Stall in Heart Disease Death Rates, Evidence From Maine, 1999–2017

Jennifer A. Sinatra

doi:10.5888/pcd17.190405

Stall in Heart Disease Death Rates, Evidence From Maine, 1999–2017

ORIGINAL RESEARCH — Volume 17 — August 20, 2020

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Figure 1.
Comparison of observed and joinpoint-modeled age-adjusted heart disease death rates, Maine, 1999–2017. Death rates are age-adjusted to the 2000 US standard population. International Classification of Diseases, 10th Revision (ICD-10) codes used: I00-I02, I05–I09, I11, I13, I20–I25, I26–I28, I30–I51. ^aAnnual percentage change from 1999–2010 is significantly different from 0 at an alpha level of .05. Data source: CDC WONDER.

Year	Observed Age-Adjusted Death Rate Per 100,000 Population	Joinpoint Modeled Death Rate Per 100,000 Population
1999	238.72	239.95
2000	233.86	229.95
2001	220.65	220.36
2002	210.61	211.18
2003	203.03	202.38
2004	189.89	193.94
2005	186.53	185.86
2006	174.31	178.12
2007	172.97	170.69
2008	164.63	163.58
2009	156.37	156.76
2010	151.1	150.23
2011	149.46	150.03
2012	145.9	149.83
2013	152.27	149.63
2014	147.89	149.43
2015	157.31	149.24
2016	149.51	149.04
2017	143.48	148.84

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Figure 2.
Heart disease mortality trends in Maine, by sex, age group, and type of heart disease, 1999–2017. All trends except age group determined using age-adjusted death rates. Data in bars are APC (95% CI). 95% CIs are provided to give the reader an indication of statistical stability and should not be used to determine whether changes in trend occurred. Significant changes in trend (increasing or decreasing) were determined by using joinpoint modeling to identify where APCs were significantly different from zero at the alpha = 0.05 level. There were fewer than 20 cases of cardiac arrest in 2017, so the death rate for that year was unreliable. Abbreviations: AMI, acute myocardial infarction; APC, annual percentage change; CI, confidence interval; COD, cause of death; HHD, hypertensive heart disease; ICD-10, International Classification of Diseases, 10th revision; IHD, ischemic heart disease; NA, not available.

Category	Period 1 Dates	Period 1 APC (95% CI)	Period 2 Dates	Period 2 APC (95% CI)
Heart Disease	1999–2010	–4.2 (–4.6 to –3.8)^a	2010–2017	–0.1 (–1.0 to 0.8)
Sex
Male	1999–2010	–3.9 (–4.5 to –3.3)^a	2010–2017	–0.2 (–1.5 to 1.1)
Female	1999–2009	–4.8 (–5.3 to –4.2)^a	2009–2017	–0.7 (–1.6 to 0.2)
Age, y
25–44	1999–2017	–0.9 (–2.4 to 0.6)	NA	NA
45–64	1999–2010	–3.1 (–4.1 to –2.0)^a	2010–2017	1.7 (–0.5 to 4.0)
65–84	1999–2011	–5.2 (–5.6 to –4.9)^a	2011–2017	–1.1 (–2.3 to 0.1)
≥85	1999–2010	–3.4 (–4.1 to –2.7)^a	2010–2017	0.0 (–1.4 to 1.4)
Underlying cause of death
Cardiac arrest	1999–2011	–5.2 (–7.0 to –3.3)^a	2011–2016	–16.2 (–25.2 to –6.2)^a
AMI	1999–2007	–6.7 (–8.0 to –5.4)^a	2007–2017	–4.1 (–5.2 to –2.9)^a
HHD	1999–2010	–5.7 (–8.6 to –2.7)^a	2010–2017	14.6 (8.4 to 21.1)^a
Heart failure	1999–2010	–1.4 (–2.5 to –0.2)^a	2010–2017	2.9 (0.7 to 5.1)^a
IHD without AMI	1999–2011	–5.3 (–5.7 to –4.8)^a	2011–2017	–1.0 (–2.6 to 0.6)
Pulmonary heart disease	1999–2017	–0.9 (–2.1 to 0.4)	NA	NA
Ill-defined heart disease	1999–2017	5.3 (3.3 to 7.3)^a	NA	NA
Multiple cause of death
Heart failure–related	1999–2009	–4.0 (–4.7 to –3.3)^a	2009–2017	3.0 (2.1 to 4.0)^a
Diabetes-related	1999–2011	–5.3 (–6.5 to –4.2)^a	2011–2017	–0.1 (–3.9 to 3.7)
Health district
Aroostook	1999–2017	–3.3 (–4.1 to –2.5)^a	NA	NA
Central	1999–2017	–2.0 (–2.7 to –1.2)^a	NA	NA
Cumberland	1999–2010	–4.8 (–5.5 to –4.0)^a	2010–2017	0.5 (–1.1 to 2.1)
Downeast	1999–2010	–4.7 (–5.6 to –3.9)^a	2010–2017	–0.3 (–2.2 to 1.6)
Midcoast	1999–2012	–4.3 (–4.8 to –3.8)^a	2012–2017	4.6 (2.3 to 6.9)^a
Penquis	1999–2017	–2.9 (–3.5 to –2.3)^a	NA	NA
Western	1999–2017	–2.3 (–2.9 to –1.7)^a	NA	NA
York	1999–2017	–3.6 (–4.3 to –2.9)^a	NA	NA
Rural/urban status
Metropolitan	1999–2010	–4.3 (–4.8 to –3.8)^a	2010–2017	–0.4 (–1.4 to 0.6)
Nonmetropolitan	1999–2009	–4.2 (–5.0 to –3.4)^a	2009–2017	–0.2 (–1.5 to 1.1)

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