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The Burden of Cardiovascular Diseases Among Us States, 1990-2016 Publisher Pubmed



Roth GA1, 2 ; Johnson CO1 ; Abate KH3 ; Abdallah F4 ; Ahmed M3 ; Alam K5 ; Alam T1 ; Alvisguzman N6 ; Ansari H7 ; Arnlov J8 ; Atey TM9 ; Awasthi A10 ; Awoke T11 ; Barac A12 Show All Authors
Authors
  1. Roth GA1, 2
  2. Johnson CO1
  3. Abate KH3
  4. Abdallah F4
  5. Ahmed M3
  6. Alam K5
  7. Alam T1
  8. Alvisguzman N6
  9. Ansari H7
  10. Arnlov J8
  11. Atey TM9
  12. Awasthi A10
  13. Awoke T11
  14. Barac A12
  15. Barnighausen T13
  16. Bedi N14
  17. Bennett D15
  18. Bensenor I16
  19. Biadgilign S17
  20. Castanedaorjuela C18
  21. Catalalopez F19
  22. Davletov K20
  23. Dharmaratne S21
  24. Ding EL22
  25. Dubey M23
  26. Faraon EJA24
  27. Farid T25
  28. Farvid MS22
  29. Feigin V26
  30. Fernandes J27
  31. Frostad J1
  32. Gebru A9
  33. Geleijnse JM28
  34. Gona PN29
  35. Griswold M1
  36. Hailu GB9
  37. Hankey GJ30
  38. Hassen HY31
  39. Havmoeller R8
  40. Hay S1
  41. Heckbert SR1
  42. Irvine CMS1
  43. James SL1
  44. Jara D32
  45. Kasaeian A33
  46. Khan AR25
  47. Khera S34
  48. Khoja AT35
  49. Khubchandani J36
  50. Kim D37
  51. Kolte D38
  52. Lal D39
  53. Larsson A40
  54. Linn S41
  55. Lotufo PA42
  56. El Razek HMA43
  57. Mazidi M44
  58. Meier T45
  59. Mendoza W46
  60. Mensah GA47
  61. Meretoja A48
  62. Mezgebe HB9
  63. Mirrakhimov E49
  64. Mohammed S50
  65. Moran AE51
  66. Nguyen G1
  67. Nguyen M1
  68. Ong KL1
  69. Owolabi M52
  70. Pletcher M1
  71. Pourmalek F53
  72. Purcell CA1
  73. Qorbani M54
  74. Rahman M55
  75. Rai RK56
  76. Ram U23
  77. Reitsma MB1
  78. Renzaho AMN57
  79. Riosblancas MJ58
  80. Safiri S59
  81. Salomon JA13
  82. Sartorius B60
  83. Sepanlou SG61
  84. Shaikh MA62
  85. Silva D63
  86. Stranges S64
  87. Tabaresseisdedos R19
  88. Atnafu NT65
  89. Thakur JS66
  90. Topormadry R67
  91. Truelsen T68
  92. Tuzcu EM69
  93. Tyrovolas S70
  94. Ukwaja KN71
  95. Vasankari T72
  96. Vlassov V73
  97. Vollset SE74
  98. Wakayo T3
  99. Weintraub R75
  100. Wolfe C76
  101. Workicho A3
  102. Xu G77
  103. Yadgir S1
  104. Yano Y78
  105. Yip P79
  106. Yonemoto N80
  107. Younis M81
  108. Yu C82
  109. Zaidi Z83
  110. El Sayed Zaki M43
  111. Zipkin B1
  112. Afshin A1
  113. Gakidou E1
  114. Lim SS1
  115. Mokdad AH1
  116. Naghavi M1
  117. Vos T1
  118. Murray CJL1

Source: JAMA Cardiology Published:2018


Abstract

IMPORTANCE Cardiovascular disease (CVD) is the leading cause of death in the United States, but regional variation within the United States is large. Comparable and consistent state-level measures of total CVD burden and risk factors have not been produced previously. OBJECTIVE To quantify and describe levels and trends of lost health due to CVD within the United States from 1990 to 2016 as well as risk factors driving these changes. DESIGN, SETTING, AND PARTICIPANTS Using the Global Burden of Disease methodology, cardiovascular disease mortality, nonfatal health outcomes, and associated risk factors were analyzed by age group, sex, and year from 1990 to 2016 for all residents in the United States using standardized approaches for data processing and statistical modeling. Burden of disease was estimated for 10 groupings of CVD, and comparative risk analysis was performed. Data were analyzed from August 2016 to July 2017. EXPOSURES Residing in the United States. MAIN OUTCOMES AND MEASURES Cardiovascular disease disability-Adjusted life-years (DALYs). RESULTS Between 1990 and 2016, age-standardized CVD DALYs for all states decreased. Several states had large rises in their relative rank ordering for total CVD DALYs among states, including Arkansas, Oklahoma, Alabama, Kentucky, Missouri, Indiana, Kansas, Alaska, and Iowa. The rate of decline varied widely across states, and CVD burden increased for a small number of states in the most recent years. Cardiovascular disease DALYs remained twice as large among men compared with women. Ischemic heart disease was the leading cause of CVD DALYs in all states, but the second most common varied by state. Trends were driven by 12 groups of risk factors, with the largest attributable CVD burden due to dietary risk exposures followed by high systolic blood pressure, high body mass index, high total cholesterol level, high fasting plasma glucose level, tobacco smoking, and low levels of physical activity. Increases in risk-deleted CVD DALY rates between 2006 and 2016 in 16 states suggest additional unmeasured risks beyond these traditional factors. CONCLUSIONS AND RELEVANCE Large disparities in total burden of CVD persist between US states despite marked improvements in CVD burden. Differences in CVD burden are largely attributable to modifiable risk exposures. © 2018 American Medical Association. All rights reserved.
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