JMIR Publications

ABSTRACT

Background:

China has the largest number of new CVDs cases and deaths worldwide, posing huge health and economic burdens to society and families. But the trends in mortality at the national level and urban-rural and gender differences with temporal changes remain unclear.

Objective:

This study comprehensively analyzed secular trends of national CVDs mortality statistics to inform future prevention and intervention programs in China.

Methods:

The annual estimate of CVDs mortality and its major subtypes were derived from the National Health Commission (NHC). We used Joinpoint analysis to detect the annual change trend, and the age-period-cohort model was used to estimate cohort and period effects.

Results:

The overall ASMR for CVDs has declined, but the total number of CVDs deaths was increasing. The rate was higher in men than women, but the trends in urban and rural areas of China showed a differentiation tendency over time. Before 2005, the ASMR in urban areas was higher than in rural areas, but after 2005, the rural mortality rates rose rapidly and surpassed urban areas. A continued decline in mortality rate from CRHDs and CDs was observed over the last three decades, while the ASMR for HHD and IHDs exhibited a trend of increase in the recent decade, especially in rural areas. The most striking cohort effect was for CRHDs, the maximum risks peaked in the generations born around 1904 and then continued to decrease across successive cohorts. But the risk of death from IHDs and HHDs has increased in recent generations.

Conclusions:

Although the age-standardized overall CVDs mortality has declined in China, the absolute number of CVDs cases kept increasing due to the growing elderly population. The rising mortality related to HHD and IHDs and the huge CVDs burden in rural areas should receive higher priority in managing CVDs burden and calls for targeted public health actions to reverse this trend.