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An evaluation of the 25 by 25 goal for premature cardiovascular disease mortality in Taiwan: an age-period-cohort analysis, population attributable fraction and national population-based study
  1. Shih-Yung Su1,
  2. Wen-Chung Lee1,2,
  3. Tzu-Ting Chen1,
  4. Hao-Chien Wang3,4,
  5. Ta-Chen Su5,6,
  6. Jiann-Shing Jeng7,
  7. Yu-Kang Tu1,
  8. Shu-Fen Liao1,2,
  9. Tzu-Pin Lu1,
  10. Kuo-Liong Chien1,8
  1. 1 Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
  2. 2 Research Center for Genes, Environment and Human Health, College of Public Health, National Taiwan University, Taipei, Taiwan
  3. 3 Department of Internal Medicine, Division of Chest Medicine, National Taiwan University Hospital, Taipei, Taiwan
  4. 4 Department of Internal Medicine, School of Medicine, National Taiwan University, Taipei, Taiwan
  5. 5 Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
  6. 6 Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
  7. 7 Stroke Center & Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
  8. 8 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  1. Correspondence to Dr Kuo-Liong Chien, Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Rm. 536, No. 17, Xuzhou Rd, Taipei 100, Taiwan; klchien{at}ntu.edu.tw

Abstract

Objectives The aim of the 25 by 25 goal is to reduce mortality from premature non-communicable diseases by 25% before 2025. Studies have evaluated the 25 by 25 goal in many countries, but not in Taiwan. The aim of this study was to estimate the 25 by 25 goal for premature mortality from cardiovascular diseases in Taiwan.

Methods We applied the age-period-cohort model to project the incidence of premature death from cardiovascular disease from 2015 to 2024 and used the population attributable fraction to estimate the contributions of targeted risk factors. The probability of death was used to estimate the percent change.

Results The percent change in business-as-usual trend during 2010-2024 was only a 6% (range 1.7-10.7%) lower risk of premature mortality from cardiovascular disease among men. The greatest reduction in the risk of mortality occurred with a 30% reduction in the prevalence of smoking; however, there was only a 14.5% (10.6-18.3%) decrease in percent change and in the corresponding number of men (3706: range 3543-3868) who were prevented from dying. More than a 25% reduction in the percent change of premature cardiovascular disease mortality among women was achieved without control of any risk factor. To reach a 25% reduction in men before 2025, there needs to be a 70% reduction in the prevalence of smoking to reduce mortality by 26.2% (22.9-29.3%).

Conclusions Cigarette smoking is the primary target in the prevention of cardiovascular disease. Through the stringent control of smoking, the goal of a 25% reduction in premature mortality from cardiovascular disease may be achieved before 2025 in Taiwan.

  • cardiovascular diseases
  • population attributable fraction
  • probability of death
  • age-period-cohort analysis
  • 25 x 25 goal

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Footnotes

  • Contributors SYS was in charge of data collection, analysis, and wrote the first draft and the revision of the manuscript. WCL and KLC contributed to study design and wrote the part of first draft of the manuscript. TTC was in charge of data collection. All authors approved the final version of the manuscript.

  • Funding The study was supported by the Ministry of Science and Technology, Taiwan, (MOST 104-2321-B-002-077 -, MOST 103-2314-B-002 -135 -MY3).

  • Competing interests None declared.

  • Ethics approval The proposal was approved by the IRB, National Taiwan University, and no consent from participants was needed because of anonymity.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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