Stall in Heart Disease Death Rates, Evidence From Maine, 1999–2017
ORIGINAL RESEARCH — Volume 17 — August 20, 2020
PEER REVIEWED
Figure 1.
Comparison of observed and joinpoint-modeled age-adjusted heart disease death rates, Maine, 1999–2017. Death rates are age-adjusted to the 2000 US standard population. International Classification of Diseases, 10th Revision (ICD-10) codes used: I00-I02, I05–I09, I11, I13, I20–I25, I26–I28, I30–I51. aAnnual percentage change from 1999–2010 is significantly different from 0 at an alpha level of .05. Data source: CDC WONDER.
| Year | Observed Age-Adjusted Death Rate Per 100,000 Population |
Joinpoint Modeled Death Rate Per 100,000 Population |
|---|---|---|
| 1999 | 238.72 | 239.95 |
| 2000 | 233.86 | 229.95 |
| 2001 | 220.65 | 220.36 |
| 2002 | 210.61 | 211.18 |
| 2003 | 203.03 | 202.38 |
| 2004 | 189.89 | 193.94 |
| 2005 | 186.53 | 185.86 |
| 2006 | 174.31 | 178.12 |
| 2007 | 172.97 | 170.69 |
| 2008 | 164.63 | 163.58 |
| 2009 | 156.37 | 156.76 |
| 2010 | 151.1 | 150.23 |
| 2011 | 149.46 | 150.03 |
| 2012 | 145.9 | 149.83 |
| 2013 | 152.27 | 149.63 |
| 2014 | 147.89 | 149.43 |
| 2015 | 157.31 | 149.24 |
| 2016 | 149.51 | 149.04 |
| 2017 | 143.48 | 148.84 |
Figure 2.
Heart disease mortality trends in Maine, by sex, age group, and type of heart disease, 1999–2017. All trends except age group determined using age-adjusted death rates. Data in bars are APC (95% CI). 95% CIs are provided to give the reader an indication of statistical stability and should not be used to determine whether changes in trend occurred. Significant changes in trend (increasing or decreasing) were determined by using joinpoint modeling to identify where APCs were significantly different from zero at the alpha = 0.05 level. There were fewer than 20 cases of cardiac arrest in 2017, so the death rate for that year was unreliable. Abbreviations: AMI, acute myocardial infarction; APC, annual percentage change; CI, confidence interval; COD, cause of death; HHD, hypertensive heart disease; ICD-10, International Classification of Diseases, 10th revision; IHD, ischemic heart disease; NA, not available.
| Category | Period 1 Dates | Period 1 APC (95% CI) | Period 2 Dates | Period 2 APC (95% CI) |
|---|---|---|---|---|
| Heart Disease | 1999–2010 | –4.2 (–4.6 to –3.8)a | 2010–2017 | –0.1 (–1.0 to 0.8) |
| Sex | ||||
| Male | 1999–2010 | –3.9 (–4.5 to –3.3)a | 2010–2017 | –0.2 (–1.5 to 1.1) |
| Female | 1999–2009 | –4.8 (–5.3 to –4.2)a | 2009–2017 | –0.7 (–1.6 to 0.2) |
| Age, y | ||||
| 25–44 | 1999–2017 | –0.9 (–2.4 to 0.6) | NA | NA |
| 45–64 | 1999–2010 | –3.1 (–4.1 to –2.0)a | 2010–2017 | 1.7 (–0.5 to 4.0) |
| 65–84 | 1999–2011 | –5.2 (–5.6 to –4.9)a | 2011–2017 | –1.1 (–2.3 to 0.1) |
| ≥85 | 1999–2010 | –3.4 (–4.1 to –2.7)a | 2010–2017 | 0.0 (–1.4 to 1.4) |
| Underlying cause of death | ||||
| Cardiac arrest | 1999–2011 | –5.2 (–7.0 to –3.3)a | 2011–2016 | –16.2 (–25.2 to –6.2)a |
| AMI | 1999–2007 | –6.7 (–8.0 to –5.4)a | 2007–2017 | –4.1 (–5.2 to –2.9)a |
| HHD | 1999–2010 | –5.7 (–8.6 to –2.7)a | 2010–2017 | 14.6 (8.4 to 21.1)a |
| Heart failure | 1999–2010 | –1.4 (–2.5 to –0.2)a | 2010–2017 | 2.9 (0.7 to 5.1)a |
| IHD without AMI | 1999–2011 | –5.3 (–5.7 to –4.8)a | 2011–2017 | –1.0 (–2.6 to 0.6) |
| Pulmonary heart disease | 1999–2017 | –0.9 (–2.1 to 0.4) | NA | NA |
| Ill-defined heart disease | 1999–2017 | 5.3 (3.3 to 7.3)a | NA | NA |
| Multiple cause of death | ||||
| Heart failure–related | 1999–2009 | –4.0 (–4.7 to –3.3)a | 2009–2017 | 3.0 (2.1 to 4.0)a |
| Diabetes-related | 1999–2011 | –5.3 (–6.5 to –4.2)a | 2011–2017 | –0.1 (–3.9 to 3.7) |
| Health district | ||||
| Aroostook | 1999–2017 | –3.3 (–4.1 to –2.5)a | NA | NA |
| Central | 1999–2017 | –2.0 (–2.7 to –1.2)a | NA | NA |
| Cumberland | 1999–2010 | –4.8 (–5.5 to –4.0)a | 2010–2017 | 0.5 (–1.1 to 2.1) |
| Downeast | 1999–2010 | –4.7 (–5.6 to –3.9)a | 2010–2017 | –0.3 (–2.2 to 1.6) |
| Midcoast | 1999–2012 | –4.3 (–4.8 to –3.8)a | 2012–2017 | 4.6 (2.3 to 6.9)a |
| Penquis | 1999–2017 | –2.9 (–3.5 to –2.3)a | NA | NA |
| Western | 1999–2017 | –2.3 (–2.9 to –1.7)a | NA | NA |
| York | 1999–2017 | –3.6 (–4.3 to –2.9)a | NA | NA |
| Rural/urban status | ||||
| Metropolitan | 1999–2010 | –4.3 (–4.8 to –3.8)a | 2010–2017 | –0.4 (–1.4 to 0.6) |
| Nonmetropolitan | 1999–2009 | –4.2 (–5.0 to –3.4)a | 2009–2017 | –0.2 (–1.5 to 1.1) |
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