Trends in CVD morbidity, mortality and survival, among 85+ in Sweden

Karin Modig, Karolinska Institutet
Sven Drefahl, Stockholm University
Anders Ahlbom, Karolinska Institutet

Cardiovascular diseases, CVD, are a major cause of death and account for a substantial part of hospitalization events as well as fatal events in Sweden and worldwide. However, the age-standardized CVD trends, both disease and mortality trends, have declined in most western countries since the 1960-ies. The reasons for this decline are several but both advances in medical care as well as declines in several important risk factors come into play. CVD trends have been published almost exclusively for populations up to 85 years of age why little is known about the trends for the oldest part of the population. As the incidence of CVD increases heavily with age it is of interest to study the trends also for the oldest. In some publications the oldest ages are included but compressed into one group, often 85+. These trends are difficult to interpret as the mean age in this group has increased over time. Increasing incidence trends (as have been shown for MI in the Swedish population of 85+) can thus be stable or even decreasing if they had been age adjusted. We used Swedish national Registries of Hospitalizations and Mortality for the total population to study age adjusted trends in CVD among 85+. Our study shows that the trends in CVD have been slightly decreasing the past 15 years in Sweden for the oldest. Trends in mortality show a somewhat larger decrease than do trends in incidence. Further, analyzing the relative effect of birth year over time in a Discrete Time Model revealed that the effect seemed to be similar over time, i.e. all age groups have benefitted equally from the decreasing CVD trends over time.