DOI QR코드

DOI QR Code

Trends in Ischemic Heart Disease Mortality in Korea, 1985-2009: An Age-period-cohort Analysis

  • Lee, Hye-Ah (Department of Preventive Medicine, Ewha Womans University School of Medicine) ;
  • Park, Hye-Sook (Department of Preventive Medicine, Ewha Womans University School of Medicine)
  • Received : 2012.01.04
  • Accepted : 2012.05.30
  • Published : 2012.09.29

Abstract

Objectives: Economic growth and development of medical technology help to improve the average life expectancy, but the western diet and rapid conversions to poor lifestyles lead an increasing risk of major chronic diseases. Coronary heart disease mortality in Korea has been on the increase, while showing a steady decline in the other industrialized countries. An age-period-cohort analysis can help understand the trends in mortality and predict the near future. Methods: We analyzed the time trends of ischemic heart disease mortality, which is on the increase, from 1985 to 2009 using an age-period-cohort model to characterize the effects of ischemic heart disease on changes in the mortality rate over time. Results: All three effects on total ischemic heart disease mortality were statistically significant. Regarding the period effect, the mortality rate was decreased slightly in 2000 to 2004, after it had continuously increased since the late 1980s that trend was similar in both sexes. The expected age effect was noticeable, starting from the mid-60's. In addition, the age effect in women was more remarkable than that in men. Women born from the early 1900s to 1925 observed an increase in ischemic heart mortality. That cohort effect showed significance only in women. Conclusions: The future cohort effect might have a lasting impact on the risk of ischemic heart disease in women with the increasing elderly population, and a national prevention policy is need to establish management of high risk by considering the age-period-cohort effect.

Acknowledgement

Supported by : Ewha Womans University

References

  1. Korean National Statistical Office. 2009 Report on the cause of death statistics [cited 2012 Sep 17]. Available from: http://kostat. go.kr/portal/korea/kor_nw/2/6/2/index.board?bmode= r ead&bSeq=&aSeq=179505&pageNo=1&rowNum=10&nav Count=10&currPg=&sTarget= title&sTxt= (Korean).
  2. Mirzaei M, Truswell AS, Taylor R, Leeder SR. Coronary heart disease epidemics: not all the same. Heart 2009;95(9):740-746.
  3. Amiri M, Janssen F, Kunst AE. The decline in ischaemic heart disease mortality in seven European countries: exploration of future trends. J Epidemiol Community Health 2011;65(8):676-681.
  4. American Heart Association. International cardiovascular disease statistics [cited 2012 Sep 17]. Available from: http://bellevuecollege. edu/artshum/materials/inter/Spring04/SizeMatters/ internatCardioDisSTATsp04.pdf.
  5. Karalis IK, Alegakis AK, Kafatos AG, Koutis AD, Vardas PE, Lionis CD. Risk factors for ischaemic heart disease in a Cretan rural population: a twelve year follow-up study. BMC Public Health 2007;7:351.
  6. Jung J, Kim N. Risk factors, subjective symptoms, knowledge of coronary artery disease and preventive health practices in postmenopausal women. Korean J Women Health Nurs 2006; 12(1):29-36 (Korean).
  7. Barker DJ, Osmond C. Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales. Lancet 1986;1(8489):1077-1081.
  8. Yang Y. Trends in U.S. adult chronic disease mortality, 1960- 1999: age, period, and cohort variations. Demography 2008; 45(2):387-416.
  9. Bravo M. Age-period-cohort analysis of dentist use in Spain from 1987 to 1997. An analysis based on the Spanish National Health Interview Surveys. Eur J Oral Sci 2001;109(3):149-154.
  10. Yang Y, Fu WJ, Land KC. A methodological comparison of ageperiod- cohort models: the intrinsic estimator and conventional generalized linear models. Sociol Methodol 2004;34(1):75-110.
  11. Yu IT, Li W, Wong TW. Effects of age, period and cohort on acute myocardial infarction mortality in Hong Kong. Int J Cardiol 2004;97(1):63-68.
  12. Wake R, Yoshiyama M. Gender differences in ischemic heart disease. Recent Pat Cardiovasc Drug Discov 2009;4(3):234-240.
  13. Natarajan S, Liao Y, Cao G, Lipsitz SR, McGee DL. Sex differences in risk for coronary heart disease mortality associated with diabetes and established coronary heart disease. Arch Intern Med 2003;163(14):1735-1740.
  14. Korea Centers for Disease Control and Prevention. 2008 Report on the Korea National Health and Nutrition Examination Survey [cited 2012 Sep 17]. Available from: http://knhanes. cdc.go.kr/knhanes/sub04/sub04_03.do?classType=7 (Korean).
  15. Korea Centers for Disease Control and Prevention. Food & nutrient intakes of Koreans in 2008: Korea National Health and Nutrition Examination Survey. Public Health Wkly Rep 2010; 3(11):169-177 (Korean).
  16. Franco-Marina F, Lazcano-Ponce E, Lopez-Carrillo L. Breast cancer mortality in Mexico: an age-period-cohort analysis. Salud Publica Mex 2009;51 Suppl 2:s157-s164.
  17. Fuchs CS, Stampfer MJ, Colditz GA, Giovannucci EL, Manson JE, Kawachi I, et al. Alcohol consumption and mortality among women. N Engl J Med 1995;332(19):1245-1250.
  18. Jhun HJ, Kim H, Cho SI. Time trend and age-period-cohort effects on acute myocardial infarction mortality in Korean adults from 1988 to 2007. J Korean Med Sci 2011;26(5):637-641.
  19. Choi Y, Kim Y, Park SK, Shin HR, Yoo KY. Age-period-cohort analysis of female breast cancer mortality in Korea. Breast Cancer 2006;13(3):266-271.
  20. Kim BY. A development of the cause of death statistics. J Korean Off Stat 1999;4(2):1-30 (Korean).