OBJECTIVE
To analyze the trends of mortality rate due to heart diseases in the regions of the Russian Federation in 2019-2021.
MATERIAL AND METHODS
For the analysis, we used the Federal State Statistics Service data on the number of deaths according to the Short Nomenclature of Causes of Death (SNCD), based on the International Statistical Classification of Diseases and Related Health Problems, and the average annual population in one-year age groups for 2019-2021. Standardized mortality rates (SMR) due to 23 cardiovascular causes listed as a separate line in the SNCD, the regional mean SMR, and the standard deviation were calculated.
RESULTS
Compared with 2019, mean regional SMR due to cardiovascular causes increased from 301.02±77.67 to 336.15±84.5 in 2020 (p=0.025) and 338.73±91.4 in 2021 (p=0.9 for 2021 vs. 2020, but p=0.015 for 2021 vs. 2019). However, a year-to-year increase in SMR (2020 vs. 2019 and 2021 vs. 2020) was recorded in 38 regions, while 4 regions reported a year-to-year decrease in SMR due to cardiovascular causes. In the remaining 40 regions, the trends are inconsistent. The proportion of cardiovascular causes from all causes was 30.5±5.8% in 2019, 29.1±5.7% in 2020, and 25.95±5.56% in 2021 (p<0.0001 for 2019 vs. 2021 and p=0.001 for 2020 vs. 2021). The largest proportion of deaths in the structure of cardiovascular causes (mean value for 3 years 62.1±13%) falls in group 1 (predominantly chronic forms of coronary heart disease — CHD) with a statistically significant increase in mean regional SMR. An annual increase in SMR was reported in 41 regions, a decrease in 3 regions, and inconsistent trends in other regions. The proportion of group 2 causes (causes probably related to acute CHD) averaged 16.58±9.56% over 3 years (differences in SMR and the proportion of SMR were statistically insignificant). A year-to-year increase in SMR was reported in 23 regions, while 18 reported a decrease in SMR. The proportion of group 3 causes (cardiac malformations, cardiopathies, endocarditis, and myocarditis) was 17.3±7.6% on average over 3 years with no significant changes. A year-to-year increase in SMR was reported in 35 regions, while 10 reported a year-to-year decrease in SMR, and the other 37 regions showed inconsistent trends. The proportion of group 4 causes (arterial hypertension) in the structure of cardiovascular causes averaged 4.2±5.1% over 3 years. Year-to-year SMR increase was reported in 18 regions. Fifteen regions reported an annual decline in SMR, while the other 49 regions showed inconsistent trends. Statistically significant differences between annual mean regional changes in SMR were found for two causes out of 23 by the SNCD: other forms of chronic coronary heart disease (increase) and recurrent myocardial infarction (decrease).
CONCLUSIONS
In 2020, there was a significant increase in mortality from cardiovascular causes, with a less increase in 2021. However, significant regional differences in the magnitude and trends of standardized mortality rates from individual cardiovascular causes indicate the defects in statistical accounting of the causes of death.
