Korean Circ J.  2015 May;45(3):202-209. 10.4070/kcj.2015.45.3.202.

Thirty-Year Trends in Mortality from Cardiovascular Diseases in Korea

• Lee SW
• Kim HC
• Lee HS
• Suh I

• KMID: 2389127
• DOI: http://doi.org/10.4070/kcj.2015.45.3.202

Abstract

BACKGROUND AND OBJECTIVES
An understanding of cardiovascular diseases (CVD) mortality is important for the development of strategies aimed at reducing the burden of CVD. Thus, we examined the changing pattern of CVD mortality in Korea over 30 years (1983-2012) by analyzing the Cause of Death Statistics.
MATERIALS AND METHODS
Deaths from diseases of the circulatory system and those of five CVD categories were analyzed: total heart diseases, acute rheumatic fever/chronic rheumatic heart disease, hypertensive heart disease, ischemic heart disease (IHD) and atherosclerosis. To assess the effects of population ageing on CVD mortality, crude and age-adjusted mortality rates were calculated. Age-adjusted mortality rates were calculated by using the direct standardization method.
RESULTS
Over the 30-year period analyzed in this study, circulatory system disease mortality markedly declined. The age-adjusted mortality rate decreased by 78.5% in men and by 76.3% in women. Consistent decreasing trends were observed for mortalities from rheumatic heart disease, hypertensive heart disease, and atherosclerosis. However, IHD mortality rapidly increased during the 30 years. Crude IHD mortality showed a steady increase until 2007, after which there were fluctuations. But the penalized regression splines showed that crude IHD mortality continued to increase. Age-adjusted IHD mortality peaked in the early 2000s, and started to decrease during the last few years.
CONCLUSION
In summary, total CVD mortality rate has significantly decreased over the 30-year period analyzed in this study but the IHD mortality rate has continuously increased until recently. The prevention and management of cardiovascular diseases amongst the Korean population, especially IHD, still represents a great challenge.

Keyword

Cardiovascular diseases; Myocardial ischemia; Mortality; Trends; Korea

MeSH Terms

Atherosclerosis
Cardiovascular Diseases*
Cause of Death
Female
Heart Diseases
Humans
Korea
Male
Mortality*
Myocardial Ischemia
Rheumatic Heart Disease

Figure

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  Fig. 1 Crude and age-adjusted mortality from diseases of the circulatory system.

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  Fig. 2 Crude and age-adjusted mortality from total heart diseases.

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  Fig. 3 Crude and age-adjusted mortality from ischemic heart diseases.

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  Fig. 4 Crude and age-adjusted mortality from ischemic heart diseases fitted by penalized B-splines method. Solid lines, gray shadows and blue dash lines represent the estimated death rates, 95% confidence intervals and 95% prediction intervals. The estimated death rates were calculated by using the penalized regression method. The 95% confidence interval means that the possibility of population death rates lying within these bands (shades) is 95%, while the 95% prediction Interval means that the possibility of a specific observation lying within these bands (dashed lines) is 95% when we are interested in a specific observation (i.e. independent variable: time). Vertical reference lines indicate peaks of each fitted death rate.

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  Fig. 5 Crude mortality rates from rheumatic heart disease (A), hypertensive disease (B), and atherosclerosis (C).

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