May 30, 2022 | Press Release

Why is Cardiovascular Mortality Stagnating in the USA?

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Cardiovascular-related mortality has been stalling in the USA since about 2010. This is exceptional compared to other high life expectancy countries as it appeared earlier and has been more pronounced. A reason for this development is that mortality for some kinds of cardiovascular diseases has stalled, others even increased. This is what a team including MPIDR Researchers found and published in their recent study, part of a Issue Supplement in the Journals of Gerontology: Series B.

Enrique Acosta, Researcher at the Max Planck Institute for Demographic Research (MPIDR) in Rostock, Germany, and colleagues analyzed the mortality gap between the USA and other high life-expectancy countries caused by cardiovascular diseases (CVD). Their four main findings are:

  • Cardiovascular mortality in the USA is consistently higher than the average cardiovascular mortality of other high life-expectancy countries.
  • The gap in life expectancy between the US and other high life-expectancy countries declined until around 2008 and increased thenafter.
  • The shift from convergence to divergence was mainly driven by slowing ischemic heart disease and stroke mortality reductions, and increasing mortality from other cardiovascular causes.
  • Among the potential risk factors, only obesity- and alcohol-related mortality showed age-specific temporal changes similar to those observed for cardiovascular mortality.

“It is possible – among other plausible explanations – that the stall in cardiovascular mortality is driven in part by increases in obesity prevalence and alcohol abuse,” says Enrique Acosta. He adds: “It is also possible that a systemic cause, resulting from the interplay of psychological and socioeconomic distress, grounded in the growing inequalities in the US, could be a trigger for deaths of despair (which includes suicides and abuse of drugs and alcohol), obesity, and the stagnation in CVD-related mortality.”

The researchers analyzed the differences in mortality by cardiovascular disease between the US and 17 other high life-expectancy countries. They used cause-of-death data from the WHO mortality database from 2000 to 2016 and looked at the mortality of several cardiovascular diseases like ischemic heart disease and stroke, as well as mortality related to potential behavioral risk factors, such as obesity, smoking, and alcohol- and drug-abuse.

Cardiovascular diseases are the leading cause of death in the world and in the US. Slight changes in mortality trends from this cause of death have considerable impacts in overall mortality trends. It has even been suggested by earlier studies that the main reason for the recent deterioration in US life expectancy is the stall in cardiovascular mortality, having even much greater impact than the opioid epidemic.

Original Publication

Acosta, E., Mehta, N., Myrskylä, M., Ebeling, M.: Cardiovascular mortality gap between the US and other high life expectancy countries in 2000-2016. The Journals of Gerontology: Series B, Volume 77, Issue Supplement_2 (2022). DOI: 10.1093/geronb/gbac032 

Authors and Affiliations

Enrique Acosta, Max Planck Institute for Demographic Research, Rostock

Neil Mehta, The University of Texas Medical Branch, Galveston

Mikko Myrskylä, Max Planck Institute for Demographic Research, Rostock; University of Helsinki, Helsinki

Marcus Ebeling, Max Planck Institute for Demographic Research, Rostock; Karolinska Institutet, Stockholm

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The Max Planck Institute for Demographic Research (MPIDR) in Rostock is one of the leading demographic research centers in the world. It's part of the Max Planck Society, the internationally renowned German research society.