Changes in mortality due to cardiovascular diseases among people aged 65 and over in Poland from 2000 to 2019

Abstract Background Demographic forecasts predict that in 2050 the percentage of people aged 65 years and over in Poland will be nearly 40%. The main cause of death in this age group is cardiovascular disease, accounting for 41.1% of all deaths. The risk of developing the disease increases with age which poses a challenge to the health care system and public health. Purpose The aim of the study was to assess changes in mortality due to cardiovascular diseases among people aged 65 and over in Poland from 2000 to 2019. Methods The study used a database of all deaths of Polish residents aged 65+ due to cardiovascular diseases (I00-I99). Trends have been analysed in two age groups: early old age (65-74 years) and late old age (over 75 years). The analysis has been carried out with the use of joinpoint models. The Annual Percentage Change (APC) for each segments of broken lines, the Average Annual Percentage Change (AAPC) for the whole study period (95% CI), and standardized death rates (SDRs) were calculated. Results Diseases of the circulatory system were the most common major group of causes of death among Polish residents aged over 65 years. The percentage of deaths due to diseases of the circulatory system decreased in all the studied subgroups in analysed period. The fastest percentage decline was observed in the group of women in early old age. The standardized death rate in this group decreased from 1027.3 in 2000 to 471.5 in 2019 (AAPC=-4.1%, p0.05). Among cardiovascular diseases, ischemic heart diseases were the most common cause of death, except for women in late old age, where it was diseases of arteries, arterioles and capillaries. The third most common cause of death in the cardiovascular disease group was cerebrovascular diseases. In each of these mentioned subgroups of causes of death among diseases of the circulatory system, in all the analysed gender and age subgroups, decreasing trends were observed in the analysed period. However, more detailed analyse show that SDRs due to ischemic heart disease have been increasing for a few years. In the early old age group of women and men, the upward trend began in 2015 and 2016 (APC=2.1% and 2.0%). In the late old age group of women and men, the increase in SDR between 2014 and 2019 was statistically significant. APC was 3.5% in the female group and 2.5% in the male group (p0.05). Conclusions In the population of elderly people, the greatest health risks are cardiovascular diseases, primarily ischemic heart disease. This indicates the need to focus on health education, prevention, mainly in the areas of modifiable risk factors such as physical activity, eating habits, alcohol and tobacco consumption, and health promotion from an early age.