Analysing Recent Socioeconomic Trends in Coronary Heart Disease Mortality in England, 2000–2007: A Population Modelling Study
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{"title"=>"Analysing recent socioeconomic trends in coronary heart disease mortality in England, 2000-2007: A population modelling study", "type"=>"journal", "authors"=>[{"first_name"=>"Madhavi", "last_name"=>"Bajekal", "scopus_author_id"=>"6602280300"}, {"first_name"=>"Shaun", "last_name"=>"Scholes", "scopus_author_id"=>"35363010600"}, {"first_name"=>"Hande", "last_name"=>"Love", "scopus_author_id"=>"54988221400"}, {"first_name"=>"Nathaniel", "last_name"=>"Hawkins", "scopus_author_id"=>"14031472900"}, {"first_name"=>"Martin", "last_name"=>"O'Flaherty", "scopus_author_id"=>"6701635334"}, {"first_name"=>"Rosalind", "last_name"=>"Raine", "scopus_author_id"=>"7005610240"}, {"first_name"=>"Simon", "last_name"=>"Capewell", "scopus_author_id"=>"56962711900"}], "year"=>2012, "source"=>"PLoS Medicine", "identifiers"=>{"scopus"=>"2-s2.0-84864718416", "doi"=>"10.1371/journal.pmed.1001237", "sgr"=>"84864718416", "isbn"=>"1549-1676 (Electronic)\\r1549-1277 (Linking)", "pmid"=>"22719232", "issn"=>"15491277", "pui"=>"365397523"}, "id"=>"79fb82be-fcf9-3c69-ab97-3d2d2cab4b8a", "abstract"=>"Coronary heart disease (CHD) mortality in England fell by approximately 6% every year between 2000 and 2007. However, rates fell differentially between social groups with inequalities actually widening. We sought to describe the extent to which this reduction in CHD mortality was attributable to changes in either levels of risk factors or treatment uptake, both across and within socioeconomic groups.", "link"=>"http://www.mendeley.com/research/analysing-recent-socioeconomic-trends-coronary-heart-disease-mortality-england-20002007-population-m", "reader_count"=>85, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>5, "Librarian"=>1, "Researcher"=>20, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>13, "Student > Postgraduate"=>3, "Student > Master"=>14, "Other"=>11, "Student > Bachelor"=>8, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>1, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>5, "Librarian"=>1, "Researcher"=>20, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>13, "Student > Postgraduate"=>3, "Student > Master"=>14, "Other"=>11, "Student > Bachelor"=>8, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>1, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>6, "Agricultural and Biological Sciences"=>3, "Arts and Humanities"=>1, "Business, Management and Accounting"=>2, "Computer Science"=>1, "Decision Sciences"=>1, "Economics, Econometrics and Finance"=>1, "Nursing and Health Professions"=>3, "Biochemistry, Genetics and Molecular Biology"=>3, "Medicine and Dentistry"=>53, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Sports and Recreations"=>2, "Psychology"=>2, "Social Sciences"=>6}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>53}, "Social Sciences"=>{"Social Sciences"=>6}, "Decision Sciences"=>{"Decision Sciences"=>1}, "Sports and Recreations"=>{"Sports and Recreations"=>2}, "Psychology"=>{"Psychology"=>2}, "Unspecified"=>{"Unspecified"=>6}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>3}}, "reader_count_by_country"=>{"United Kingdom"=>6, "France"=>1}, "group_count"=>4}

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  • {"files"=>["https://ndownloader.figshare.com/files/624311"], "description"=>"<p>See <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001237#pmed.1001237.s001\" target=\"_blank\">Text S1</a>, Table K for weighted averages of risk factor levels for each deprivation quintile, 2000 and 2007.</p>a<p>England average weighted by 2007 population distribution in 10-y age bands.</p><p>IMD, index of multiple deprivation.</p>", "links"=>[], "tags"=>["levels", "2000", "2007", "england", "stratified", "deprivation", "quintiles"], "article_id"=>294786, "categories"=>["Biotechnology"], "users"=>["Madhavi Bajekal", "Shaun Scholes", "Hande Love", "Nathaniel Hawkins", "Martin O'Flaherty", "Rosalind Raine", "Simon Capewell"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001237.t006", "stats"=>{"downloads"=>1, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Absolute_change_in_risk_factor_levels_between_2000_and_2007_for_England_and_stratified_by_deprivation_quintiles_and_sex_/294786", "title"=>"Absolute change in risk factor levels between 2000 and 2007 for England and stratified by deprivation quintiles and sex.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-12 01:19:46"}
  • {"files"=>["https://ndownloader.figshare.com/files/324162"], "description"=>"<div><h3>Background</h3><p>Coronary heart disease (CHD) mortality in England fell by approximately 6% every year between 2000 and 2007. However, rates fell differentially between social groups with inequalities actually widening. We sought to describe the extent to which this reduction in CHD mortality was attributable to changes in either levels of risk factors or treatment uptake, both across and within socioeconomic groups.</p> <h3>Methods and Findings</h3><p>A widely used and replicated epidemiological model was used to synthesise estimates stratified by age, gender, and area deprivation quintiles for the English population aged 25 and older between 2000 and 2007. Mortality rates fell, with approximately 38,000 fewer CHD deaths in 2007. The model explained about 86% (95% uncertainty interval: 65%–107%) of this mortality fall. Decreases in major cardiovascular risk factors contributed approximately 34% (21%–47%) to the overall decline in CHD mortality: ranging from about 44% (31%–61%) in the most deprived to 29% (16%–42%) in the most affluent quintile. The biggest contribution came from a substantial fall in systolic blood pressure in the population not on hypertension medication (29%; 18%–40%); more so in deprived (37%) than in affluent (25%) areas. Other risk factor contributions were relatively modest across all social groups: total cholesterol (6%), smoking (3%), and physical activity (2%). Furthermore, these benefits were partly negated by mortality increases attributable to rises in body mass index and diabetes (−9%; −17% to −3%), particularly in more deprived quintiles. Treatments accounted for approximately 52% (40%–70%) of the mortality decline, equitably distributed across all social groups. Lipid reduction (14%), chronic angina treatment (13%), and secondary prevention (11%) made the largest medical contributions.</p> <h3>Conclusions</h3><p>The model suggests that approximately half the recent CHD mortality fall in England was attributable to improved treatment uptake. This benefit occurred evenly across all social groups. However, opposing trends in major risk factors meant that their net contribution amounted to just over a third of the CHD deaths averted; these also varied substantially by socioeconomic group. Powerful and equitable evidence-based population-wide policy interventions exist; these should now be urgently implemented to effectively tackle persistent inequalities.</p> <h3></h3><p> <em>Please see later in the article for the Editors' Summary</em></p> </div>", "links"=>[], "tags"=>["analysing", "socioeconomic", "trends", "coronary"], "article_id"=>123971, "categories"=>["Biotechnology"], "users"=>["Madhavi Bajekal", "Shaun Scholes", "Hande Love", "Nathaniel Hawkins", "Martin O'Flaherty", "Rosalind Raine", "Simon Capewell"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001237", "stats"=>{"downloads"=>9, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Analysing_Recent_Socioeconomic_Trends_in_Coronary_Heart_Disease_Mortality_in_England_2000_2007_A_Population_Modelling_Study/123971", "title"=>"Analysing Recent Socioeconomic Trends in Coronary Heart Disease Mortality in England, 2000–2007: A Population Modelling Study", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-12 01:06:11"}
  • {"files"=>["https://ndownloader.figshare.com/files/624143"], "description"=>"<p>England overall and by socioeconomic quintile.</p>", "links"=>[], "tags"=>["coronary", "attributable"], "article_id"=>294633, "categories"=>["Biotechnology"], "users"=>["Madhavi Bajekal", "Shaun Scholes", "Hande Love", "Nathaniel Hawkins", "Martin O'Flaherty", "Rosalind Raine", "Simon Capewell"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001237.g001", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Proportion_of_coronary_heart_disease_mortality_decline_attributable_to_treatment_or_risk_factor_changes_2000_8211_2007_/294633", "title"=>"Proportion of coronary heart disease mortality decline attributable to treatment or risk factor changes, 2000–2007.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-06-12 01:17:13"}
  • {"files"=>["https://ndownloader.figshare.com/files/624220"], "description"=>"a<p>Sub-totals (in rows).</p>b<p>DPP counts for England (column 1) have been rounded to nearest 5. All counts are in italics.</p>c<p>Abbreviations: CAD, coronary artery disease; IMD, index of multiple deprivation; NSTEACS, non-ST elevation acute coronary syndrome; MI, myocardial infarction; revasc, revascularisation; STEMI, ST elevation myocardial infarction.</p>", "links"=>[], "tags"=>["deaths", "prevented", "postponed", "deprivation"], "article_id"=>294705, "categories"=>["Biotechnology"], "users"=>["Madhavi Bajekal", "Shaun Scholes", "Hande Love", "Nathaniel Hawkins", "Martin O'Flaherty", "Rosalind Raine", "Simon Capewell"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001237.t004", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Percentage_distribution_of_deaths_prevented_of_postponed_by_deprivation_quintile_/294705", "title"=>"Percentage distribution of deaths prevented of postponed by deprivation quintile.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-12 01:18:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/624358"], "description"=>"<p>Rates have been standardised to the European Union reference population aged 25 and over. Separate breakdowns for males and females are available in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001237#pmed.1001237.s001\" target=\"_blank\">Text S1</a>, Table E.</p><p>IMD, index of multiple deprivation.</p>", "links"=>[], "tags"=>["coronary", "age-standardised", "rates", "2000", "2007", "deaths", "prevented", "postponed", "england", "stratified", "deprivation"], "article_id"=>294834, "categories"=>["Biotechnology"], "users"=>["Madhavi Bajekal", "Shaun Scholes", "Hande Love", "Nathaniel Hawkins", "Martin O'Flaherty", "Rosalind Raine", "Simon Capewell"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001237.t001", "stats"=>{"downloads"=>5, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Observed_coronary_heart_disease_deaths_age_standardised_rates_2000_and_2007_and_deaths_prevented_or_postponed_in_England_and_stratified_by_deprivation_quintiles_/294834", "title"=>"Observed coronary heart disease deaths, age-standardised rates 2000 and 2007 and deaths prevented or postponed in England and stratified by deprivation quintiles.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-12 01:20:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/624263"], "description"=>"<p>The overall treatment uptake rate is a weighted average over all age groups 25+ and both sexes.</p>a<p>Eligible patient numbers rounded to nearest 5.</p>b<p>Sub-totals (in rows) for CHD patient groups.</p><p>Abbreviations: B-blocker: beta-blocker; CABG: coronary artery bypass graft; CAD, coronary artery disease; CPR, cardiopulmonary resuscitation; IMD, index of multiple deprivation; NSTEACS, non-ST elevation acute coronary syndrome; MI, myocardial infarction; PCI, percutaneous coronary intervention; PG, platelet glycoprotein; PTCA, percutaneous transluminal coronary angioplasty; STEMI, ST elevation myocardial infarction.</p>", "links"=>[], "tags"=>["uptake", "rates", "2000", "2007", "england", "stratified", "deprivation"], "article_id"=>294742, "categories"=>["Biotechnology"], "users"=>["Madhavi Bajekal", "Shaun Scholes", "Hande Love", "Nathaniel Hawkins", "Martin O'Flaherty", "Rosalind Raine", "Simon Capewell"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001237.t005", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Percentage_treatment_uptake_rates_2000_and_2007_for_England_and_stratified_by_deprivation_quintiles_/294742", "title"=>"Percentage treatment uptake rates 2000 and 2007 for England and stratified by deprivation quintiles.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-12 01:19:02"}
  • {"files"=>["https://ndownloader.figshare.com/files/624415"], "description"=>"<p>Subtotals for England (column 1) have been rounded to nearest 5.</p>a<p>The 95% uncertainty interval corresponds to the lower (2.5th percentile) and upper (97.5th percentile) limits of the uncertainty analysis. These are shown to indicate range around the central estimate of percent of DPPs explained (column 3).</p>b<p>Sub-totals (in rows) for CHD patient groups.</p>c<p>We have assumed no change in cardiopulmonary resuscitation (CPR) uptake in the community between 2000 and 2007. Their contribution to DPPs have therefore been set to zero.</p>d<p>No change in uptake between 2000 and 2007.</p><p>Abbreviations: B-blocker, beta-blocker; CABG, coronary artery bypass graft; CAD, coronary artery disease; IMD, index of multiple deprivation; MI, myocardial infarction; NSTEACS, non-ST elevation acute coronary syndrome; PCI, percutaneous coronary intervention; PG, platelet glycoprotein; PTCA, percutaneous transluminal coronary angioplasty; STEMI, ST elevation myocardial infarction.</p>", "links"=>[], "tags"=>["deaths", "prevented", "postponed", "changes", "uptake", "2000", "2007", "england", "stratified", "deprivation"], "article_id"=>294889, "categories"=>["Biotechnology"], "users"=>["Madhavi Bajekal", "Shaun Scholes", "Hande Love", "Nathaniel Hawkins", "Martin O'Flaherty", "Rosalind Raine", "Simon Capewell"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001237.t002", "stats"=>{"downloads"=>2, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Coronary_heart_disease_deaths_prevented_or_postponed_due_to_changes_in_treatment_uptake_between_2000_and_2007_in_England_and_stratified_by_deprivation_quintiles_/294889", "title"=>"Coronary heart disease deaths prevented or postponed due to changes in treatment uptake between 2000 and 2007 in England and stratified by deprivation quintiles.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-12 01:21:29"}
  • {"files"=>["https://ndownloader.figshare.com/files/624466"], "description"=>"<p>Subtotals for England (column 1) have been rounded to nearest 5.</p>a<p>The 95% uncertainty interval corresponds to the lower (2.5th percentile) and upper (97.5th percentile) limits of the uncertainty analysis.</p>b<p>After subtracting DPPs due to hypertension treatment in primary prevention.</p>c<p>After subtracting DPPs due to statin treatment in primary prevention.</p>d<p>See <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001237#pmed-1001237-t002\" target=\"_blank\">Table 2</a> for detailed breakdown by patient group and treatment type.</p><p>Abbreviations: IMD, index of multiple deprivation.</p>", "links"=>[], "tags"=>["deaths", "prevented", "postponed", "changes", "prevalence", "2000", "2007", "england", "stratified", "deprivation"], "article_id"=>294942, "categories"=>["Biotechnology"], "users"=>["Madhavi Bajekal", "Shaun Scholes", "Hande Love", "Nathaniel Hawkins", "Martin O'Flaherty", "Rosalind Raine", "Simon Capewell"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001237.t003", "stats"=>{"downloads"=>7, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_CHD_deaths_prevented_or_postponed_due_to_changes_in_risk_factor_prevalence_between_2000_and_2007_in_England_and_stratified_by_deprivation_quintiles_/294942", "title"=>"CHD deaths prevented or postponed due to changes in risk factor prevalence between 2000 and 2007 in England and stratified by deprivation quintiles.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-12 01:22:22"}

PMC Usage Stats | Further Information

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Relative Metric

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