Recent trends in cardiovascular mortality in the United States and public health goals.
Abstract
IMPORTANCE: Heart disease (HD) and cancer are the 2 leading causes of death in the United States. During the first decade of the 21st century, HD mortality declined at a much greater rate than cancer mortality and it appeared that cancer would overtake HD as the leading cause of death. OBJECTIVES: To determine whether changes in national trends had occurred in recent years in mortality rates due to all cardiovascular disease (CVD), HD, stroke, and cancer and to evaluate the gap between mortality rates from HD and cancer. DESIGN, SETTING, AND PARTICIPANTS: The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research data system was used to determine national trends in age-adjusted mortality rates due to all CVD, HD, stroke, and cancer from January 1, 2000, to December 31, 2011, and January 1, 2011, to December 31, 2014, overall, by sex, and by race/ethnicity. The present study was conducted from December 30, 2105, to January 18, 2016. MAIN OUTCOMES AND MEASURES: Comparison of annual rates of change and trend in gap between HD and cancer mortality rates. RESULTS: The rate of the decline in all CVD, HD, and stroke mortality decelerated substantially after 2011, and the rate of decline for cancer mortality remained relatively stable. Reported as percentage (95% CI), the annual rates of decline for 2000-2011 were 3.79% (3.61% to 3.97%), 3.69% (3.51% to 3.87%), 4.53% (4.34% to 4.72%), and 1.49% (1.37% to 1.60%) for all CVD, HD, stroke, and cancer mortality, respectively; the rates for 2011-2014 were 0.65% (-0.18% to 1.47%), 0.76% (-0.06% to 1.58%), 0.37% (-0.53% to 1.27%), and 1.55% (1.07% to 2.04%), respectively. Deceleration of the decline in all CVD mortality rates occurred in males, females, and all race/ethnicity groups. For example, the annual rates of decline for total CVD mortality for 2000-2011 were 3.69% (3.48% to 3.89%) for males and 3.98% (3.81% to 4.14%) for females; for 2011-2014, the rates were 0.23% (-0.71% to 1.16%) and 1.17% (0.41% to 1.93%), respectively. The gap between HD and cancer mortality persisted. CONCLUSIONS AND RELEVANCE: Deceleration in the decline of all CVD, HD, and stroke mortality rates has occurred since 2011. If this trend continues, strategic goals for lowering the burden of CVD set by the American Heart Association and the Million Hearts Initiative may not be reached.
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Solid RCT evidence delineates treatments and strategies that lead to better patient outcomes, which can then be implemented in clinical practice.
“Solid RCT evidence delineates treatments and strategies that lead to better patient outcomes, which can then be implemented in clinical practice.106”
From Levels of Evidence Supporting American College of Cardiology/American Heart Association and European Society of Cardiology Guidelines, 2008-2018 (2019) · cites this paper as [106]
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- Authors
- Sidney, S., Quesenberry, C. P., Jaffe, M. G., Sorel, M., Nguyen-Huynh, M. N., Kushi, L. H., Go, A. S., & Rana, J. S.
- Affiliations
- Kaiser Permanente (US)
- Kaiser Permanente South San Francisco Medical Center (US)
- Department of Neurology, Kaiser Permanente Northern California, Walnut Creek
- Corresponding author
- Sidney, Stephen
- ORCID
- Venue
- JAMA Cardiology
- Publisher
- American Medical Association (AMA)
- Published
- 2016-08-01
- Volume
- 1
- Issue
- 5
- Pages
- 594
- ISSN
- 2380-6583 (ISSN-L)
- OpenAlex
- W2462712634
- Cited by
- 569
- References
- 26
- Citations by year
- 2026: 43 · 2025: 56 · 2024: 46 · 2023: 44 · 2022: 52 · 2021: 65 · 2020: 75 · 2019: 72 · 2018: 56 · 2017: 46 · 2016: 13
- FWCI
- 58.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (RC2HL101666)
- National Cancer Institute (U24CA171524)
- Topics
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- cardiovascular mortality, heart disease mortality, cancer mortality, stroke mortality, mortality trends, public health objectives, sex differences, racial and ethnic disparities, age-adjusted mortality rates, United States, cardiovascular disease
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Child, Child, Preschool, Female, Goals, Heart Diseases, Humans, Infant, Male, Middle Aged, Neoplasms, United States, Stroke, Young Adult
About these checks
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