Start Submission Become a Reviewer

Reading: Assessing the Global Burden of Ischemic Heart Disease: Part 2: Analytic Methods and Estimate...

Download

A- A+
Alt. Display

Original Research

Assessing the Global Burden of Ischemic Heart Disease: Part 2: Analytic Methods and Estimates of the Global Epidemiology of Ischemic Heart Disease in 2010

Authors:

Mohammad H. Forouzanfar,

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, US
X close

Andrew E. Moran ,

Division of General Medicine, Department of Medicine, Columbia University Medical Center, New York, NY, US
X close

Abraham D. Flaxman,

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, US
X close

Gregory Roth,

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA; Department of Cardiology, University of Washington, Seattle, WA, US
X close

George A. Mensah,

Department of Medicine, University of Cape Town, Cape Town, ZA
X close

Majid Ezzati,

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, US; MRC-HPA Centre for Environment and Health and Department of Epidemiology and Biostatistics, Imperial College London, London, GB
X close

Mohsen Naghavi,

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, US
X close

Christopher J.L. Murray

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, US
X close

Abstract

BACKGROUND Ischemic heart disease (IHD) is the leading cause of death worldwide. The Global Burden of Diseases, Injuries and Risk Factors (GBD) 2010 Study estimated IHD mortality and disability burden for 21 world regions for the years 1990 to 2010.

METHODS Data sources for GBD IHD epidemiology estimates were mortality surveillance, verbal autopsy, and vital registration data (for IHD mortality) and systematic review of IHD epidemiology literature published from 1980 to 2008 (for nonfatal IHD outcomes). An estimation and validation process led to an ensemble model of IHD mortality by country for all 21 world regions, adjusted for country-level covariates. Disease models were developed for the nonfatal sequelae of IHD: myocardial infarction, stable angina pectoris, and ischemic heart failure.

RESULTS Country-level covariates including metabolic and nutritional risk factors, education, war, and annual income per capita contributed to the ensemble model for the analysis of IHD death. In the acute myocardial infarction model, inclusion of troponin in the diagnostic criteria of studies published after the year 2000 was associated with a 50% higher incidence. Self-reported diagnosis of angina significantly overestimated stable angina prevalence compared with “definite” angina elicited by the Rose angina questionnaire. For 2010, Eastern Europe and Central Asia had the highest rates of IHD death and the Asia Pacific High-Income, East Asia, Latin American Andean, and Sub-Saharan Africa regions had the lowest.

CONCLUSIONS Global and regional IHD epidemiology estimates are needed for estimating the worldwide burden of IHD. Using descriptive meta-analysis tools, the GBD 2010 standardized and pooled international data by adjusting for region-level mortality and risk factor data, as well as study-level diagnostic method. Analyses maximized internal consistency, generalizability, and adjustment for known sources of bias. The GBD IHD analysis, nonetheless, highlights the need for improved IHD epidemiology surveillance in many regions and the need for uniform diagnostic standards.

How to Cite: Forouzanfar MH, Moran AE, Flaxman AD, Roth G, Mensah GA, Ezzati M, et al.. Assessing the Global Burden of Ischemic Heart Disease: Part 2: Analytic Methods and Estimates of the Global Epidemiology of Ischemic Heart Disease in 2010. Global Heart. 2012;7(4):331–42. DOI: http://doi.org/10.1016/j.gheart.2012.10.003
13
Views
8
Downloads
66
Citations
Published on 01 Dec 2012.
Peer Reviewed

Downloads

  • PDF (EN)

    comments powered by Disqus