Stephen Sidney1, Michael E Sorel2, Charles P Quesenberry2, Marc G Jaffe3, Matthew D Solomon4, Mai N Nguyen-Huynh5, Alan S Go6, Jamal S Rana7. 1. Division of Research, Kaiser Permanente Northern California, Oakland. Electronic address: steve.sidney@kp.org. 2. Division of Research, Kaiser Permanente Northern California, Oakland. 3. Department of Endocrinology, Kaiser Permanente Northern California, South San Francisco. 4. Division of Research, Kaiser Permanente Northern California, Oakland; Department of Cardiology, Kaiser Permanente Northern California, Oakland. 5. Department of Neurology, Kaiser Permanente Northern California, Walnut Creek. 6. Division of Research, Kaiser Permanente Northern California, Oakland; Departments of Epidemiology, Biostatistics, and Medicine, University of California, San Francisco; Department of Health Research and Policy, Stanford University School of Medicine, Stanford, Calif. 7. Division of Research, Kaiser Permanente Northern California, Oakland; Department of Cardiology, Kaiser Permanente Northern California, Oakland; Department of Medicine, University of California, San Francisco, San Francisco.
Abstract
OBJECTIVES: Heart disease and stroke remain among the leading causes of death nationally. We examined whether differences in recent trends in heart disease, stroke, and total mortality exist in the United States and Kaiser Permanente Northern California (KPNC), a large integrated healthcare delivery system. METHODS: The main outcome measures were comparisons of US and KPNC total, age-specific, and sex-specific changes from 2000 to 2015 in mortality rates from heart disease, coronary heart disease, stroke, and all causes. The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research data system was used to determine US mortality rates. Mortality rates for KPNC were determined from health system, Social Security vital status, and state death certificate databases. RESULTS: Declines in age-adjusted mortality rates were noted in KPNC and the United States for heart disease (36.3% in KPNC vs 34.6% in the United States), coronary heart disease (51.0% vs 47.9%), stroke (45.5% vs 38.2%), and all-cause mortality (16.8% vs 15.6%). However, steeper declines were noted in KPNC than the United States among those aged 45 to 65 years for heart disease (48.3% KPNC vs 23.6% United States), coronary heart disease (55.6% vs 35.9%), stroke (55.8% vs 26.0%), and all-cause mortality (31.5% vs 9.1%). Sex-specific changes were generally similar. CONCLUSIONS: Despite significant declines in heart disease and stroke mortality, there remains an improvement gap nationally among those aged less than 65 years when compared with a large integrated healthcare delivery system. Interventions to improve cardiovascular mortality in the vulnerable middle-aged population may play a key role in closing this gap.
OBJECTIVES:Heart disease and stroke remain among the leading causes of death nationally. We examined whether differences in recent trends in heart disease, stroke, and total mortality exist in the United States and Kaiser Permanente Northern California (KPNC), a large integrated healthcare delivery system. METHODS: The main outcome measures were comparisons of US and KPNC total, age-specific, and sex-specific changes from 2000 to 2015 in mortality rates from heart disease, coronary heart disease, stroke, and all causes. The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research data system was used to determine US mortality rates. Mortality rates for KPNC were determined from health system, Social Security vital status, and state death certificate databases. RESULTS: Declines in age-adjusted mortality rates were noted in KPNC and the United States for heart disease (36.3% in KPNC vs 34.6% in the United States), coronary heart disease (51.0% vs 47.9%), stroke (45.5% vs 38.2%), and all-cause mortality (16.8% vs 15.6%). However, steeper declines were noted in KPNC than the United States among those aged 45 to 65 years for heart disease (48.3% KPNC vs 23.6% United States), coronary heart disease (55.6% vs 35.9%), stroke (55.8% vs 26.0%), and all-cause mortality (31.5% vs 9.1%). Sex-specific changes were generally similar. CONCLUSIONS: Despite significant declines in heart disease and stroke mortality, there remains an improvement gap nationally among those aged less than 65 years when compared with a large integrated healthcare delivery system. Interventions to improve cardiovascular mortality in the vulnerable middle-aged population may play a key role in closing this gap.
Authors: Benjamin A Steinberg; Deepak L Bhatt; Shamir Mehta; Philip A Poole-Wilson; Philip O'Hagan; Gilles Montalescot; Christie M Ballantyne; Christopher P Cannon Journal: Am Heart J Date: 2008-07-11 Impact factor: 4.749
Authors: Robert W Yeh; Stephen Sidney; Malini Chandra; Michael Sorel; Joseph V Selby; Alan S Go Journal: N Engl J Med Date: 2010-06-10 Impact factor: 91.245
Authors: Stephen S Lim; Theo Vos; Abraham D Flaxman; Goodarz Danaei; Kenji Shibuya; Heather Adair-Rohani; Markus Amann; H Ross Anderson; Kathryn G Andrews; Martin Aryee; Charles Atkinson; Loraine J Bacchus; Adil N Bahalim; Kalpana Balakrishnan; John Balmes; Suzanne Barker-Collo; Amanda Baxter; Michelle L Bell; Jed D Blore; Fiona Blyth; Carissa Bonner; Guilherme Borges; Rupert Bourne; Michel Boussinesq; Michael Brauer; Peter Brooks; Nigel G Bruce; Bert Brunekreef; Claire Bryan-Hancock; Chiara Bucello; Rachelle Buchbinder; Fiona Bull; Richard T Burnett; Tim E Byers; Bianca Calabria; Jonathan Carapetis; Emily Carnahan; Zoe Chafe; Fiona Charlson; Honglei Chen; Jian Shen Chen; Andrew Tai-Ann Cheng; Jennifer Christine Child; Aaron Cohen; K Ellicott Colson; Benjamin C Cowie; Sarah Darby; Susan Darling; Adrian Davis; Louisa Degenhardt; Frank Dentener; Don C Des Jarlais; Karen Devries; Mukesh Dherani; Eric L Ding; E Ray Dorsey; Tim Driscoll; Karen Edmond; Suad Eltahir Ali; Rebecca E Engell; Patricia J Erwin; Saman Fahimi; Gail Falder; Farshad Farzadfar; Alize Ferrari; Mariel M Finucane; Seth Flaxman; Francis Gerry R Fowkes; Greg Freedman; Michael K Freeman; Emmanuela Gakidou; Santu Ghosh; Edward Giovannucci; Gerhard Gmel; Kathryn Graham; Rebecca Grainger; Bridget Grant; David Gunnell; Hialy R Gutierrez; Wayne Hall; Hans W Hoek; Anthony Hogan; H Dean Hosgood; Damian Hoy; Howard Hu; Bryan J Hubbell; Sally J Hutchings; Sydney E Ibeanusi; Gemma L Jacklyn; Rashmi Jasrasaria; Jost B Jonas; Haidong Kan; John A Kanis; Nicholas Kassebaum; Norito Kawakami; Young-Ho Khang; Shahab Khatibzadeh; Jon-Paul Khoo; Cindy Kok; Francine Laden; Ratilal Lalloo; Qing Lan; Tim Lathlean; Janet L Leasher; James Leigh; Yang Li; John Kent Lin; Steven E Lipshultz; Stephanie London; Rafael Lozano; Yuan Lu; Joelle Mak; Reza Malekzadeh; Leslie Mallinger; Wagner Marcenes; Lyn March; Robin Marks; Randall Martin; Paul McGale; John McGrath; Sumi Mehta; George A Mensah; Tony R Merriman; Renata Micha; Catherine Michaud; Vinod Mishra; Khayriyyah Mohd Hanafiah; Ali A Mokdad; Lidia Morawska; Dariush Mozaffarian; Tasha Murphy; Mohsen Naghavi; Bruce Neal; Paul K Nelson; Joan Miquel Nolla; Rosana Norman; Casey Olives; Saad B Omer; Jessica Orchard; Richard Osborne; Bart Ostro; Andrew Page; Kiran D Pandey; Charles D H Parry; Erin Passmore; Jayadeep Patra; Neil Pearce; Pamela M Pelizzari; Max Petzold; Michael R Phillips; Dan Pope; C Arden Pope; John Powles; Mayuree Rao; Homie Razavi; Eva A Rehfuess; Jürgen T Rehm; Beate Ritz; Frederick P Rivara; Thomas Roberts; Carolyn Robinson; Jose A Rodriguez-Portales; Isabelle Romieu; Robin Room; Lisa C Rosenfeld; Ananya Roy; Lesley Rushton; Joshua A Salomon; Uchechukwu Sampson; Lidia Sanchez-Riera; Ella Sanman; Amir Sapkota; Soraya Seedat; Peilin Shi; Kevin Shield; Rupak Shivakoti; Gitanjali M Singh; David A Sleet; Emma Smith; Kirk R Smith; Nicolas J C Stapelberg; Kyle Steenland; Heidi Stöckl; Lars Jacob Stovner; Kurt Straif; Lahn Straney; George D Thurston; Jimmy H Tran; Rita Van Dingenen; Aaron van Donkelaar; J Lennert Veerman; Lakshmi Vijayakumar; Robert Weintraub; Myrna M Weissman; Richard A White; Harvey Whiteford; Steven T Wiersma; James D Wilkinson; Hywel C Williams; Warwick Williams; Nicholas Wilson; Anthony D Woolf; Paul Yip; Jan M Zielinski; Alan D Lopez; Christopher J L Murray; Majid Ezzati; Mohammad A AlMazroa; Ziad A Memish Journal: Lancet Date: 2012-12-15 Impact factor: 79.321
Authors: Quanhe Yang; Xin Tong; Linda Schieb; Adam Vaughan; Cathleen Gillespie; Jennifer L Wiltz; Sallyann Coleman King; Erika Odom; Robert Merritt; Yuling Hong; Mary G George Journal: MMWR Morb Mortal Wkly Rep Date: 2017-09-08 Impact factor: 17.586
Authors: Saif Ahmad; Shah Alam Khan; Adam Kindelin; Tasha Mohseni; Kanchan Bhatia; Md Nasrul Hoda; Andrew F Ducruet Journal: Neuromolecular Med Date: 2019-09-12 Impact factor: 3.843
Authors: Marilyn L Kwan; Richard K Cheng; Carlos Iribarren; Romain Neugebauer; Jamal S Rana; Mai Nguyen-Huynh; Zaixing Shi; Cecile A Laurent; Valerie S Lee; Janise M Roh; Hanjie Shen; Eileen Rillamas-Sun; Margarita Santiago-Torres; Dawn L Hershman; Lawrence H Kushi; Heather Greenlee Journal: J Clin Oncol Date: 2022-01-13 Impact factor: 50.717
Authors: Matthew D Solomon; Thomas K Leong; Eleanor Levin; Jamal S Rana; Marc G Jaffe; Stephen Sidney; Sue Hee Sung; Catherine Lee; Anthony DeMaria; Alan S Go Journal: J Am Heart Assoc Date: 2020-03-05 Impact factor: 5.501
Authors: J Frank Wharam; Jamie Wallace; Fang Zhang; Xin Xu; Christine Y Lu; Adrian Hernandez; Dennis Ross-Degnan; Joseph P Newhouse Journal: JAMA Netw Open Date: 2020-07-01
Authors: Eric Jorgenson; Navneet Matharu; Melody R Palmer; Jie Yin; Jun Shan; Thomas J Hoffmann; Khanh K Thai; Xujia Zhou; James M Hotaling; Gail P Jarvik; Nadav Ahituv; Hunter Wessells; Stephen K Van Den Eeden Journal: Proc Natl Acad Sci U S A Date: 2018-10-08 Impact factor: 11.205