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Circulation. 2014 Apr 8;129(14):1483-92. doi: 10.1161/CIRCULATIONAHA.113.004042. Epub 2014 Feb 26.

Temporal trends in ischemic heart disease mortality in 21 world regions, 1980 to 2010: the Global Burden of Disease 2010 study.

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Division of General Medicine, Department of Medicine, Columbia University Medical Center, New York, NY (A.E.M.); Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA (M.H.F., G.A.R., C.J.L.M., M.N.); Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA (G.A.R.); Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.A.M.); and MRC-HPA Centre for Environment and Health and Department of Epidemiology and Biostatistics, Imperial College London, London, UK (M.E.).



Ischemic heart disease (IHD) is the leading cause of death worldwide. The Global Burden of Diseases, Risk Factors and Injuries 2010 Study estimated global and regional IHD mortality from 1980 to 2010.


Sources for IHD mortality estimates were country-level surveillance, verbal autopsy, and vital registration data. Regional income, metabolic and nutritional risk factors, and other covariates were estimated from surveys and a systematic review. An estimation and validation process led to an ensemble model of IHD mortality for 21 world regions. Globally, age-standardized IHD mortality has declined since the 1980s, and high-income regions (especially Australasia, Western Europe, and North America) experienced the most remarkable declines. Age-standardized IHD mortality increased in former Soviet Union countries and South Asia in the 1990s and attenuated after 2000. In 2010, Eastern Europe and Central Asia had the highest age-standardized IHD mortality rates. More IHD deaths occurred in South Asia in 2010 than in any other region. On average, IHD deaths in South Asia, North Africa and the Middle East, and sub-Saharan Africa occurred at younger ages in comparison with most other regions.


In most world regions, particularly in high-income regions, age-standardized IHD mortality rates have declined significantly since 1980. High age-standardized IHD mortality in Eastern Europe, Central Asia, and South Asia point to the need to prevent and control established risk factors in those regions and to research the unique behavioral and environmental determinants of higher IHD mortality.


epidemiology; mortality; myocardial ischemia; trends; world health

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