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Mortality from ischemic heart disease falls in the UK, more lives are lost to Alzheimer’s disease

Today, fewer people are dying from and stroke in the United Kingdom, according to a new, comprehensive analysis of trend data from 188 countries.

Professor Terry Brugha, Professor of Psychiatry in the University’s Department of Health Sciences, was one of the scientists involved in the new study. It found mortality from ischemic heart disease dropped 45% between 1990 and 2013. At the same time, a number of diseases, including Alzheimer’s disease and esophageal cancer, claimed more lives in the United Kingdom in 2013 than in 1990. Life expectancy improved for both men and women in the United Kingdom, at an average of 5.3 years gained since 1990.

Published in The Lancet on Thursday 18 December, “Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013″ was conducted by an international consortium of researchers coordinated by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

Dr Brugha said: “Rapid falls in death rates for cardiovascular and circulatory diseases have occurred in the UK and notably in four other high income countries, Israel, Denmark, Norway, South Korea.

“It is more difficult to say whether this is due to wider use of effective treatment or to lifestyle improvements (for example diet, smoking) or a combination of both. Whilst it is encouraging that death due to ischemic heart disease has declined in the UK it has become the leading cause of mortality throughout the world.

“We should be cautious in interpreting the increase in the number of deaths attributed to Alzheimer’s disease as there has been a growing awareness and recognition of this condition that is not reflected in true rates in the population which do not seem to be increasing in England, according to a report in the Lancet late last year (2013). This new study also does not reflect the considerable influence of severe mental illnesses such as schizophrenia on early mortality presumably because mental illness as a cause is rarely entered on death certificates. It is hoped that future research will address such gaps in information.”

The leading killers in the United Kingdom were ischemic heart disease, stroke, and Alzheimer’s disease, accounting for 35% of all deaths in 2013. Suicide and ischemic heart disease were the top two causes of death for people between the ages of 15 and 49, resulting in 4,850 lives lost in 2013. Among individuals 70 and older, ischemic heart disease claimed the most lives that year. The top cause of child mortality was preterm birth complications in 2013, killing 1,164 children under the age of 5.

In the United Kingdom, Alzheimer’s disease and esophageal cancer took more lives in 2013 than in 1990, with deaths increasing 52% and 34%, respectively. Mortality from prostate cancer also increased 31% between 1990 and 2013.

Since 1990, the United Kingdom saw marked declines in mortality from a number of diseases that used to take a large toll on the country. For instance, by 2013, mortality from ischemic heart disease decreased 45%, and stroke caused 25% fewer deaths. In 1990, these diseases killed 256,332 people. Twenty-three years later, they claimed 100,440 fewer lives.

The study also revealed how some diseases and injuries cause different mortality patterns for males and females. For example, in the United Kingdom, lung cancer took a greater toll on men, killing 21,651 males and 16,179 females in 2013. By contrast, stroke claimed 34,944 women’s lives and 22,202 men’s lives.

Globally, people live an average of 6.2 years longer than they did in 1990, with life expectancy rising to just under 72 years in 2013. Women showed a slightly larger average gain (an increase of 6.6 years) than men (a rise of 5.8 years). Improvements in health, reduced fertility, and shifts in the world’s age patterns have driven these global gains in life expectancy.

In the United Kingdom, the average life expectancy for women was 82.8 years in 2013, with men living an average of 79.1 years. By contrast, women lived an average of 78.4 years and men had a life expectancy of 72.9 years in 1990. Out of the 188 countries included in the study the United Kingdom ranked 24th for women and 17th for men for longest life expectancies. In 2013, Andorra had the longest life expectancy for women (86.7 years) and Qatar had the longest for men (81.2 years). Lesotho had the shortest life expectancy for both women (51.2 years) and men (45.6 years).

“The fact that people are living longer in most parts of the world is good news but we must do more to address health disparities,” said IHME Director Dr. Christopher Murray. “Only with the best available evidence can we develop policies to improve health and save lives.”

Worldwide, ischemic heart disease, stroke, and chronic obstructive pulmonary disease (COPD) claimed the most lives, accounting for nearly 32% of all deaths. Much global progress has been made in reducing mortality from diseases such as measles and diarrhea, with 83% and 51% declines, respectively, from 1990 to 2013.

The Global Burden of Disease (GBD) Study 2013 is part of an ongoing effort to produce the most timely and up-to-date understanding of what kills and ails people worldwide. Thousands of collaborators worldwide work together to generate annual estimates of deaths by cause, years of life lost to disability, and rates of premature mortality and illness. To make these data as useful and relevant to policymakers and country leaders as possible, findings from the GBD study can be used at the global, regional, national, and even subnational levels to track trends in health over time.

Researchers found a widening gap between countries with the lowest and highest death rates from a given disease – a potential sign of increasing inequalities in health. They also emphasise the importance of measuring local disease burdens, as the health challenges found in one corner of a country can widely vary from those experienced a few hours away.

Globally, a number of diseases that have received less attention relative to others are some of the biggest causes of premature death, particularly drug use disorders, diabetes, chronic kidney disease, and cirrhosis. The gender gap in death rates for adults between the ages of 20 to 44 is widening, and HIV/AIDS, interpersonal violence, road injuries, and maternal mortality are some of the key conditions responsible. For children under five, diarrheal diseases, pneumonia, neonatal disorders, and malaria are still among the leading causes of death.