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Population assessment of future trajectories in coronary heart disease mortality.

Thorolfsdottir, RB; Aspelund, T; Capewell, S; Critchley, J; Gudnason, V; Andersen, K (2014) Population assessment of future trajectories in coronary heart disease mortality. PLoS One, 9 (1). e85800 -e85800 (8). https://doi.org/10.1371/journal.pone.0085800
SGUL Authors: Critchley, Julia

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Abstract

Background: 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. Methods and findings: 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. Conclusions: 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.

Item Type: Article
Additional Information: Copyright: 2014 Thorolfsdottir et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: PLoS One
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Dates:
DateEvent
21 January 2014Published
PubMed ID: 24465713
Web of Science ID: 24465713
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URI: https://openaccess.sgul.ac.uk/id/eprint/104570
Publisher's version: https://doi.org/10.1371/journal.pone.0085800

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