title: Temporal trends in the incidence and recurrence of hospitalised atherothrombotic disease in an Australian population, 2000-07: data linkage study.
abstract: OBJECTIVE
  To examine temporal trends in the incidence and recurrence of hospitalised coronary heart disease (CHD), cerebrovascular disease (CeVD) and peripheral arterial disease (PAD) separately and combined, and by the history of all forms of atherothrombotic disease (ATD).
  
  
  METHODS
  Population-based longitudinal data linkage study.
  
  
  METHODS
  Western Australia.
  
  
  METHODS
  All patients aged 35-84 years hospitalised in Western Australia for CHD, CeVD or PAD from 2000 to 2007.
  
  
  METHODS
  Age-standardised incidence and recurrence rates of CHD, CeVD and PAD stratified by ATD history, sex and age.
  
  
  RESULTS
  107 576 events (65.9% men) were identified; 70% of all admissions were for CHD. In patients without a history of any ATD, incidence rates declined significantly in all groups, although the reduction in incident CHD in women was marginal (-0.7%/year, 95% CI -1.5 to +0.1%). The largest annual reductions in incidence rates were for PAD (men, -6.4%/year, 95% CI -7.7 to -5.0%; women, -5.4%/year, 95% CI -7.2 to -3.6%) and CeVD in women (-4.0%/year, 95% CI -5.0 to -3.0%). Falls in overall recurrence rates were greatest for CeVD (men, -3.2%/year, 95% CI -4.7 to -1.6%; women -4.6%/year, 95% CI -6.4 to -2.7%). Trends across all categories of polyvascular ATD were generally downward, although not all changes were statistically significant.
  
  
  CONCLUSIONS
  The incidence and recurrence rates of hospitalised ATD have decreased over time, including in patients with disease involving multiple vascular territories. This implies that primary and secondary prevention strategies have been broadly effective. However, high absolute rates of recurrence and limited reduction in 35-54-year-old individuals highlight patient groups to target to reduce further the burden of ATD.
authors: School of Population Health, M431, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia. lee.nedkoff@uwa.edu.au
authors: Lee
authors: L
authors: Nedkoff
authors: Thomas G
authors: TG
authors: Briffa
authors: Matthew
authors: M
authors: Knuiman
authors: Joseph
authors: J
authors: Hung
authors: Paul E
authors: PE
authors: Norman
authors: Graeme J
authors: GJ
authors: Hankey
authors: Peter L
authors: PL
authors: Thompson
authors: Elizabeth
authors: E
authors: Geelhoed
authors: Frank M
authors: FM
authors: Sanfilippo
authors: Siobhan
authors: S
authors: Hickling
authors: Alexandra
authors: A
authors: Bremner
authors: Michael
authors: M
authors: Hobbs
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000453:epidemiology* / Q000628:therapy; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000628:therapy; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology* / Q000628:therapy; D012008:Recurrence; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D013927:Thrombosis / Q000453:epidemiology* / Q000628:therapy; D013997:Time Factors; D014904:Western Australia / Q000453:epidemiology