Main components of life expectancy increase during the cardiovascular revolution in Spain

Résumé 0

The circulatory system diseases have contributed decisively to an increase in life expectancy (LE) in Spain. The contribution to LE is calculated through a decomposition analysis by sex and five-year age groups. We divide the years studied into two periods, 1980–1996 and 1996–2012. Using the Human Cause-of-Death Database (HCD), we examine specific subcauses at a 4-digit ICD-10 level and how they contribute to the change in LE among men and among women. The analysis shows that cerebrovascular diseases (CBVDs) contribute most to years gained until 1996, while ischemic heart diseases (IHDs) contribute most thereafter. Among women, the largest increase is due to specific CBVDs subcauses; among men IHD subcauses also have an important role. Regarding contribution by age, gains by CVDs are particularly significant at older ages, while contributions by IHDs are more relevant from the age of 50 onwards, especially among men. Furthermore, the gender gap in LE is influenced by the different evolution of various circulatory diseases during the period of study, but the evolution of these diseases is not always reflected equally in both sexes. The study evidences the need for greater precision in the registers in order to take advantage of the potentialities of the 4-digit classification of the ICD, thus leading to a better in depth knowledge in health trends. Finally, it shows the mortality due to modifiable factors mainly classified in IHDs, and the consequent need for the Spanish health system to act on them.