CHD-related/specific mortality of 3.17 million people in a transitioning region: trends, risk factors, and prevention

Background Demographic shifts cause uncertain changes in the burden of coronary heart disease (CHD) in transitioning regions. We aimed to analyze the trends of CHD burden and its risk factors in Pudong, Shanghai, and explore prevention strategies for transitioning regions.Methods We analyzed CHD-related and CHD-specific deaths in Pudong from 2005 to 2020, including the crude mortality rate (CMR), age-standardized mortality rate worldwide (ASMRW), years of life lost (YLL), and age-specific proportions. We also examined the impact of population aging on the burden of CHD. The Joinpoint Regression Program was used to analyze trends, and the decomposition method was used to evaluate the impact of demographics on the mortality rate.Results Of the 86,171 CHD-related deaths, 52,152 (60.52%) were CHD-specific deaths. For both CHD-related and CHD-specific deaths, there was a significant increase in the CMR, ASMRW, and YLL rate, except in the 70-79-year age group, which exhibited a distinctive and statistically significant decline in these rates (all P < 0.05). There were steadily increasing trends in the rates caused by aging from 2005 to 2020, with average annual percent changes (AAPCs) of 42.59% and 41.43%, respectively (all P < 0.05).Conclusions Our results indicate that the CHD burden in Pudong has been persistently increasing, but in the age group of 70-79 years, substantial declines were observed. The quality of primary healthcare services may be a critical point in addressing the overwhelming CHD burden.