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European Heart Journal Advance Access published online on October 4, 2005

European Heart Journal, doi:10.1093/eurheartj/ehi511
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received April 1, 2005
Revised August 16, 2005
Accepted September 1, 2005

Clinical research

Dynamics of cardiovascular and all-cause mortality in Western and Eastern Europe between 1970 and 2000

Hugo Kesteloot 1, Susana Sans 2, and Daan Kromhout 3*

1 Department of Epidemiology, Kapucijnenvoer 35, 3000 Leuven, Belgium
2 Institute of Health Studies, Hospital de Sant Pau, Pare Claret 167, 08025 Barcelona, Spain
3 Division of Human Nutrition, Wageningen University, PO Box 8129, 6700 EV Wageningen, The Netherlands; Department of Epidemiology, Kapucijnenvoer 35, 3000 Leuven, Belgium

* To whom correspondence should be addressed.
Daan Kromhout, E-mail: hugo.kesteloot{at}med.kuleuven.be


   Abstract

Aims Important changes in cardiovascular and all-cause mortality rates are occurring in Western and Eastern Europe, each with their own dynamics. Differences in trends will be analysed and possible causes are discussed.

Methods and results Mortality data for cardiovascular and all-cause mortality rates from different countries were obtained from WHO and were analysed for the period 1970-2000. The annual changes in cause-specific mortality rates were calculated using linear and polynomial regression models. Mortality rates declined almost linearly for ischaemic heart disease, stroke, and total cardiovascular diseases between 1970 and 2000 in Western Europe. In both men and women, the decline for these diseases varied between 50 and 65% or ~2%/year in this period. In contrast, in Eastern Europe cardiovascular mortality rates reached a maximum in the period 1990-94, followed by a decline of ~3%/year in Poland, 2%/year in Hungary, and 5%/year in the Baltic states. The changes in cardiovascular mortality rates were reflected in all-cause mortality rates in both Western and Eastern Europe.

Conclusion Over the past 30 years, mortality rates in cardiovascular diseases increased or decreased very rapidly. The causes are complex but changes in diet appear to play a major role. The more recent declines in Western Europe also reflect improvements in modern cardiovascular treatment.

Keywords: Cardiovascular diseases; Mortality; Diet; Lifestyle; Treatment.
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