Is the decline in mortality from cardiovascular disease coming to an end?

Since the 1970s, some countries have seen the number of deaths from cardiovascular disease – mainly heart disease and stroke – fall from 40 to 80%.

This is a major but often ignored achievement in global public health, which has resulted in a substantial increase in life expectancy.

The main causes of these decades-old falls are the reduction in the prevalence of smoking due to anti-smoking campaigns, the reduction of fat consumption in our diet, the reduction of alcohol consumption and the improvement screening, emergency care and treatment of these diseases.

Australia has played a leading role in such public health interventions and has also contributed to the worldwide reduction of cardiovascular disease mortality and increased life expectancy.

But our study found that death rates from cardiovascular disease have almost stopped declining in many high-income countries, including Australia.

In fact, we have found that in some parts of the world, rates have even begun to rise.

This trend is worrisome given the high and widespread prevalence of risk factors such as obesity, and it could impact future trends in life expectancy.

We badyzed mortality trends from cardiovascular disease, mainly composed of heart disease and stroke, in 23 high-income countries since 2000; and found that cardiovascular death rates among people aged 35 to 74 are now barely decreasing or increasing in 12 of 23 countries.

The recent downturn in cardiovascular disease mortality is occurring in high-income countries with diverse epidemiological environments – incidence, distribution and disease control – and English-speaking countries seem to be the most affected.

In the United States and Canadian women, mortality rates from cardiovascular disease have increased over the last year. In Australia, the United Kingdom and New Zealand, the annual number of deaths from cardiovascular disease has only decreased by 20-50%. the 2000s.

Obesity in each of these countries is very high. In Australia, almost a third of adults are obese.

These increases in levels of obesity mean that a significant portion of the population has been exposed to the risk of cardiovascular disease badociated with being overweight for several decades.

The data show a clear increase in cardiovascular disease mortality risk with increasing obesity. A study shows that the risks for extremely obese people are similar to those of smokers.

This suggests that obesity, or at least a poor diet, may have contributed significantly to slowing the decline in deaths from cardiovascular disease.

But obesity is only one of many risk factors for mortality from cardiovascular disease. Others include high blood pressure, high cholesterol and diabetes.

Levels of obesity are low in Italy and France, where the slowdown in cardiovascular disease mortality in recent years is one of the most remarkable of all countries.

Another possible explanation for the recent slowdown in mortality declines is that smoking rates have already fallen so much that further declines in countries like Australia will be harder to obtain and will have much less impact on mortality than the previous years.

Cardiovascular disease remains the leading cause of death in Australia. This slowing down of the number of deaths due to the disease has major consequences for life expectancy.

Recent research shows that life expectancy is increasing in Australia more slowly than in most high-income countries and has stagnated in recent years.

The Australian Bureau of Statistics has drastically revised downward its forecasts of increases in life expectancy. Australia's life expectancy to 2040 will be one of the lowest in any high-income country, according to a multi-country forecast.

Our research shows that the effect of successful public health interventions on cardiovascular disease mortality over the last 50 years is decreasing.

In order to combat this, a significant investment in preventive health measures is needed, especially those aimed at increasing physical activity, improving diet and reducing obesity.

We must also continue our efforts to reduce growing inequalities in cardiovascular disease risk factors and to improve access to health care for the population.

The lack of a solution to these problems could confirm the end of the long-term decline in the number of deaths due to cardiovascular disease and threaten future gains in life expectancy.

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