Secular trends in coronary heart disease mortality, hospitalization rates, and major cardiovascular risk factors in Taiwan, 1971-2001.
BACKGROUND
While mortality from coronary heart disease (CHD) has declined substantially in most developed countries in recent decades, discordant rising trends have been observed in many developing and newly developed countries. In this study, we examined the trends of CHD mortality and its hospitalization rate, and correlated the trends with changes in major cardiovascular risk factors in Taiwan.


METHODS
Mortality data during the period 1971-2001 were obtained from official vital statistics. Hospitalization rates were calculated using information extracted from the National Health Insurance Database, which was available from 1996 to 2001. Changes in major cardiovascular risk factors were obtained from official statistics and review of previous epidemiologic studies.


RESULTS
In 2001, the age-standardized CHD mortality in Taiwan was 28.7 per 100,000 for men and 15.5 per 100,000 for women. For both men and women, age-adjusted CHD mortality increased slowly but steadily from 1971 to 1992, but after that, a downward trend was observed. Hospitalization rates for CHD, however, increased substantially from 1996 to 2001. Levels of per-capita cigarette consumption, dietary fat intake, body mass index, and prevalence of hypertension and diabetes had all increased over the past three decades.


CONCLUSIONS
The overall cardiovascular risk profile has worsened in the general population in Taiwan. The decline in CHD mortality observed in recent years was most likely attributable to the improvement in acute cardiac care and medical treatment among patients with CHD. We anticipated that CHD incidence and prevalence would continue to rise in Taiwan.
Cheng
Yawen
Y
Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan. ycheng@ha.mc.ntu.edu.tw
Chen
Ko-Jung
KJ
Wang
Chi-Jane
CJ
Chan
Shih-Hung
SH
Chang
Wei-Ching
WC
Chen
Jyh-Hong
JH
D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003327:Coronary Disease / Q000453:epidemiology / Q000401:mortality*; D004041:Dietary Fats; D002149:Energy Intake; D005260:Female; D015438:Health Behavior; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
D004041:Dietary Fats