Korean Circ J.  2021 Apr;51(4):320-332. 10.4070/kcj.2020.0424.

Thirty-six Year Trends in Mortality from Diseases of Circulatory System in Korea

• Baek J
• Lee H
• Lee HH
• Heo JE
• Cho SMJ
• Kim HC

• KMID: 2514635
• DOI: http://doi.org/10.4070/kcj.2020.0424

Abstract

Background and Objectives
Understanding the trends in cardiovascular disease (CVD) mortality is important for developing burden reduction strategies. Based on the Cause of Death Statistics, we examined the changing patterns of CVD mortality in Korea between 1983 and 2018.
Methods
Causes of death were coded according to the International Classification of Disease, 10th revision. Deaths from all diseases of circulatory system (I00-I99) and the following 6 subcategories were analyzed: total heart diseases (I00-I13 and I20-I51), hypertensive heart diseases (I10-I13), ischemic heart diseases (I20-I25), myocardial infarction (I21-I23), heart failure (I50), and cerebrovascular diseases (I60-I69). Crude, age-standardized, and age-stratified rates were calculated to assess temporal trends in CVD mortality.
Results
The number of deaths and crude mortality rate for all diseases of circulatory system increased recently mainly due to the population ageing. Specifically, total heart diseases showed increasing trend, whereas cerebrovascular diseases showed decreasing trend. Between 1983 and 2018, age-standardized mortality rates significantly declined for all diseases of circulatory system, total heart diseases, hypertensive heart diseases, and cerebrovascular diseases. Age-standardized mortality rates for ischemic heart diseases and myocardial infarction peaked in the early 2000s then decreased thereafter. However, agestandardized mortality rate for heart failure rapidly increased, especially in recent years.
Conclusions
CVD mortality in Korea has remarkably decreased over the last 36 years. However, the recent rise in the absolute number of deaths from heart diseases, especially from heart failure, calls for attention in prevention and management of CVD and its sequelae.

Keyword

Cardiovascular diseases; Heart failure; Mortality; Age distribution; Korea

Figure

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  Figure 1 Number of deaths from cardiovascular diseases.

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  Figure 2 Crude, age-standardized, and age-stratified mortality from all diseases of circulatory system.

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  Figure 3 Age-standardized mortality from cardiovascular diseases.

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  Figure 4 Age-stratified mortality from heart failure.

Reference

1. Mensah GA, Wei GS, Sorlie PD, et al. Decline in cardiovascular mortality: possible causes and implications. Circ Res. 2017; 120:366–380. PMID: 28104770.

2. Rehan F, Qadeer A, Bashir I, Jamshaid M. Risk factors of cardiovascular disease in developing countries. Int Curr Pharm J. 2016; 5:69–72.

3. Gaziano TA, Bitton A, Anand S, Abrahams-Gessel S, Murphy A. Growing epidemic of coronary heart disease in low- and middle-income countries. Curr Probl Cardiol. 2010; 35:72–115. PMID: 20109979.

4. Statistics Korea. Cause of death statistics in 2018. Daejeon: Statistics Korea;2018.

5. Lee SW, Kim HC, Lee HS, Suh I. Thirty-year trends in mortality from cardiovascular diseases in Korea. Korean Circ J. 2015; 45:202–209. PMID: 26023308.

6. Lee SW, Kim HC, Lee HS, Suh I. Thirty-year trends in mortality from cerebrovascular diseases in Korea. Korean Circ J. 2016; 46:507–514. PMID: 27482259.

7. Sung KC, Ryu S, Cheong ES, et al. All-cause and cardiovascular mortality among Koreans: effects of obesity and metabolic health. Am J Prev Med. 2015; 49:62–71. PMID: 26094228.

8. Sung KC, Ryu S, Wild SH, Byrne CD. An increased high-density lipoprotein cholesterol/apolipoprotein A-I ratio is associated with increased cardiovascular and all-cause mortality. Heart. 2015; 101:553–558. PMID: 25637367.

9. Yi SW, Yoo SH, Sull JW, Ohrr H. Association between alcohol drinking and cardiovascular disease mortality and all-cause mortality: Kangwha cohort study. J Prev Med Public Health. 2004; 37:120–126. PMID: 25178442.

10. Kim EH, Lee H, Shin DW, et al. Association between weight changes after smoking cessation and cardiovascular disease among the Korean population. Korean J Fam Med. 2017; 38:122–129. PMID: 28572887.

11. Bae JC, Cho NH, Suh S, et al. Cardiovascular disease incidence, mortality and case fatality related to diabetes and metabolic syndrome: a community-based prospective study (Ansung-Ansan cohort 2001-12). J Diabetes. 2015; 7:791–799. PMID: 25407754.

12. Song YM, Ferrer RL, Cho SI, Sung J, Ebrahim S, Davey Smith G. Socioeconomic status and cardiovascular disease among men: the Korean national health service prospective cohort study. Am J Public Health. 2006; 96:152–159. PMID: 16373668.

13. Park K, Lim S, Park Y, Ju W, Shin Y, Yeom H. Cardiovascular disease risk factors and obesity levels in Korean adults: results from the Korea National Health and Nutrition Examination Survey, 2007–2015. Osong Public Health Res Perspect. 2018; 9:150–159. PMID: 30159220.

14. Korean Society of Lipid and Atherosclerosis. Dyslipidemia fact sheets in Korea. Seoul: Korean Society of Lipid and Atherosclerosis;2020.

15. Lee H, Park S, Kim HC. Temporal and geospatial trends of hypertension management in Korea: a nationwide study 2002–2016. Korean Circ J. 2019; 49:514–527. PMID: 30808085.

16. Ko SH, Han K, Lee YH, et al. Past and current status of adult type 2 diabetes mellitus management in Korea: a national health insurance service database analysis. Diabetes Metab J. 2018; 42:93–100. PMID: 29676539.

17. Korean Society Hypertension (KSH). Hypertension Epidemiology Research Working Group. Kim HC, Cho MC. Korea hypertension fact sheet 2018. Clin Hypertens. 2018; 24:13. PMID: 30288297.

18. Rhee EJ. Prevalence and current management of cardiovascular risk factors in Korean adults based on fact sheets. Endocrinol Metab (Seoul). 2020; 35:85–94. PMID: 32207267.

19. Shin HJ, Park YH, Cho BK. Recent surgical outcomes of congenital heart disease according to Korea Heart Foundation data. Korean Circ J. 2020; 50:677–690. PMID: 32212426.

20. Won TY, Kang BS, Im TH, Choi HJ. The study of accuracy of death statistics. J Korean Soc Emerg Med. 2007; 18:256–262.

21. Kim HJ, Kim Y, Cho Y, Jun B, Oh KW. Trends in the prevalence of major cardiovascular disease risk factors among Korean adults: results from the Korea National Health and Nutrition Examination Survey, 1998–2012. Int J Cardiol. 2014; 174:64–72. PMID: 24742812.

22. Kim HC, Oh SM. Noncommunicable diseases: current status of major modifiable risk factors in Korea. J Prev Med Public Health. 2013; 46:165–172. PMID: 23946874.

23. Lee JH, Lim NK, Cho MC, Park HY. Epidemiology of heart failure in Korea: present and future. Korean Circ J. 2016; 46:658–664. PMID: 27721857.

24. Murakoshi N, Aonuma K. Epidemiology of arrhythmias and sudden cardiac death in Asia. Circ J. 2013; 77:2419–2431. PMID: 24067274.

25. Lee SR, Choi EK. Prevalence of atrial fibrillation in Korean population. Int J Arrhythm. 2017; 18:195–204.

26. Wilmot KA, O'Flaherty M, Capewell S, Ford ES, Vaccarino V. Coronary heart disease mortality declines in the United States from 1979 through 2011: evidence for stagnation in young adults, especially women. Circulation. 2015; 132:997–1002. PMID: 26302759.

27. Zhang Y, Vittinghoff E, Pletcher MJ, et al. Associations of blood pressure and cholesterol levels during young adulthood with later cardiovascular events. J Am Coll Cardiol. 2019; 74:330–341. PMID: 31319915.

28. Lee H, Cho SM, Park JH, Park S, Kim HC. 2017 ACC/AHA blood pressure classification and cardiovascular disease in 15 million adults of age 20–94 years. J Clin Med. 2019; 8:1832.

29. Yang S, Khang YH, Chun H, Harper S, Lynch J. The changing gender differences in life expectancy in Korea 1970–2005. Soc Sci Med. 2012; 75:1280–1287. PMID: 22739261.

30. Roth GA, Johnson C, Abajobir A, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol. 2017; 70:1–25. PMID: 28527533.