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European Heart Journal Advance Access originally published online on February 5, 2008
European Heart Journal 2008 29(10):1316-1326; doi:10.1093/eurheartj/ehm604
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

An update on regional variation in cardiovascular mortality within Europe

Jacqueline Müller-Nordhorn*, Sylvia Binting, Stephanie Roll and Stefan N. Willich

Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Luisenstr. 57, D-10117 Berlin, Germany

Received 25 May 2007; revised 22 November 2007; accepted 6 December 2007; online publish-ahead-of-print 5 February 2008.

* Corresponding author. Tel: +49 30 450 529026, Fax: +49 30 450 529902. Email: jacqueline.mueller-nordhorn{at}charite.de

Aims: For risk assessment in primary prevention of cardiovascular disease, different risk charts are used for high-risk and low-risk countries. The objective of the present study was to analyse the current regional variation in cardiovascular mortality within Europe.

Methods and results: Age-standardized mortality rates were calculated for ischaemic heart disease (IHD) and cerebrovascular disease (CVD) from data provided by Eurostat and the National Statistical Offices of the respective countries (2000). For age-standardization, the European standard population (1976) was taken. Rates were calculated both on a national and on a regional level. There is still a clear north–east to south–west gradient in mortality from IHD. With regard to CVD, there appears to be a ‘green’ circle of reduced mortality in the centre of Western Europe including countries such as France or the northern regions of Italy and Spain. Countries with higher mortality rates, such as the Central and East European countries as well as some Mediterranean countries including Greece, Portugal, and certain regions in Southern Spain and Italy, surround this circle.

Conclusion: There is a changing pattern of cardiovascular mortality within Europe, which needs to be taken into account in the definition of high- and low-risk countries in the primary prevention of cardiovascular disease.

Key Words: Regional variation • Cardiovascular mortality • Europe • Prevention


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