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[Trends in cardiovascular morbidity and mortality in the Netherlands, 1980-2000]
H L Koek1, D E Grobbee, M L Bots
1Universitair Medisch Centrum Utrecht, Julius Centrum voor Gezondheidswetenschappen en Eerstelijnsgeneeskunde, Postbus 85.060, Huispostnummer Str.6.118, 3508 AB Utrecht. h.l.koek@jc.azu.nl
Objective:
To describe and interpret trends in cardiovascular morbidity and mortality among the Dutch population from 1980 to 2000, in particular the decline in hospital admissions for cardiovascular disease during the second half of the 1990s.
Design:
Descriptive.
Method:
An analysis of trends in hospital admissions and cardiovascular mortality for the period 1980 to 2000 was performed using Dutch hospital admissions and mortality data, specified according to age and sex. These data were taken from the National Medical Register of hospital admissions maintained by Prismant and from the national statistics on the causes of mortality maintained by Statistics Netherlands.
Results:
Since the 1970s, the mortality due to cardiovascular diseases has gradually declined. The age-adjusted mortality has declined by 36% for men and 33% for women. The decline is evident for both acute and chronic diseases. After an initial increase, hospital admission rates for cardiovascular disease showed a marked decline during the second half of the 1990s. The age-adjusted hospital admission rate has declined by 15% for men and 13% for women. This decline was seen in all age groups and for both acute and chronic diseases.
Conclusion:
The recent decrease in hospital admissions for cardiovascular disease during the second half of the 1990s appears mainly to be the consequence of a shift from hospital admissions to day care and outpatients' clinics.
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