Spatiotemporal Variations in Ischemic Heart Disease Mortality and Related Risk Factors in China Between 2010 and 2015: A Multilevel Analysis
Objectives: To explore the relationship between geographical differences of mortality and related risk factors in ischemic heart disease(IHD) in China.Methods: Data were collected from the national death cause surveillance system of the Chinese Center for Disease Control and Prevention, surveillance of chronic diseases and risk factors in China in 2013, as well as the 2010 national census. Descriptive analysis was used to analyze the mortality of IHD in Chinese population from 2010 to 2015.
... m 2010 to 2015. Multilevel negative binomial regression model was established. MLwiN2.30 software was used for multilevel analysis.Results: The crude mortality rate of IHD was 108.74/100,000 in 2015. The standardized mortality rate for IHD increased by 5.51% from 2010 to 2015. Multilevel analysis indicated significant differences in gender, urban/rural and different regions for IHD mortality for people aged over 40 years. The high urbanization rate was negatively associated with IHD mortality (risk ratio[RR]=0.728, 95% ; confidence interval[CI]=( 0.631, 0.840)). Mortality of IHD was significantly higher in population without medical insurance (RR= 1.218, 95%CI: 1.007, 1.473). The average levels of body mass index(BMI) and systolic blood pressure (SBP) were positively correlated with IHD mortality, while the average level of high density lipoprotein (HDL) was negatively correlated.The relationship between the current smoking rate, excessive intake of red meat and vegetables and fruits intake rate and IHD mortality did not reach statistical significance. The negative correlation between the average sedentary time and the mortality of IHD is not conclusive due to the possible deviation of the data. Conclusions: The mortality of IHD showed an upward trend for people aged over 40 years in China during 2010-2015. SBP and overweight / obesity are risk factors of IHD. HDL is a protective factor. Higher urbanization rate and medical insurance ratio are beneficial to reduce the mortality of IHD.