Cardiovascular
Mortality Burden of Atherosclerotic Cardiovascular Diseases and Associated Risk Factors in Taiwan: 2000-2020 Fang-Wen Nora Lu* Hsien-Ho Lin Fang-Wen Nora Lu Bo-Chen Liu Wen-Kai Yang April Hill Wei-Cheng Lo Hsien-Ho Lin
Study Aim: We estimated the patterns of Atherosclerotic Cardiovascular Diseases (ASCVD)-related mortality over an extended timeframe (2000-2020) in Taiwan and the impact of major risk factors.
Methods: We analyzed the multiple cause of death data in the vital registry of Taiwan and used a verified naïve Bayes classifier algorithm to redistribute the garbage codes to the underlying causes of death. We used the redistributed mortality data in adults (>=20 years) to calculate the age-standardized mortality rate of ischemic heart disease (IHD) and ischemic stroke (IS), and estimated years of life lost (YLL) using the life table of Taiwan. Data from the National Health Interview Survey (2001, 2005, 2009, 2013, 2017) and the Nutrition and Health Survey in Taiwan (2013-2016) were used to estimate the prevalence and population attributable fraction (PAF) of five major ASCVD risk factors: high systolic blood pressure, high LDL cholesterol, high fasting plasma glucose, high body mass index, and smoking.
Results: During the past two decades, there was a notable decline in the age-standardized mortality rate and YLL rate due to ASCVD (Figure 1). The decline was faster in the first than the second decade, with an average annual percent change of the mortality rate being 2.58% and 0.77% in the first and second decade respectively for IHD (Figure 1A) and 16.11% and -3.04% respectively for IS (Figure 1B). The analysis of risk factor revealed that in 2013, high systolic blood pressure accounted for the largest proportion of the ASCVD mortality burden, with a PAF of 48.51%. This was followed by 20.10% for high LDL cholesterol, 20.08% for high fasting plasma glucose, 10.03% for high body mass index and 9.47% for smoking.
Conclusions: Our analysis revealed an alarming deceleration of the decline of ASCVD mortality burden in Taiwan. Interventions targeting high systolic blood pressure, high LDL cholesterol, and high fasting plasma glucose are needed to alleviate the ASCVD burden.
