Trends in Cerebrovascular Diseases Mortality in Serbia, 1997-2016: a Nationwide Descriptive Study

Overview

Journal BMJ Open

Specialty General Medicine

Date 2019 Feb 21

PMID 30782903

Citations 6

Authors

Irena Ilic

Milena Ilic

Sandra Sipetic Grujicic

Affiliations

Soon will be listed here.

Abstract

Objectives: Over the last decades, mortality from cerebrovascular diseases (CVDs) has decreased in many countries. The aim of this study was to assess the trends of CVDs mortality in Serbia.

Methods: Descriptive epidemiological study. Age-standardised rates (ASRs) for CVDs mortality were assessed by joinpoint regression analysis to identify significant changes in trends and estimate annual per cent changes with 95% CI. The age-period-cohort analysis has been used to describe variations in mortality.

Results: Over this 20-year period, there were 312 847 deaths from CVDs, with the overall average annual ASR of 148.4 per 100 000. The trend of ASRs from CVDs mortality in males in Serbia showed a significant joinpoint: rates insignificantly decreased from 1997 to 2005 by -0.8% per year (95% CI -1.7% to 0.2%) and thereafter rapidly decreased by -5.0% per year (95% CI -5.6% to -4.5%). A joinpoint for females was found in 2006: the mortality trend was first significantly decreasing by -1.0% per year (95% CI -1.9% to -0.0%) and then sharply falling down by -6.0% per year (95% CI -6.8% to -5.3%). Results of age-period-cohort analysis indicated that the relative risk for CVDs mortality showed statistically significant (p<0.05) cohort and period effects, as well as the net drift and local drifts in Serbian population. The trends in mortality for all subtypes of CVDs were similar in both sexes: trends significantly decreased for most subtypes, with the exception of a significant increase for cerebral infarction.

Conclusions: After a decade of increase, CVDs mortality rates are declining in last decade in Serbia. However, mortality rates from CVDs remain exceedingly high in Serbia. Differences in mortality trends of the stroke subtypes should be taken into account in the creation of both prevention and treatment guidelines.

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References

Feigin V, Krishnamurthi R, Barker-Collo S, McPherson K, Barber P, Parag V . 30-Year Trends in Stroke Rates and Outcome in Auckland, New Zealand (1981-2012): A Multi-Ethnic Population-Based Series of Studies. PLoS One. 2015; 10(8):e0134609. PMC: 4546383. DOI: 10.1371/journal.pone.0134609. View

Luepker R, Arnett D, Jacobs Jr D, Duval S, Folsom A, Armstrong C . Trends in blood pressure, hypertension control, and stroke mortality: the Minnesota Heart Survey. Am J Med. 2006; 119(1):42-9. DOI: 10.1016/j.amjmed.2005.08.051. View

Rosenberg P, Check D, Anderson W . A web tool for age-period-cohort analysis of cancer incidence and mortality rates. Cancer Epidemiol Biomarkers Prev. 2014; 23(11):2296-302. PMC: 4221491. DOI: 10.1158/1055-9965.EPI-14-0300. View

Bennett D, Krishnamurthi R, Barker-Collo S, Forouzanfar M, Naghavi M, Connor M . The global burden of ischemic stroke: findings of the GBD 2010 study. Glob Heart. 2014; 9(1):107-12. DOI: 10.1016/j.gheart.2014.01.001. View

Cruz C, Campuzano-Rincon J, Calleja-Castillo J, Hernandez-Alvarez A, Parra M, Moreno-Macias H . Temporal Trends in Mortality from Ischemic and Hemorrhagic Stroke in Mexico, 1980-2012. J Stroke Cerebrovasc Dis. 2017; 26(4):725-732. DOI: 10.1016/j.jstrokecerebrovasdis.2016.09.042. View

Tian D, Yang Q, Dong Q, Li N, Yan B, Fan D . Trends in stroke subtypes and vascular risk factors in a stroke center in China over 10 years. Sci Rep. 2018; 8(1):5037. PMC: 5864718. DOI: 10.1038/s41598-018-23356-9. View

Ma E, Takahashi H, Mizuno A, Okada M, Yamagishi K, Iso H . Stratified age-period-cohort analysis of stroke mortality in Japan, 1960 to 2000. J Stroke Cerebrovasc Dis. 2007; 16(3):91-102. DOI: 10.1016/j.jstrokecerebrovasdis.2006.11.006. View

Pham T, Fujino Y, Kubo T, Murata A, Le D, Ozasa K . Premature mortality due to stroke and trend in stroke mortality in Japan (1980-2005). Eur J Public Health. 2010; 21(5):609-12. DOI: 10.1093/eurpub/ckq165. View

Mathers C, Fat D, Inoue M, Rao C, Lopez A . Counting the dead and what they died from: an assessment of the global status of cause of death data. Bull World Health Organ. 2005; 83(3):171-7. PMC: 2624200. DOI: /S0042-96862005000300009. View

10.

Ezzati M, Obermeyer Z, Tzoulaki I, Mayosi B, Elliott P, Leon D . Contributions of risk factors and medical care to cardiovascular mortality trends. Nat Rev Cardiol. 2015; 12(9):508-30. PMC: 4945698. DOI: 10.1038/nrcardio.2015.82. View

11.

Kim H, Fay M, Yu B, Barrett M, Feuer E . Comparability of segmented line regression models. Biometrics. 2004; 60(4):1005-14. DOI: 10.1111/j.0006-341X.2004.00256.x. View

12.

Janssen F, Kunst A . Cohort patterns in mortality trends among the elderly in seven European countries, 1950-99. Int J Epidemiol. 2005; 34(5):1149-59. DOI: 10.1093/ije/dyi123. View

13.

Evans A, Tolonen H, Hense H, Ferrario M, Sans S, Kuulasmaa K . Trends in coronary risk factors in the WHO MONICA project. Int J Epidemiol. 2002; 30 Suppl 1:S35-40. DOI: 10.1093/ije/30.suppl_1.s35. View

14.

Andersen K, Andersen Z, Olsen T . Predictors of early and late case-fatality in a nationwide Danish study of 26,818 patients with first-ever ischemic stroke. Stroke. 2011; 42(10):2806-12. DOI: 10.1161/STROKEAHA.111.619049. View

15.

Yusuf S, Reddy S, Ounpuu S, Anand S . Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001; 104(22):2746-53. DOI: 10.1161/hc4601.099487. View

16.

Thrift A, Howard G, Cadilhac D, Howard V, Rothwell P, Thayabaranathan T . Global stroke statistics: An update of mortality data from countries using a broad code of "cerebrovascular diseases". Int J Stroke. 2017; 12(8):796-801. DOI: 10.1177/1747493017730782. View

17.

Gupta R, Joshi P, Mohan V, Reddy K, Yusuf S . Epidemiology and causation of coronary heart disease and stroke in India. Heart. 2007; 94(1):16-26. DOI: 10.1136/hrt.2007.132951. View

18.

Mozaffarian D, Benjamin E, Go A, Arnett D, Blaha M, Cushman M . Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2015; 133(4):e38-360. DOI: 10.1161/CIR.0000000000000350. View

19.

Owolabi M, Sarfo F, Akinyemi R, Gebregziabher M, Akpa O, Akpalu A . Dominant modifiable risk factors for stroke in Ghana and Nigeria (SIREN): a case-control study. Lancet Glob Health. 2018; 6(4):e436-e446. PMC: 5906101. DOI: 10.1016/S2214-109X(18)30002-0. View

20.

Vlajinac H, Adanja B, Jarebinski M, Sipetic S . Cardiovascular disease mortality in Belgrade: trends from 1975-89. J Epidemiol Community Health. 1994; 48(3):254-7. PMC: 1059955. DOI: 10.1136/jech.48.3.254. View