Substantial differences between US counties for death rates from ischemic heart disease, stroke

May 16, 2017, The JAMA Network Journals
Credit: CC0 Public Domain

Although the absolute difference in U.S. county-level cardiovascular disease mortality rates have declined substantially over the past 35 years for both ischemic heart disease and cerebrovascular disease, large differences remain, according to a study published by JAMA.

Cardiovascular disease remains the leading cause of death in the United State despite declines in the national cardiovascular disease mortality rate between 1980 and 2015. Mortality rates for smaller regions of the country, such as counties, can differ substantially from the national average; these differences have important implications for local and national health policy. Gregory A. Roth, M.D., M.P.H., of the Division of Cardiology, Institute for Health Metrics and Evaluation, University of Washington, Seattle, and colleagues used death records 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 from 1980 through 2014 to estimate from cardiovascular diseases by U.S. county (n = 3,110).

The researchers found that the mortality rate for cardiovascular diseases in the U.S. declined from 507 deaths per 100,000 persons in 1980 to 253 deaths per 100,000 persons in 2014, a relative decline of 50 percent.

In 2014, cardiovascular diseases accounted for more than 846,000 deaths. There were substantial differences between county and stroke mortality rates; smaller differences were found for diseases of the myocardium, , aortic and , , and endocarditis.

The largest concentration of counties with high cardiovascular disease mortality extended from southeastern Oklahoma along the Mississippi River Valley to eastern Kentucky. Several cardiovascular disease conditions were clustered substantially outside the South, including atrial fibrillation (Northwest), aortic aneurysm (Midwest), and endocarditis (Mountain West and Alaska).

The lowest cardiovascular mortality rates were found in the counties surrounding San Francisco, central Colorado, northern Nebraska, central Minnesota, northeastern Virginia, and southern Florida.

Several limitations of the study are noted in the article, including that vital statistics data and census population data were used to calculate rates and both of these sources are subject to error because deaths and individuals within the population may be missed or allocated to the wrong county.

"These findings suggest major efforts are still needed to reduce geographic variation in risk of death due to ischemic heart and cerebrovascular diseases," the authors write.

Explore further: American death rate from drugs, alcohol, and mental disorders nearly triples since 1980

More information: JAMA (2017). jamanetwork.com/journals/jama/ … .1001/jama.2017.4150

Related Stories

American death rate from drugs, alcohol, and mental disorders nearly triples since 1980

December 13, 2016
More than 2,000 US counties witnessed increases of 200% or more in deaths related to substance abuse and mental disorders since 1980, including clusters of counties in Kentucky, West Virginia, and Ohio with alarming surges ...

Over 20 percent of maternal mortality in illinois due to CVD

April 18, 2017
(HealthDay)—More than one in five maternal deaths in Illinois in 2002 to 2011 were attributable to cardiovascular disease, according to a study published in the May issue of Obstetrics & Gynecology.

Rate of decline of cardiovascular deaths slows in US

June 29, 2016
In a study published online by JAMA Cardiology, Stephen Sidney, M.D., M.P.H., of Kaiser Permanente Northern California, Oakland, and colleagues examined recent national trends in death rates due to all cardiovascular disease ...

New study finds where you live may determine likelihood of dying from cancer

January 24, 2017
The rate at which Americans die from cancers varies dramatically by where they live, according to a new scientific analysis.

Gap growing between longest and shortest lifespans in the US

May 8, 2017
Babies born today in 13 US counties have shorter expected lifespans than their parents did when they were born decades ago, according to a new study. For example, life expectancy at birth in Owsley County, Kentucky, was 72.4 ...

Study examines trends in infectious disease mortality in US

November 22, 2016
In a study appearing in the November 22/29 issue of JAMA, Heidi E. Brown, Ph.D., of the University of Arizona, Tucson, and colleagues investigated trends in infectious disease mortality in the United States from 1980 through ...

Recommended for you

New cellular pathway helps explain how inflammation leads to artery disease

June 21, 2018
Investigators have identified a new cellular pathway that may help explain how arterial inflammation develops into atherosclerosis—deposits of cholesterol, fats and other substances that create plaque, clog arteries and ...

'Smart stent' detects narrowing of arteries

June 19, 2018
For every three individuals who have had a stent implanted to keep clogged arteries open and prevent a heart attack, at least one will experience restenosis—the renewed narrowing of the artery due to plaque buildup or scarring—which ...

Marriage may protect against heart disease / stroke and associated risk of death

June 18, 2018
Marriage may protect against the development of heart disease/stroke as well as influencing who is more likely to die of it, suggests a pooled analysis of the available data, published online in the journal Heart.

Deaths from cardiac arrest are misclassified, overestimated

June 18, 2018
Forty percent of deaths attributed to cardiac arrest are not sudden or unexpected, and nearly half of the remainder are not arrhythmic—the only situation in which CPR and defibrillators are effective—according to an analysis ...

Tick-borne meat sensitivity linked to heart disease

June 15, 2018
University of Virginia School of Medicine researchers have linked sensitivity to an allergen in red meat—a sensitivity spread by tick bites—with a buildup of fatty plaque in the arteries of the heart. This buildup may ...

Tobacco aside, e-cigarette flavorings may harm blood vessels

June 14, 2018
Flavor additives used in electronic cigarettes and related tobacco products could impair blood vessel function and may be an early indicator of heart damage, according to new laboratory research in Arteriosclerosis, Thrombosis ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.