 years were to continue, the declining death rates of past decades would level off, reflecting population ageing. (2) If recent trends in risk factors (past 5 years) continue, this would result in a death rate increasing from 49 to 70 per 100,000. This would reflect a recent plateau in previously falling cholesterol levels and recent rapid increases in obesity and diabetes prevalence. 3) Assuming that in 2040 the entire population enjoys optimal risk factor levels observed in low risk cohorts, this would prevent almost all premature CHD deaths before 2040.<h4>Conclusions</h4>The potential increase in CHD deaths with recent trends in risk factor levels is alarming both for Iceland and probably for comparable Western populations. However, our results show considerable room for reducing CHD mortality. Achieving the best case scenario could eradicate premature CHD deaths by 2040. Public health policy interventions based on these predictions may provide a cost effective means of reducing CHD mortality in the future.
format	article
author	Rosa Björk Thorolfsdottir Thor Aspelund Simon Capewell Julia Critchley Vilmundur Gudnason Karl Andersen
author_facet	Rosa Björk Thorolfsdottir Thor Aspelund Simon Capewell Julia Critchley Vilmundur Gudnason Karl Andersen
author_sort	Rosa Björk Thorolfsdottir
title	Population assessment of future trajectories in coronary heart disease mortality.
title_short	Population assessment of future trajectories in coronary heart disease mortality.
title_full	Population assessment of future trajectories in coronary heart disease mortality.
title_fullStr	Population assessment of future trajectories in coronary heart disease mortality.
title_full_unstemmed	Population assessment of future trajectories in coronary heart disease mortality.
title_sort	population assessment of future trajectories in coronary heart disease mortality.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/1703686e0ef6441db4eaeb59f6148b64
work_keys_str_mv	AT rosabjorkthorolfsdottir populationassessmentoffuturetrajectoriesincoronaryheartdiseasemortality AT thoraspelund populationassessmentoffuturetrajectoriesincoronaryheartdiseasemortality AT simoncapewell populationassessmentoffuturetrajectoriesincoronaryheartdiseasemortality AT juliacritchley populationassessmentoffuturetrajectoriesincoronaryheartdiseasemortality AT vilmundurgudnason populationassessmentoffuturetrajectoriesincoronaryheartdiseasemortality AT karlandersen populationassessmentoffuturetrajectoriesincoronaryheartdiseasemortality
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Population assessment of future trajectories in coronary heart disease mortality.

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