Mortality trend analysis of ischemic heart disease in China between 2010 and 2019: a joinpoint analysis

This study presented the mortality trend of ischemic heart disease (IHD) in Chinese residents from 2010 to 2019 and provided a basis for further establishment of relevant interventions.

Data, such as sex, age, urban and rural areas, and death status, were extracted from the China Death Surveillance Dataset from 2010 to 2019, with mortality and age-adjusted death rates (AADRs) as the main indicators. The joinpoint regression model was used to analyze mortality and AADRs trends in IHD. A semi-structured expert interview was conducted to propose targeted intervention measures and countermeasures.

We observed an overall upward trend in IHD mortality rates and AADRs in China from 2010 to 2019 (average annual percentage change [AAPC] = 5.14%, AAPC_AADRs = 1.60%, P < 0.001). Mortality rates and AADRs increased for both males (AAPC = 4.91%, AAPC_AADRs = 1.09%, P < 0.05) and females (AAPC = 5.57%, AAPC_AADRs = 1.84%, P < 0.001), with higher mortality rate for males than females but higher variation for females than males. Urban (AAPC = 4.80%, AAPC_AADRs = 1.76%, P < 0.05) and rural (AAPC = 5.31%, P < 0.001; AAPC_AADRs = 0.99%, P > 0.05) mortality rates increased, with the mortality rate higher in rural areas than in urban areas. In the age analysis, mortality rate was higher in middle-aged and older adults than in other age groups. The age-sex cross-analysis found the highest trend in mortality rates among females aged ≥ 75 years (annual percentage change [APC] = 2.43%, P < 0.05).

The upward trend in IHD mortality in China from 2010 to 2019, especially among female residents aged ≥ 75 years, poses continuing challenges to public health policies and actions.