IHD is the largest single cause of death in the EU

IHD by itself is the most common single cause of death in the EU, accounting for 741.000 deaths each year. Around one in six men (16%) and over one in seven women (15%) die from the disease, as shown by the figure Death by main cause.

IHD mortality shows a clear East-West gradient

Recently, an analysis was performed on Eurostat mortality data following the recommendations by the EUROCISS project (EUROCISS, 2003). According to these recommendations, data were selected for the age range 35-74, since below 35 events are rare and above 74 the age structure differs a lot between countries. Data were age-standardised according to the European Standard population.

In the age range 35-74, IHD mortality accounts for 15% of deaths, and this percentage increases with age. IHD mortality patterns show a clear-cut East-West gradient, with the highest rates being reported from the Baltic countries and from Eastern Europe. When observed per country, the rates vary between 42.7 deaths per 100,000 population in France to 327 per 100,000 in Latvia. This 8-fold difference applies both to men and women (men: 72 deaths per 100,000 in France and 555 per 100,000 in Latvia; in women these numbers are 16 and 167, respectively).

Mortality decreases in all regions, but more slowly in the East

Over the past ten years, the data for the 35-74 age range show a decreasing IHD mortality in each of the six regions (see Trends in IHD mortality for men in six European regions and Trends in IHD mortality for women in six European regions). The decrease is strongest, in relative terms, in Central Eastern Europe (Czech and Slovak Republics, Poland), followed by the North (Scandinavian countries, Ireland and the United Kindom) and Central Europe (Belgium, The Netherland, Luxembourg, Germany, Austria and Slovenia).

The actual percentage decreases are, for men and women, respectively: Central Eastern Europe: 45%, 51%; Northern Europe: 38%, 41%; Central Europe: 37%, 40%; Southern Europe: 34%, 41%; Baltic states: 27%, 36%; Balkan Eastern: 27%, 23%. In all regions except Balkan Eastern, not only the rates themselves, but also the percentage decrease seems to be more favourable for women than for men. For more details, see Trends in IHD mortality for men in six European regions and Trends in IHD mortality for women in six European regions.

In the time range covered by the MONICA project (mid-1980s to mid-1990s), around two-thirds of the decline in IHD mortality was due to a decline in IHD incidence rates; the remaining one-third of the decline was due to improvements in survival because of better treatments (Tunstall-Pedoe et al., 1999; Kuulasmaa et al., 2000; Tunstall-Pedoe et al., 2000).

In addition to the EUROCISS compilation, trend data on IHD mortality by country (standardised death rates) are also available from the WHO mortality database: see Mortality (SDR) from IHD in men, all ages, Mortality (SDR) from IHD in men, ages 25-64, Mortality (SDR) from IHD in women, all ages and Mortality (SDR) from IHD in women, ages 25-64. When compared to the figures shown for the six European regions for 1994-2003, these trends show the same steady decrease also from 1980. The numbers are not directly comparable because of different age windows being used.