title: National trend in congenital heart disease mortality in China during 2003 to 2010: a population-based study.
abstract: BACKGROUND
  Previous studies suggest that mortality from congenital heart diseases (CHDs) is declining in the United States. But we do not know what the CHD mortality trend is in China, especially the rural versus urban patterns. Our study aimed to determine recent changes in death caused by CHD in China and describe CHD mortality in rural and urban Chinese populations.
  
  
  METHODS
  The data source was the China Ministry of Health 2003 to 2010 annual reports. Mortality was defined as death caused by CHD. Mortality rates for each year were calculated per 10,000,000 person-years. Poisson regression and descriptive analyses were conducted for overall trend and subgroup analysis was conducted by sex, age, and urban versus rural residency to understand potential disparities in mortality.
  
  
  RESULTS
  From 2003 to 2010, the overall mortality rate increased from 141 per 10,000,000 person-years in 2003 to 229 per 10,000,000 person-years in 2010, a 62.4% relative increase. This represents a region-sex adjusted annual increase of 9% (incidence rate ratio, 1.09; 95% confidence interval, 1.09-1.10). The increase in CHD mortality was not uniformly observed across age groups, urban versus rural residence, and sex. The relative increases were 65.3%, 212.2%, and 131.7% for ages 1 to 10 years, 21 to 64 years, and 65 years or older groups, respectively. Urban areas had a relative increase of 154.5% versus 5.3% for rural areas. Females who lived in an urban environment had a relative increase of 313.5%.
  
  
  CONCLUSIONS
  Our observation showed an obvious increasing trend of CHD mortality in China. What is more, the increase in CHD mortality was not uniformly observed across subgroups. Such information is needed for strategy-making procedures.
authors.affiliation: Surgery Department, Peking Union Medical College Hospital, Beijing, China; Department of Cardiac Surgery, Peking University First Hospital, Beijing, China.
authors.forename: Zhan
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Chinese National Center for Cardiovascular Diseases, Beijing, China; Department of Surgery, Center for Regenerative Medicine, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. Electronic address: yuanxin1008@yahoo.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Yuan
authors.affiliation: National Center for Health Statistics, Ministry of Health of the People's Republic of China, Beijing, China.
authors.forename: Keqin
authors.initials: K
authors.lastname: Rao
authors.affiliation: Chinese National Center for Cardiovascular Diseases, Beijing, China; Department of Surgery, Center for Regenerative Medicine, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zheng
authors.affiliation: Chinese National Center for Cardiovascular Diseases, Beijing, China; Department of Surgery, Center for Regenerative Medicine, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Shengshou
authors.initials: S
authors.lastname: Hu
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D002648:Child; D046688:Child Mortality / Q000639:trends; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006330:Heart Defects, Congenital / Q000401:mortality*; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012423:Rural Health / Q000639:trends*; D017678:Sex Distribution; D012737:Sex Factors; D013997:Time Factors; D014504:Urban Health / Q000639:trends*; D055815:Young Adult