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Emmert-Fees, K. ; Luhar, S.* ; O'Flaherty, M.* ; Kypridemos, C.* ; Laxy, M.

Forecasting the mortality burden of coronary heart disease and stroke in Germany: National trends and regional inequalities.

Int. J. Cardiol. 393:131359 (2023)
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Background: The decline of cardiovascular disease (CVD) mortality has slowed in many countries, including Germany. We examined the implications of this trend for future coronary heart disease (CHD) and stroke mortality in Germany considering persistent mortality inequalities between former East and West Germany. Methods: We retrieved demographic and mortality data from 1991 to 2019 from the German Federal Statistical Office. Using a Bayesian age-period-cohort framework, we projected CHD and stroke mortality from 2019 to 2035, stratified by sex and German region. We decomposed annual changes in deaths into three components (mortality rates, population age structure and population size) and assessed regional inequalities with age-sex-standardized mortality ratios. Results: We confirmed that declines of CVD mortality rates in Germany will likely stagnate. From 2019 to 2035, we projected fewer annual CHD deaths (114,600 to 103,500 [95%-credible interval: 81,700; 134,000]) and an increase in stroke deaths (51,300 to 53,700 [41,400; 72,000]). Decomposing past and projected mortality, we showed that population ageing was and is offset by declining mortality rates. This likely reverses after 2030 leading to increased CVD deaths thereafter. Inequalities between East and West declined substantially since 1991 and are projected to stabilize for CHD but narrow for stroke. Conclusions: CVD deaths in Germany likely keep declining until 2030, but may increase thereafter due to population ageing if the reduction in mortality rates slows further. East-West mortality inequalities for CHD remain stable but may converge for stroke. Underlying risk factor trends need to be monitored and addressed by public health policy.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Cardiovascular Disease ; Demography ; Forecast ; Mortality ; Population Health; Health Interview; United-states; Future Burden; West-germany; East; Decline; Prevalence; Difference
Language english
Publication Year 2023
HGF-reported in Year 2023
ISSN (print) / ISBN 0167-5273
e-ISSN 1874-1754
Journal International Journal of Cardiology
Quellenangaben Volume: 393, Issue: , Pages: , Article Number: 131359 Supplement: ,
Publisher Elsevier
Publishing Place Elsevier House, Brookvale Plaza, East Park Shannon, Co, Clare, 00000, Ireland
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology (EPI)
POF-Topic(s) 30202 - Environmental Health
Research field(s) Genetics and Epidemiology
PSP Element(s) G-504000-010
Grants German Federal Ministry of Education and Research
National Centre for Research and Development (NCBR)
Research Council of Norway (RCN)
University of Auckland, School of Population Health
Netherlands Organisation for Health Research and Development (ZonMw)
Ministry of Education, University and Research (MIUR)
Health Research Board (HRB)
Federal Ministry of Education and Research (BMBF)
Institut National de la Recherche Agronomique (INRA)
Joint Programming Initiative "A Healthy Diet for a Healthy Life" (JPI HDHL) , a research and innovation initiative of EU member states and associated countries
Policy Evaluation Network (PEN) project
DOI 10.1016/j.ijcard.2023.131359
WOS ID 001098943300001
Scopus ID 85173167957
PubMed ID 37757987
Erfassungsdatum 2023-10-18
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