Coronary Disease Mortality Variations in England Analyzed

Most variation attributed to population traits; better hypertension detection may lower mortality

TUESDAY, Nov. 9 (HealthDay News) -- Differences in population characteristics explain most of the variation in coronary heart disease (CHD) mortality among the English, but better detection of hypertension is related to reductions in CHD mortality, according to a study in the Nov. 10 issue of the Journal of the American Medical Association.

Louis S. Levene, of the University of Leicester in the United Kingdom, and colleagues analyzed data on population characteristics and health care variables for the 152 primary care trusts in England, covering 54.3 million people. The researchers conducted logistic regression to associate age-standardized CHD mortality rates in 2006, 2007, and 2008 with population characteristics (such as smoking, ethnicity, and diabetes) as well as health care delivery factors (such as primary care service delivery and detection rates for hypertension).

The researchers found that the mean age-standardized CHD mortality rates per 100,000 European Standard Population were 97.9, 93.5, and 88.4 for 2006, 2007, and 2008, respectively. The population characteristics positively associated with CHD mortality included index of multiple deprivation (an index combining income, employment, health, education, barriers to housing and services, living environment, and crime), smoking, white ethnicity, and diabetes prevalence, while the primary health care delivery factor identified was level of detected hypertension, which was negatively associated with CHD mortality.

"In England, variations in CHD mortality are predominantly explained by population characteristics; however, greater detection of hypertension is associated with lower CHD mortality," the authors write.

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