The association of dietary folate, B6, and B12 with cardiovascular mortality in Spain: an ecological analysis.

OBJECTIVES: This study assessed the association of dietary folate, vitamin B6, and vitamin B12 with cardiovascular mortality. METHODS: Poisson regression analyses assessed coronary/cerebrovascular mortality rates via nutrient data obtained from the National Nutrition Survey, which recorded 7-day food intakes from a national sample of 21,155 households. RESULTS: In regard to coronary mortality, male and female rate ratios (highest vs lowest quintile) were 0.83 (95% confidence interval [CI] = 0.77, 0.91) and 0.95 (95% CI = 0.86, 1.05), respectively, for folate and 0.74 (95% CI = 0.65, 0.84) and 0.86 (95% CI = 0.73, 0.99), respectively, for B12. Intake of folate and B6 (but not B12) was significantly associated with cerebrovascular mortality. CONCLUSIONS: B vitamins are associated with cardiovascular mortality in the general population.

Time trends, cohort effect and spatial distribution of cerebrovascular disease mortality in Spain.

STUDY OBJECTIVE: This study describes mortality due to cerebrovascular disease (CVD) in Spain, based on time-series analysis in the period 1951-1995 by age, sex, and cohort of birth; spatial distribution observed for the five-year period 1991 1995, and time-spatial analysis in the period 1992-1995 vs. 1988-1991. Special attention is paid to risk of medium aged population. DESIGN: Longitudinal and cross-sectional observational study. SETTING AND PARTICIPANTS: Spanish population. All mortality data used were taken from official statistics. Time trends and spatial distribution were analyzed using log-linear Poisson regression models. MAIN RESULTS: CVD mortality declined over the last two decades of the study period (1974-1995) by an annual average of 4.16% (95% CI: 3.95-4.36) and 4.00% (95% CI: 3.77-4.24) in men and women, respectively. The downward trends were accelerated in last decade. An excess of male mortality was in evidence. For all age groups mortality declined with more recent cohorts, but the decline was less marked among ages 35 64. Spatial distribution of CVD mortality revealed a north-south pattern, but this is being difuminated by increasing rates in the lower risk provinces. Internationally, Spain ranks midway to low in terms of its overall CVD mortality. CONCLUSIONS: Efforts to reduce CVD incidence and case fatality are the essential prerequisite for any long-term improvement in mortality. Accordingly, further research is called for into current disease morbidity and the risk factors to be targeted at a general population level, nationwide.

[Cerebrovascular mortality in Spain]. / Mortalidad por enfermedad cerebrovascular en España.

INTRODUCTION: Although the mortality due to cerebrovascular disease in Spain has been considerably reduced in the past twenty years, at all ages and in both sexes, it is still the second cause of death in men and first in women. OBJECTIVE: To describe the mortality due to cerebrovascular disease in Spain. MATERIAL AND METHODS: We analyse a time series over a period of 45 years (1951-1995) by age, sex, period of death (calendar year) and cohort of birth, the geographical distribution in the last five year period available (1991-1995), and compared with other industrial countries. RESULTS: The mortality due to cerebrovascular disease in Spain has dropped over the past twenty years. This fall has accelerated over the past five years, mainly in the older age groups. Both effects, period and cohort, are seen in this drop. There is marked male predominance. The geographical distribution is in a north-south pattern. At an international level, mortality due to cerebrovascular disease in Spain is medium-low, although in some provinces it is high. CONCLUSIONS: Efforts to reduce the incidence and severity of cerebrovascular disease are essential to reduce mortality. It is necessary to continue investigations as to the true impact of this group of disorders, incidence, gravity and mortality, and the distribution of cardiovascular risk factors in the whole population.