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Stall in Heart Disease Death Rates, Evidence From Maine, 1999–2017

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Figure 1.

Comparison of observed and joinpoint-modeled age-adjusted heart disease death rates, Maine, 1999–2017. Death rates are age-adjusted to the 2000 US standard population. International Classification of Diseases, 10th Revision (ICD-10) codes used: I00-I02, I05–I09, I11, I13, I20–I25, I26–I28, I30–I51. aAnnual percentage change from 1999–2010 is significantly different from 0 at an alpha level of .05. Data source: CDC WONDER.

Year Observed Age-Adjusted Death Rate
Per 100,000 Population
Joinpoint Modeled Death Rate
Per 100,000 Population
1999 238.72 239.95
2000 233.86 229.95
2001 220.65 220.36
2002 210.61 211.18
2003 203.03 202.38
2004 189.89 193.94
2005 186.53 185.86
2006 174.31 178.12
2007 172.97 170.69
2008 164.63 163.58
2009 156.37 156.76
2010 151.1 150.23
2011 149.46 150.03
2012 145.9 149.83
2013 152.27 149.63
2014 147.89 149.43
2015 157.31 149.24
2016 149.51 149.04
2017 143.48 148.84

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Figure 2.

Heart disease mortality trends in Maine, by sex, age group, and type of heart disease, 1999–2017. All trends except age group determined using age-adjusted death rates. Data in bars are APC (95% CI). 95% CIs are provided to give the reader an indication of statistical stability and should not be used to determine whether changes in trend occurred. Significant changes in trend (increasing or decreasing) were determined by using joinpoint modeling to identify where APCs were significantly different from zero at the alpha = 0.05 level. There were fewer than 20 cases of cardiac arrest in 2017, so the death rate for that year was unreliable. Abbreviations: AMI, acute myocardial infarction; APC, annual percentage change; CI, confidence interval; COD, cause of death; HHD, hypertensive heart disease; ICD-10, International Classification of Diseases, 10th revision; IHD, ischemic heart disease; NA, not available.

Category Period 1 Dates Period 1 APC (95% CI) Period 2 Dates Period 2 APC (95% CI)
Heart Disease 1999–2010 –4.2 (–4.6 to –3.8)a 2010–2017 –0.1 (–1.0 to 0.8)
Sex
Male 1999–2010 –3.9 (–4.5 to –3.3)a 2010–2017 –0.2 (–1.5 to 1.1)
Female 1999–2009 –4.8 (–5.3 to –4.2)a 2009–2017 –0.7 (–1.6 to 0.2)
Age, y
25–44 1999–2017 –0.9 (–2.4 to 0.6) NA NA
45–64 1999–2010 –3.1 (–4.1 to –2.0)a 2010–2017 1.7 (–0.5 to 4.0)
65–84 1999–2011 –5.2 (–5.6 to –4.9)a 2011–2017 –1.1 (–2.3 to 0.1)
≥85 1999–2010 –3.4 (–4.1 to –2.7)a 2010–2017 0.0 (–1.4 to 1.4)
Underlying cause of death
Cardiac arrest 1999–2011 –5.2 (–7.0 to –3.3)a 2011–2016 –16.2 (–25.2 to –6.2)a
AMI 1999–2007 –6.7 (–8.0 to –5.4)a 2007–2017 –4.1 (–5.2 to –2.9)a
HHD 1999–2010 –5.7 (–8.6 to –2.7)a 2010–2017 14.6 (8.4 to 21.1)a
Heart failure 1999–2010 –1.4 (–2.5 to –0.2)a 2010–2017 2.9 (0.7 to 5.1)a
IHD without AMI 1999–2011 –5.3 (–5.7 to –4.8)a 2011–2017 –1.0 (–2.6 to 0.6)
Pulmonary heart disease 1999–2017 –0.9 (–2.1 to 0.4) NA NA
Ill-defined heart disease 1999–2017 5.3 (3.3 to 7.3)a NA NA
Multiple cause of death
Heart failure–related 1999–2009 –4.0 (–4.7 to –3.3)a 2009–2017 3.0 (2.1 to 4.0)a
Diabetes-related 1999–2011 –5.3 (–6.5 to –4.2)a 2011–2017 –0.1 (–3.9 to 3.7)
Health district
Aroostook 1999–2017 –3.3 (–4.1 to –2.5)a NA NA
Central 1999–2017 –2.0 (–2.7 to –1.2)a NA NA
Cumberland 1999–2010 –4.8 (–5.5 to –4.0)a 2010–2017 0.5 (–1.1 to 2.1)
Downeast 1999–2010 –4.7 (–5.6 to –3.9)a 2010–2017 –0.3 (–2.2 to 1.6)
Midcoast 1999–2012 –4.3 (–4.8 to –3.8)a 2012–2017 4.6 (2.3 to 6.9)a
Penquis 1999–2017 –2.9 (–3.5 to –2.3)a NA NA
Western 1999–2017 –2.3 (–2.9 to –1.7)a NA NA
York 1999–2017 –3.6 (–4.3 to –2.9)a NA NA
Rural/urban status
Metropolitan 1999–2010 –4.3 (–4.8 to –3.8)a 2010–2017 –0.4 (–1.4 to 0.6)
Nonmetropolitan 1999–2009 –4.2 (–5.0 to –3.4)a 2009–2017 –0.2 (–1.5 to 1.1)

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