Inequalities in premature mortality due to cerebrovascular disease in Europe between 1990 and 2014

Osszefoglalo. Bevezetes: A cerebrovascularis betegsegek nepegeszsegugyi szempontbol jelentősek, vilagszerte a vezető halalokok kozott szerepelnek, es a rokkantsag egyik fő okat kepezik. Celkitűzes: Vizsgalatunk celja a cerebrovascularis betegsegekből eredő, idő előtti halalozas hazai es nemzetkozi adatainak elemzese regionkenti bontasban a 45-59 eves korcsoportban. Modszerek: Retrospektiv, kvantitativ elemzes kereteben vizsgaltuk a cerebrovascularis betegsegekből eredő, korspecifikus, 1990 es 2014 kozotti halalozast az Egeszsegugyi Vilagszervezet (WHO) Europai Regiojan belul kivalasztott nyugat-europai (n = 17), kelet-europai orszagokban (n = 10) es a volt Szovjetunio utodallamaiban (n = 15), 100 000 főre vetitve, a WHO Europai Halalozasi Adatbazisanak adatai alapjan. Leiro statisztikai modszereket, idősoros kimutatast, Kruskal-Wallis-probat alkalmaztunk. Eredmenyek: A cerebrovascularis betegsegekből eredő, 100 000 főre vetitett korspecifikus halalozas a nyugat-europai orszagokban volt a legalacsonyabb (ferfiak: 1990: 35,14, 2014: 14,31; nők: 1990: 21,11, 2014: 8,76) es a Szovjetunio utodallamaiban a legmagasabb (ferfiak: 1990: 134,19; 2014: 91,13; nők: 1990: 83,62, 2014: 41,83) (p<0,05). A kelet-europai es a nyugat-europai orszagok, valamint a nyugat-europai orszagok es a Szovjetunio utodallamainak korspecifikus, cerebrovascularis halalozasa kozott szignifikans kulonbseget talaltunk mindket nemben (1990, 2004, 2014: p<0,05). A cerebrovascularis betegsegek korspecifikus standardizalt halalozasa 1990 es 2014 kozott a nyugat-europai orszagokban (ferfiak: -59,28%, nők: -58,29%) csokkent a legnagyobb mertekben, melyet a vizsgalt kelet-europai orszagok (ferfiak: -54,14%, nők: -57,53%), majd a Szovjetunio utodallamai (ferfiak: -32,09%, nők: -49,97%) kovettek. Kovetkeztetesek: A korspecifikus, cerebrovascularis halalozas a ferfiak es a nők koreben egyarant csokkent az egyes regiokban. Magyarorszagon a nyugat-europai atlagnal jobban, 62,2%-kal csokkent a ferfiak es 59,1%-kal a nők korai cerebrovascularis halalozasa 1990 es 2014 kozott. Orv Hetil. 2021; 162(4): 144-152. SUMMARY INTRODUCTION Cerebrovascular diseases are a significant public health concern, they are among the leading causes of death worldwide and one of the major causes of disability. OBJECTIVE Our aim was to analyse national and international data regarding premature, cerebrovascular disease mortality per region in the 45-59 age group. METHODS We performed a retrospective, quantitative analysis on age-specific, premature cerebrovascular disease mortality between 1990 and 2014 per 100 000 population on data derived from the World Health Organisation, European Mortality Database on Western European (n = 17), Eastern European (n = 10) countries, and countries of the former Soviet Union (n = 15). Descriptive statistics, time series analysis and Kruskal-Wallis test were performed. RESULTS Age-related, cerebrovascular disease mortality per 100 000 population was the lowest in Western European countries (males: 1990: 35.14, 2014: 14.31; females: 1990: 21.11, 2014: 8.76), and the highest in former Soviet Union countries (males: 1990: 134.19; 2014: 91.13; females: 1990: 83.62, 2014: 41.83) (p<0,05). Significant differences were found in age-specific, cerebrovascular disease mortality in both sexes between Eastern and Western European countries and former Soviet Union countries (1990, 2004, 2014: p<0.05). Between 1990 and 2014, age-specific, standardized cerebrovascular disease mortality showed the biggest decrease in Western European countries (males: -59.28%, females: -58.29%) followed by Eastern European (males: -54.14%, females: -57.53%) and former Soviet Union countries (males: -32.09%, females: -49.97%). CONCLUSIONS Age-specific, cerebrovascular disease mortality decreased in both sexes in all regions analysed. Hungary was found to have seen a decrease above the Western European average, premature cerebrovascular mortality decreased by 62.2% in males and 59.1% in females between 1990 and 2014. Orv Hetil. 2021; 162(4): 144-152.