How have the mortality rates of coronary artery disease (CAD) and myocardial infarction (MI, heart attack) changed outside the US?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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In the European Union, death rates related to CAD dropped by almost 30% between the mid 1960s to the mid and late 1990s; however, within Eastern European countries, there was an increase in death rates related to acute MI in the early1990s, followed by a subsequent decline. In the Russian Federation, cardiovascular mortality remained the same. [28]  

Cardiovascular disease in other developed countries and in developing nations

An analysis of death certificates from the World Health Organization (WHO) database demonstrated that CAD mortality in Japan was significantly lower than in the United States and Europe, and it was further reduced by about 30% by the mid 1990s. [28]

In China, there has been a significant increase in mortality related to CAD, this is most likely attributed to the increase in cardiovascular disease risk factors, predominantly smoking and dyslipidemia. [29]

The incidence of CAD and related mortality is expected to rise dramatically in other developing countries including India, Latin America, the Middle East and Sub-Saharan Africa, with an estimated 80% increase, from approximately 9 million in 1990 to a projected 20 million by 2020. [30, 31]

It is believed that these international trends in the incidence of CAD and subsequent acute MI are largely related to consequences of social and economic changes in these countries, resulting in better healthcare access and increases in life expectancy, in addition to adoption of westernized diets, reduction in physical activity, and higher rates of smoking.

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