Cardiology Letters 2013, 22(6):449-458
The causes of changes in coronary heart disease mortality rates using the IMPACT model: a systematic review
- 1 Katedry verejného zdravotníctva, Fakulta zdravotníctva a sociálnej práce, Trnavská univerzita v Trnave, Slovenská republika
- 2 Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
- 3 Národný ústav srdcových a cievnych chorôb a.s. v Bratislave, Slovenská republika
Introduction: Cardiovascular diseases (CVDs), and among them coronary heart disease (CHD), are the leading cause of death worldwide and in European countries including Central European countries. In the last decades, however, it has been possible to observe decreases in mortality rates from this group of diseases. It is of great importance to know the causes that have led to these decreases because a better understanding will allow us to make evidence-based decisions and so to manage and allocate resources effectively. Because the development of mortality rates trend reflects complex determinants, it is difficult to explain it. In this context mathematical models become important.
Aim: This systematic review describes the results of the IMPACT mathematical model which has been widely used to explore past CHD mortality rates trends in several European and nonEuropean countries.
Methods: We identified 19 articles that were published between the years 1999 - 2013 and that were indexed in the Web of Science, Scopus and EBSCO Discovery Service databases and used the IMPACT model to explore past trends of CHD mortality rates.
Results: 16 articles analysed the decreases in CHD mortality rates and 3 articles analysed the increases in CHD mortality rates. According to the IMPACT model estimates the contribution of evidence-based treatments (EBT) on the fall of CHD mortality rates can range between 23-47%. Risk factor reduction contributed to the decline by some 44-73%. The articles agree that it is not possible to substantially decrease the CHD mortality without a comprehensive strategy that promotes primary prevention (especially healthy diet, physical activity and reduction of smoking) and evidence-based medical treatments.
Conclusion: The IMPACT model offers an innovative approach to generate evidence further quantifying the influence of risk factors and EBT uptake on CHD mortality trends. In the Central European area the model has been developed only in the Czech Republic and Poland. We are convinced that it is desirable to also create a Slovak version of the model.
Keywords: IMPACT model; coronary heart disease; mortality rate; risk factors; evidence-based treatments
Published: June 1, 2013 Show citation
