title: Time trends in cardiovascular and all-cause mortality in the 'old' and 'new' European Union countries.
abstract: OBJECTIVE
  There are large differences in all-cause and cardiovascular disease (CVD) mortality between eastern and western countries in Europe. We reviewed the development of these mortality trends in countries of the European Union (EU) over the past 40 years and evaluated available data regarding possible determinants of these differences.
  
  
  RESULTS
  We summarized all-cause mortality and specific cardiovascular mortality for two country groups - 10 countries that joined the European Union (EU) after 2004 (East), and 15 countries that joined before 2004 (West). Standardized mortality rates were retrieved from the World Health Organization "European Health for All" database for each country between 1970 and 2007. Currently (in the 2000s), mortality due to circulatory system disease, ischemic heart disease (IHD), cerebrovascular disease (CBVD), and all-causes in the 'new' EU countries (East) is approximately twice that in the 'old' EU countries (West). These differences were much smaller in the 1970s. The increasing gap in mortality between West and East is primarily the result of a continuous and rapid improvement in the West.
  
  
  CONCLUSIONS
  Differences in lifestyle (i.e. diet, alcohol consumption, physical activity, and smoking) provide insufficient explanation for the observed mortality gap in these two groups of EU countries. Higher expenditures on health, better access to invasive and acute cardiac care, and better pharmacological control of hypertension and hypercholesterolemia in the West are well documented. Socioeconomic and psychosocial factors may also contribute to the changes in mortality trends.
authors: Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Canada.
authors: Eftyhia
authors: E
authors: Helis
authors: Lana
authors: L
authors: Augustincic
authors: Sabine
authors: S
authors: Steiner
authors: Li
authors: L
authors: Chen
authors: Penelope
authors: P
authors: Turton
authors: J George
authors: JG
authors: Fodor
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death / Q000639:trends; D005060:Europe / Q000453:epidemiology; D005062:European Union; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors