Monday 13 May 2019

Is premature death from heart disease on the rise?

As societies become healthier, people are more likely to die from heart disease. If you avoid other causes of death, eventually your heart will pack up. This explains the apparent paradox of smokers being less likely to die of heart disease than nonsmokers.

But whilst you might expect more heart disease deaths overall, you'd expect premature deaths from heart disease to decline.

According to an unreferenced press release from the British Heart Foundation today, that is no longer happening in Britain. The BBC reported is as follows...

Heart deaths up for first time in 50 years

Deaths from heart and circulatory diseases among people under 75 is on the rise for the first time in 50 years, UK figures show.

The British Heart Foundation (BHF) says increasing rates of diabetes and obesity are partly responsible. 

In 2017 there were 42,384 deaths in under-75s from heart and circulatory conditions, up from 41,042 in 2014.

The charity says the historic pace of progress in reducing these deaths "has slowed to a near standstill".

According to the BHF, mortality is rising even among the under-65s...

The number of deaths caused by heart and circulatory diseases in under 65s is also increasing, peaking at 18,668 in 2017, up from 17,982 five years earlier.

The BHF do not link to their source and only say that they come from the 'latest national health statistics'. They don't seem to tally with figures from the Office for National Statistics. 

The ONS stats only look at England and Wales, but the trends are in the opposite direction.

For cardiovascular disease, they show 14,929 deaths among the under-65s and 34,169 deaths among the under-75s in 2016. In 2017, the number deaths fell to 13,528 and 31,443 respectively. 

For ischaemic heart disease, there were 7,916 deaths among the under-65s and 18,170 deaths among the under-75s in 2016. In 2017, these figures fell to 7,291 and 16,819 respectively.

For both diagnoses combined, the number of deaths among the under-65s fell from 22,845 to 20,819 and the number of deaths among the under-75s fell from 52,339 to 48,262.

The fact that the BHF's numbers are all smaller, despite including the whole UK, suggests that they are using a somewhat narrower definition of 'heart and circulatory diseases'. It is theoretically possible that a huge rise in heart disease in Scotland and Northern Ireland could explain the difference between the trend reported by the BHF and that found by the ONS, although it is extremely unlikely in practice.

It would be more useful to show the death rate per 100,000 people as the absolute numbers are affected by the size of the population (this is particularly important now that the baby boomers have reached old age).

But these are relatively minor issues. I'd be interested to know which figures the BHF are using because the standard official data do not support the claim that 'heart deaths are up for the first time in fifty years'.

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