Key result
Younger men aged 25-44 experienced a significant 22.5% per year decline in out-of-hospital ischemic heart disease mortality from 1988 to 2012 (p=0.047).
Observational
Yes
p-value: p=0.047
Out-of-hospital IHD mortality in Kaunas, Lithuania declined significantly among younger men (25-44 years) between 1988 and 2012, particularly in those without a prior history of AMI.
Warrants sustained IHD prevention focus in young men; extends observational trends but leaves causal factors open.
AIM: The aim of the study was to evaluate trends in out-of-hospital ischemic heart disease (IHD) mortality in the Kaunas, Lithuania population aged 25-64, from 1988 to 2012. METHODS: The registry was maintained according to the World Health Organisation (WHO) recommendations for the multinational MONICA (MONItoring of trends and determinants in CArdiovascular disease) project. We analysed out-of-hospital deaths from IHD, by sex and age groups, using the linear logistic regression model for identifying trends. RESULTS: In 1988-2012, the out-of-hospital IHD deaths in Kaunas accounted for 78.4% and 68.4%, on average, of all IHD deaths in men and women aged 25-64, respectively. During the study period, the out-of-hospital IHD mortality for the Kaunas population aged 25-64 was 134.5 per 100,000 men and 18.2 per 100,000 women. From 1988 to 2012, the out-of-hospital IHD mortality for men and women aged 25-64 tended to decline by, on average, 8.3% per year (p = 0.269) and 16.2% per year (p = 0.101), respectively; whereas the corresponding rates for men aged 25-44 were declining significantly, by 22.5% per year (p = 0.047). The most significant changes in out-of-hospital IHD mortality were among men aged 25-44 with no previous history of acute myocardial infarction (AMI), in whom the out-of-hospital IHD mortality was significantly declining, by 21.3% per year (p = 0.015); whereas the corresponding rates for men aged 45-54 with a previous history of AMI tended to decline by 20.4% per year (p = 0.114). CONCLUSIONS: In 1988-2012, the out-of-hospital IHD deaths of younger men and middle-aged women accounted for the highest percentage of all IHD deaths; and a higher proportion of both men and women with no previous history of AMI, as compared to the proportion of those with a previous history of AMI.
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Bernotienė et al. (2015) conducted an observational in Ischemic heart disease. Younger men aged 25-44 experienced a significant 22.5% per year decline in out-of-hospital ischemic heart disease mortality from 1988 to 2012 (p=0.047).
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