The association between mortality from ischaemic heart disease and mortality from leading chronic diseases

Aims Coronary risk factors raise the risk of other chronic disorders. We th erefore tested the hypothesis that the geographic distribution of ischaemic heart disease mortality is associated with that of other chronic diseases with which it shares risk factors. Methods and Results For the 50 provinces of Spain, we collected mortality d ata for the period 1980-1995 from the national vital statistics. We calcula ted age-adjusted mortality rates for the leading causes of death in quintil es of provincial distribution of ischaemic heart disease mortality, and cor relation coefficients with respect to provincial ischaemic heart disease mo rtality. As expected, because they share risk factors with ischaemic heart disease, mortality from cerebrovascular disease, malignant tumours, lung ca ncer, respiratory diseases, chronic obstructive pulmonary disease, diseases of the digestive system, cirrhosis of the liver and all causes, increase w ith the rise from lower to higher quintiles of ischaemic heart disease mort ality. Ischaemic heart disease mortality registered correlations over 0.5 ( P<0.001) with mortality from many of the above diseases in the periods 1980 -1984 and 1991-1995. Expectations were similarly borne out for disorders no t sharing risk factors with ischaemic heart disease, in that mortality from prostate and breast cancer, injury and poisoning, traffic accidents and il l-defined causes in most cases did not show a provincial association with i schaemic heart disease mortality. In general, these results were observed f or both sexes and across all age groups. Conclusion Ischaemic heart disease mortality is associated with mortality f rom chronic diseases which share coronary risk factors: across provinces of Spain over the period 1980-1995. This suggests that the geographic variati on in such chronic diseases is due to common factors, potentially susceptib le to similar preventive interventions. (Eur Heart J 2000; 21: 1841-1852, d oi:10.1053/euhj.2000. 2320) (C) 2000 The European Society of Cardiology.