Globally, cardiovascular disease (CVD) is the majority cause of death in those aged 35 to 70 years; however, according to a new study, in high-income countries, cancer mortalities are more common than death from CVD.
The Prospective Urban Rural Epidemiology (PURE) study, results of which were published in The Lancet, involved 162,534 participants aged 35 to 70 years old from 21 countries across five continents, including low-income countries (LICs), middle-income countries (MICs), and high-income countries (HICs).
The HICs included Canada, Saudi Arabia, Sweden, and United Arab Emirates. Middle-income countries were Argentina, Brazil, Chile, China, Columbia, Iran, Malaysia, Palestine, Philippines, Poland, Turkey, and South Africa. Bangladesh, India, Pakistan, Tanzania, and Zimbabwe comprised the LICs.
The researchers discovered that CVD occurred more often in LICs (7.1 cases per 1,000 person-years) and MICs (6.8 cases per 1,000 person-years) than in HICs (4.3 cases per 1,000 person-years). On the other hand, incident cancers, injuries, chronic obstructive pulmonary disease, and pneumonia most commonly occurred in HICs as opposed to LICs. In HICs, deaths from cancer (1.7 deaths per 1,000 person-years) were about 2.5 times more common than those from cardiovascular disease (0.6 deaths per 1,000 person-years). Mortality rates in LICs were almost double those in MICs (13.3 deaths per 1,000 person-years vs 6.9 deaths per 1,000 person-years) and quadruple those in HICs (3.4 deaths per 1,000 person-years). Overall, CVD was the most common cause of deaths among all types of countries, accounting for 40% of deaths. However, CVD only accounts for 23% of deaths in HICs (vs 41% in MICs and 43% in LICs).
One of the study authors, Salim Yusuf, DPhil, Professor at McMaster University in Ontario, Canada, stated, "The fact that cancer deaths are now twice as frequent as CVD deaths in high-income countries indicates a transition in the predominant causes of death in middle age."
"If ways of lowering CVD deaths that have been effective in high-income countries are implemented in middle- and lower-income countries, we could expect large drops in CVD deaths there as well over time. If that happens, we might also expect that cancer will become relatively more common as a cause of death," commented lead author of this study, Gilles Dagenais, MD, Professor in the Department of Cardiology at Universite Laval in Quebec, Canada.
For More Information
Dagenais GR, Leong DP, Rangarajan S, et al (2019). Variations in common diseases, hospital admissions, and deaths in middle-aged adults in 21 countries from five continents (PURE): a prospective cohort study. Lancet. [Epub ahead of print] DOI:10.1016/S0140-6736(19)32007-0
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