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Quantifying the role of modifiable risk factors in the differences in cardiovascular disease mortality rates between metropolitan and rural populations in Australia: a macrosimulation modelling study

Alston, Laura, Peterson, Karen Louise, Jacobs, Jane P., Allender, Steven and Nichols, Melanie 2017, Quantifying the role of modifiable risk factors in the differences in cardiovascular disease mortality rates between metropolitan and rural populations in Australia: a macrosimulation modelling study, BMJ Open, vol. 7, no. 11, pp. 1-10, doi: 10.1136/bmjopen-2017-018307.

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Title Quantifying the role of modifiable risk factors in the differences in cardiovascular disease mortality rates between metropolitan and rural populations in Australia: a macrosimulation modelling study
Author(s) Alston, Laura
Peterson, Karen LouiseORCID iD for Peterson, Karen Louise orcid.org/0000-0003-2822-9926
Jacobs, Jane P.
Allender, StevenORCID iD for Allender, Steven orcid.org/0000-0002-4842-3294
Nichols, MelanieORCID iD for Nichols, Melanie orcid.org/0000-0002-7834-5899
Journal name BMJ Open
Volume number 7
Issue number 11
Article ID e018307
Start page 1
End page 10
Total pages 10
Publisher BMJ Open
Place of publication London, Eng.
Publication date 2017-11-03
ISSN 2044-6055
Keyword(s) coronary heart disease
preventive medicine
public health
Summary OBJECTIVES: The study aimed (1) to quantify differences in modifiable risk factors between urban and rural populations, and (2) to determine the number of rural cardiovascular disease (CVD) and ischaemic heart disease (IHD) deaths that could be averted or delayed if risk factor levels in rural areas were equivalent to metropolitan areas.

SETTING: National population estimates, risk factor prevalence, CVD and IHD deaths data were analysed by rurality using a macrosimulation Preventable Risk Integrated Model for chronic disease risk. Uncertainty analysis was conducted using a Monte Carlo simulation of 10 000 iterations to calculate 95% credible intervals (CIs).

PARTICIPANTS: National data sets of men and women over the age of 18 years living in urban and rural Australia.

RESULTS: If people living in rural Australia had the same levels of risk factors as those in metropolitan areas, approximately 1461 (95% CI 1107 to 1791) deaths could be delayed from CVD annually. Of these CVD deaths, 793 (95% CI 506 to 1065) would be from IHD. The IHD mortality gap between metropolitan and rural populations would be reduced by 38.2% (95% CI 24.4% to 50.6%).

CONCLUSIONS: A significant portion of deaths from CVD and IHD could be averted with improvements in risk factors; more than one-third of the excess IHD deaths in rural Australia were attributed to differences in risk factors. As much as two-thirds of the increased IHD mortality rate in rural areas could not be accounted for by modifiable risk factors, however, and this requires further investigation.
Language eng
DOI 10.1136/bmjopen-2017-018307
Field of Research 110201 Cardiology (incl Cardiovascular Diseases)
111706 Epidemiology
111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 920103 Cardiovascular System and Diseases
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution non-commercial licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30104713

Document type: Journal Article
Collections: Population Health
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.