![]() Re-emergence of deaths from rheumatic heart disease, infections, increased alcoholism, and violence increase in ischemic and hypertensive diseases in the youngįor countries in the earliest stage of development, the predominant circulatory diseases are rheumatic heart disease, those due to other infections, and nutritional deficiency–related disorders of the heart muscle. Age of health regression and social upheaval Western Europe, North America, Australia, New Zealandĥ. Stroke and ischemic heart disease at old age Urban India, former socialist economies, aboriginal communities Age of degenerative and man-made diseasesĪll forms of strokes, ischemic heart disease at young ages, increasing obesity, and diabetes Sub-Saharan Africa, rural India, South AmericaĪs above+hypertensive heart disease and hemorrhagic strokesģ. Rheumatic heart disease, infections, and nutritional cardiomyopathies Modified Model of the Stages of Epidemiologic Transition as it Pertains to Cardiovascular Diseases Stages of Developmentĭuring Stages 1 to 4, life expectancy increases, whereas in Stage 5 life expectancy decreases compared with stages 4 and even 3. This transition can occur not only between different disease categories (eg, deaths from childhood diarrhea and malnutrition giving way to adult chronic diseases), but also within a specific disease category (eg, rheumatic heart disease of the young giving way to chronic coronary artery diseases of middle age or valve calcification, degeneration, and heart failure of the elderly 3) ( Table 1). This shift has been termed “the epidemiologic transition.” 2 At any given time, different countries in the world or even different regions within a country are at different stages of the epidemiologic transition. ![]() With industrialization, the major causes of death and disability, in the more advanced societies, have shifted from a predominance of nutritional deficiencies and infectious diseases, to those classified as degenerative. 1 The health status and disease profile of human societies have historically been linked to the level of their economic development and social organization. ![]() Life expectancy at birth has increased from a global average of 46 years in 1950 to 66 years in 1998. ![]() ![]()
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