Abstract

Background Trends in cardiovascular risk factors among UK adults present a complex picture. Ominous increases in obesity and diabetes among young adults raise concerns about subsequent coronary heart disease mortality rates in this group. The objective of our study was to examine recent trends in age-specific mortality rates from coronary heart disease, particularly those among younger adults.

Methods and Results We used mortality data from 1984-2004 to calculate age-specific mortality rates for British adults aged 35+ years and joinpoint regression to assess changes in trends. Overall, the age-adjusted mortality rate decreased by -54.7% in men and by -48.3% in women. However, among men aged 35-44 years, coronary heart disease mortality rates in 2002 increased for the first time in over two decades. Furthermore, the recent declines in CHD mortality rates appear to be slowing in both men and women aged 45-54. Among older adults however, mortality rates continued to decrease steadily throughout the period.

Conclusions The flattening mortality rates for coronary heart disease among younger adults may represent a sentinel event. Deteriorations in medical management of coronary heart disease appear implausible. Thus, unfavorable trends in risk factors for coronary heart disease, specifically obesity and diabetes, provide the most likely explanation for the observed trends.