Drop in Cardiac Mortality Varies by Subtype and Ethnicity

MedicalResearch.com Interview with:
Matthew D. Ritchey, DPT
Division for Heart Disease and Stroke Prevention
US Centers for Disease Control and Prevention, Atlanta, Georgia

Medical Research: What is the background for this study? What are the main findings?

Dr. Ritchey: This study analyzes the contribution of heart disease subtypes – such as coronary heart disease, heart failure, hypertensive heart disease and arrhythmia – to overall trends in heart disease death rates between 2000 and 2010. Our research revealed that overall heart disease-related deaths declined during that time frame at a rate of almost four percent annually. Most of this decline appears to be driven by decreases in coronary heart disease mortality, which includes deaths due to heart attacks.

However, not all heart disease subtypes saw similar decreases. Arrhythmia and hypertensive heart disease death rates increased annually during this period. In addition, there were differences depending on age group, subtype, gender and race/ethnicity. For example, hypertensive heart disease rates were much higher (more than double) among non-Hispanic blacks in 2010 than among non-Hispanic whites. That could be due to factors including uncontrolled blood pressure and obesity among younger adults. Also, the increase in arrhythmia mortality was highest among non-Hispanic whites, women and adults age 75 and over. That increase might be linked to the growing aging population, the result of individuals living longer with heart failure, increases in chronic kidney disease and hypertensive heart disease prevalence and changes in how the condition is reported.

To determine these findings, we examined de-identified death certificates of U.S. residents ages 35 and up who died from 2000 to 2010. The data was pulled from the CDC WONDER database, which contains death certificate information from every U.S. state and the District of Columbia.

Medical Research: What should clinicians and patients take away from your report?

Dr. Ritchey: Between 2000 and 2010, more than 7 million heart disease deaths occurred, including 600,000 deaths in 2010. These statistics show that we still have work to do to create a heart-healthy world.

Heart disease remains one of the most widespread and costly health problems facing the nation, so this research is beneficial because it helps reveal disparities and existing and potential trends. Knowing how the risks break down – including by race, gender and heart disease subtype – will help clinicians, patients and public health representatives focus efforts as needed. Clinicians should continue to develop and apply evidence-based interventions to prevent and treat all subtypes of heart disease, such as those stressed by Million Hearts®, a national initiative aimed at preventing one million heart attacks and strokes by 2017. Patients can use this information as incentive to make lifestyle changes aimed at reducing their own cardiovascular risk, including quitting smoking and managing blood pressure and cholesterol.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Ritchey: We will continue to track overall heart disease mortality trends, as well as trends by heart disease subtype, to help guide heart disease prevention efforts nationwide. In addition, further research should be considered to examine what factors are causing increases in hypertensive heart disease and arrhythmia rates
Citation:

Ritchey MD, Loustalot F, Bowman BA, Hong Y. Trends in Mortality Rates by Subtypes of Heart Disease in the United States, 2000-2010. JAMA. 2014;312(19):2037-2039. doi:10.1001/jama.2014.11344.

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