Background: Coronary heart disease (CHD) mortality has declined substantially in the Czech Republic over the last two decades. Design: The purpose of this study was to determine what proportion of this CHD mortality decline could be associated with temporal trends in major CHD risk factors and what proportion with advances in medical and surgical treatments. Methods: The validated IMPACT mortality model was used to combine and analyze data on uptake and effectiveness of CHD management and risk factor trends in the Czech Republic in adults aged 25–74 years between 1985 and 2007. The main sources were official statistics, national quality of care registries, published trials and meta-analyses, and the Czech MONICA and post-MONICA studies. Results: Between 1985 and 2007, age-adjusted CHD mortality rates in the Czech Republic decreased, representing in the age group 25–74 years 12,080 fewer CHD deaths in 2007. Changes in CHD risk factors explained approximately 52% of the total mortality decrease, improvements in medical treatments approximately 43%. Conclusions: More than half of the fall in CHD mortality in the Czech Republic between 1985 and 2007 was attributable to reduction in major cardiovascular risk factors. These findings emphasize the value of primary and secondary prevention.

Explaining the decline in coronary heart disease mortality in the Czech Republic between 1985 and 2007 [elektronický zdroj] /

XLIII. konference České demografické společnosti. Praha, 22.-23. května 2013

Literatura

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$a Background: Coronary heart disease (CHD) mortality has declined substantially in the Czech Republic over the last two decades. Design: The purpose of this study was to determine what proportion of this CHD mortality decline could be associated with temporal trends in major CHD risk factors and what proportion with advances in medical and surgical treatments. Methods: The validated IMPACT mortality model was used to combine and analyze data on uptake and effectiveness of CHD management and risk factor trends in the Czech Republic in adults aged 25–74 years between 1985 and 2007. The main sources were official statistics, national quality of care registries, published trials and meta-analyses, and the Czech MONICA and post-MONICA studies. Results: Between 1985 and 2007, age-adjusted CHD mortality rates in the Czech Republic decreased, representing in the age group 25–74 years 12,080 fewer CHD deaths in 2007. Changes in CHD risk factors explained approximately 52% of the total mortality decrease, improvements in medical treatments approximately 43%. Conclusions: More than half of the fall in CHD mortality in the Czech Republic between 1985 and 2007 was attributable to reduction in major cardiovascular risk factors. These findings emphasize the value of primary and secondary prevention.

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