Exploring the trend of age-standardized mortality rates from cardiovascular disease in Malaysia: A joinpoint analysis (2010-2021)

Abstract Introduction: Cardiovascular disease (CVD) is a major health concern worldwide, particularly in low- and middle-income countries. The COVID-19 pandemic that emerged in late 2019 may have had an impact on the trend of CVD mortality. This study aimed to investigate the trend and changes in CVD mortality rates in Malaysia, using age-standardized mortality rates (ASMR) from 2010 to 2021. Methods The Malaysian population and mortality data from 2010 through 2021 were obtained from Department of Statistics Malaysia (DOSM). ASMRs from CVD per 100,000 population were calculated based on the World Health Organization (2000–2025) standard population using direct method. The ASMRs were computed based on sex, age groups (including premature mortality age, 30–70 years), and CVD types. The annual percentage change (APC) and average annual percentage change (AAPC) of the ASMR with corresponding 95% confidence intervals (CI) were estimated from jointpoint regression model using the Joinpoint Regression Program, Version 4.9.1.0. Results Throughout the study period (2010–2021), ASMRs for CVD exhibited an increase from 93.1 to 147.0 per 100,000, with an AAPC of 3.6% (95% CI: 2.1 to 5.2). The substantial increase was observed between 2015 and 2018 (APC 12.6%), with significant changes in both sexes, and age groups 50–59, 70 years, and 30–69 (premature mortality age). Notably, the ASMR trend remained consistently high in the premature mortality group across other age groups, with males experiencing higher rates than females. No significant changes were detected before or after the COVID-19 pandemic (between 2019 and 2021), except for females who died from IHD (10.3% increase) and those aged 0–4 (25% decrease). Conclusion The overall CVD mortality trend, particularly premature mortality, has generally increased over the past decades. However, our analysis reveals that there was no substantial change in trend of CVD mortality during the COVID-19 pandemic in Malaysia. Given the scarcity of point data following the COVID-19 outbreak, the interpretation of findings for the true burden of COVID-19 on CVD death should be undertaken with caution.