title: Modelling Future Coronary Heart Disease Mortality to 2030 in the British Isles.
abstract: OBJECTIVE
  Despite rapid declines over the last two decades, coronary heart disease (CHD) mortality rates in the British Isles are still amongst the highest in Europe. This study uses a modelling approach to compare the potential impact of future risk factor scenarios relating to smoking and physical activity levels, dietary salt and saturated fat intakes on future CHD mortality in three countries: Northern Ireland (NI), Republic of Ireland (RoI) and Scotland.
  
  
  METHODS
  CHD mortality models previously developed and validated in each country were extended to predict potential reductions in CHD mortality from 2010 (baseline year) to 2030. Risk factor trends data from recent surveys at baseline were used to model alternative future risk factor scenarios: Absolute decreases in (i) smoking prevalence and (ii) physical inactivity rates of up to 15% by 2030; relative decreases in (iii) dietary salt intake of up to 30% by 2030 and (iv) dietary saturated fat of up to 6% by 2030. Probabilistic sensitivity analyses were then conducted.
  
  
  RESULTS
  Projected populations in 2030 were 1.3, 3.4 and 3.9 million in NI, RoI and Scotland respectively (adults aged 25-84). In 2030: assuming recent declining mortality trends continue: 15% absolute reductions in smoking could decrease CHD deaths by 5.8-7.2%. 15% absolute reductions in physical inactivity levels could decrease CHD deaths by 3.1-3.6%. Relative reductions in salt intake of 30% could decrease CHD deaths by 5.2-5.6% and a 6% reduction in saturated fat intake might decrease CHD deaths by some 7.8-9.0%. These projections remained stable under a wide range of sensitivity analyses.
  
  
  CONCLUSIONS
  Feasible reductions in four cardiovascular risk factors (already achieved elsewhere) could substantially reduce future coronary deaths. More aggressive polices are therefore needed in the British Isles to control tobacco, promote healthy food and increase physical activity.
authors.affiliation: UKCRC Centre of Excellence for Public Health, Queen's University, Belfast, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Hughes
authors.affiliation: Department of Epidemiology &Public Health University College Cork, Cork, Ireland.
authors.forename: Zubair
authors.initials: Z
authors.lastname: Kabir
authors.affiliation: Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Bennett
authors.affiliation: School of Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Joel W
authors.initials: JW
authors.lastname: Hotchkiss
authors.affiliation: UKCRC Centre of Excellence for Public Health, Queen's University, Belfast, United Kingdom.
authors.forename: Frank
authors.initials: F
authors.lastname: Kee
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Alastair H
authors.initials: AH
authors.lastname: Leyland
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Davies
authors.affiliation: Department of Public Health & Policy, Institute of Psychology, Health & Society, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Piotr
authors.initials: P
authors.lastname: Bandosz
authors.affiliation: Department of Public Health & Policy, Institute of Psychology, Health & Society, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Maria
authors.initials: M
authors.lastname: Guzman-Castillo
authors.affiliation: Department of Public Health & Policy, Institute of Psychology, Health & Society, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: O'Flaherty
authors.affiliation: Department of Public Health & Policy, Institute of Psychology, Health & Society, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Capewell
authors.affiliation: Population Health Research Institute, St Georges University of London, London, United Kingdom.
authors.forename: Julia
authors.initials: J
authors.lastname: Critchley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000401:mortality*; D005260:Female; D005544:Forecasting; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009026:Mortality / Q000639:trends; D009660:Northern Ireland / Q000453:epidemiology; D012606:Scotland / Q000453:epidemiology