Elevated Cardiovascular Mortality Concentrated in US Geographic Clusters

MedicalResearch.com Interview with:

Dr. Gregory Roth MD MPH Division of Cardiology, Department of Medicine Institute for Health Metrics and Evaluation University of Washington, Seattle

Dr. Roth

Dr. Gregory Roth MD MPH
Division of Cardiology, Department of Medicine
Institute for Health Metrics and Evaluation
University of Washington, Seattle

MedicalResearch.com: What is the background for this study?

Response: My colleagues and I at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, evaluated and analyzed mortality rates from cardiovascular diseases (CVD) on the county level from throughout the United States. We obtained the data from: The National Center for Health Statistics and population counts from the U.S. Census Bureau, the National Center for Health Statistics, and the Human Mortality Database. This data ranged from 1980 through 2014.

MedicalResearch.com: What are the main findings?

Response: Despite declines in the overall CVD mortality rate nationally over the past 34 years, cardiovascular disease remains the leading cause of death in the United States. Rates of death on the county level can differ substantially from the national average.

MedicalResearch.com: What should readers take away from your report?

Response: Over the period of time studied, there was a decline in mortality of 50 percent – from 507 deaths per 100,000 persons in 1980 to 253 deaths per 100,000 persons in 2014. In 2014, CVD-related diseases accounted for more than 846,000 deaths. There were substantial differences between county ischemic heart disease and stroke mortality rates. In addition, there were smaller differences for diseases of: myocardium, atrial fibrillation, aortic and peripheral arterial disease, rheumatic heart disease, and endocarditis.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: I believe our findings indicate major efforts still are needed to help address wide geographic disparities in deaths resulting from ischemic heart disease and cerebrovascular diseases. There are significant concentrations of counties with high CVD mortality in southeastern Oklahoma, along the Mississippi River Valley, and into eastern Kentucky. Moreover, there were several clusters of various CVD-related conditions in the Northwest (atrial fibrillation), Midwest (aortic aneurysm), and Mountain West and Alaska (endocarditis).

MedicalResearch.com: Is there anything else you would like to add?

Response: Interestingly, the lowest CVD-related death rates were in counties surrounding: San Francisco, central Colorado, northern Nebraska, central Minnesota, northeastern Virginia, and southern Florida.

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Roth GA, Dwyer-Lindgren L, Bertozzi-Villa A, Stubbs RW, Morozoff C, Naghavi M, Mokdad AH, Murray CJL. Trends and Patterns of Geographic Variation in Cardiovascular Mortality Among US Counties, 1980-2014. JAMA. 2017;317(19):1976-1992. doi:10.1001/jama.2017.4150

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Last Updated on May 21, 2017 by Marie Benz MD FAAD