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Temporal trends in mortality due to coronary heart disease in Germany from 1998 to 2023

Henriette Steppuhn1, Jens Baumert1, Viktoria Rücker2

  • 1Robert Koch Institute, Department for Epidemiology and Health Monitoring, Berlin, Germany.

Journal of Health Monitoring
|June 19, 2025
PubMed

Insights

Coronary heart disease (CHD) mortality decreased significantly in Germany from 1998-2023, but the trend has flattened since the 2010s, especially for middle-aged adults and chronic CHD mortality in men.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Coronary heart disease (CHD) is a leading cause of death in Germany.
  • Comprehensive long-term CHD mortality trend analyses distinguishing between acute myocardial infarction (AMI) and chronic CHD are lacking.

Purpose of the Study:

  • To analyze long-term trends in CHD mortality in Germany from 1998 to 2023.
  • To differentiate trends between AMI and non-AMI-related chronic CHD.
  • To identify potential unmet needs in prevention strategies.

Main Methods:

  • Utilized German cause-of-death statistics (1998-2023).
  • Calculated age-specific and age-standardized CHD mortality rates.
  • Employed joinpoint regression analysis to estimate annual and average annual percentage changes.

Main Results:

  • Age-standardized CHD mortality rates declined annually by -3.9% for women and -3.2% for men.
  • The downward trend in CHD mortality has flattened since the 2010s, particularly in the 60-74 age group.
  • Mortality rates for chronic CHD declined less sharply than for AMI, especially in men.

Conclusions:

  • The observed flattening of CHD mortality trends, particularly in middle-aged adults and for chronic CHD in men, warrants further investigation.
  • Identifying unmet needs at various prevention levels for specific life stages is crucial.
  • The impact of the COVID-19 pandemic on CHD mortality trends requires further study.
Abstract

Keywords:
Acute myocardial infarctionCHDChronic CHDCoronary heart diseaseJoinpoint regressionMortalityTime series analysis

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