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Recent Trends in Cardiovascular Disease Mortality in Kazakhstan
Gulnara Junusbekova1, Meiramgul Tundybayeva1, Nazgul Akhtaeva2
1Cardiology Department, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
Insights
Cardiovascular disease mortality in Kazakhstan decreased overall from 2011-2021, with stronger reductions in males. However, rising trends in 2020-2021 and high mortality among young people indicate a need for improved primary care and public health literacy for cardiovascular disease prevention.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Medicine
Background:
- Cardiovascular diseases (CVD) represent the leading cause of death in Kazakhstan.
- Healthcare reforms have been implemented to reduce mortality from significant diseases, including CVD.
Purpose of the Study:
- To analyze the trend of avoidable mortality from cardiovascular diseases (CVD) in Kazakhstan between 2011 and 2021.
Main Methods:
- Utilized national statistics data on population and mortality rates for specific CVDs (rheumatic heart disease, hypertensive diseases, ischemic heart disease, cerebrovascular diseases) from 2011-2021.
- Applied joinpoint regression to calculate the average annual percentage change (AAPC) in mortality rates.
- Calculated crude mortality trends per 100,000 population by gender and age group.
Main Results:
- Avoidable mortality rates for the four studied CVD groups decreased from 2011-2019, but increased in 2020-2021.
- Overall avoidable CVD mortality showed a significant decrease (AAPC -6.0%) between 2011-2021.
- Reductions were more pronounced in males than females for ischemic heart disease, cerebrovascular, and hypertensive diseases, though crude mortality remains high in young individuals.
Conclusions:
- The decline in avoidable CVD mortality may be linked to policies strengthening primary care for early diagnosis and risk factor detection.
- Primary healthcare facilities require enhanced efforts in public health literacy, focusing on medication adherence and CVD risk factor management for effective prevention.
Introduction:
Cardiovascular diseases (CVD) are the leading cause of mortality in Kazakhstan. In the last decade, Kazakhstan has carried out a number of reforms in the healthcare sector, in particular, to reduce mortality from significant diseases, including CVD. This study aimed to provide the trend of avoidable mortality from CVD in Kazakhstan.
Methods:
We extracted data from the Bureau of National Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan on population by age; mortality rates from chronic rheumatic heart disease (I05-I09); hypertensive diseases (I10-I15); ischaemic heart disease (I20-I25); cerebrovascular diseases (I60-I69) from 2011 to 2021, by gender and 5-year age group (0, 1-4, 5-9, 74). We applied join point regression to calculate the average annual percentage change (AAPC). In addition, crude mortality and trends were calculated per 100,000 population.
Results:
The avoidable mortality rates, including treatable and preventable mortality decreased between 2011 and 2019 and then increased in the last two years (2020 and 2021) in all four studied disease groups. The AAPC showed that total avoidable mortality rates decreased between 2011 and 2021-6.0 points (-10.6 to - 1.1) (p = 0.017), whereas in males -4.2 (-8.3 to 0.1) and females - 5.1 (-8.8 to -1.3) (p = 0.009). Avoidable mortality rates from ischemic heart disease, cerebrovascular and hypertensive disease has been reduced stronger in male compared to female. The crude mortality declined over the period given; however, among young people mortality is still high.
Discussion:
Our findings showed that avoidable mortality from CVD decreased over the last years, which could be related to the policy on strengthening the primary care on early diagnosis and detection of CVD and its risk factors. However, primary healthcare facilities need to improve activities on health literacy (drug adherence, risk factors) of the population, including the prevention of CVD.
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