[Impact of changes in cardiovascular and cerebrovascular diseases death spectrum on the gender gap in life expectancy among Tianjin residents from 2004 to 2020].

Objective: To analyze the impact of changes in cardiovascular and cerebrovascular diseases mortality on the gender gap in life expectancy among Tianjin residents from 2004 to 2020. Methods: This is a cross-sectional study. The data sources included all-cause death surveillance data collected by the Tianjin Centre for Disease Control and Prevention, covering the entire population of Tianjin from 2004 to 2020, and the number of urban and rural residents by age, sex, and urban and rural areas from the Population Management Office of the Tianjin Public Security Bureau during the same period. The abbreviated life table and Arriaga's decomposition method were applied to analyze the cause-of-death surveillance data of Tianjin residents from 2004 to 2020, and to calculate the impact of changes in mortality rates of cardiovascular and cerebrovascular diseases on gender differences in life expectancy by age, subcategory, and urban and rural areas. Results: In 2004, there were 56 189 deaths among Tianjin residents, including 31 233 males and 24 956 females. In 2020, there were 79 782 deaths among Tianjin residents, including 44 829 males and 34 953 females. The gender difference in life expectancy attributable to cardiovascular and cerebrovascular diseases among Tianjin residents increased from 1.52 years in 2004 to 2.02 years in 2020, with females having a longer life expectancy than males. The cumulative impact rate was higher among residents aged 40-74 years, increasing from 26.41% to 33.48%, while the cumulative impact rate among residents aged≥75 declined from 12.66% to 8.54%. The impact rates of intracerebral hemorrhage and cerebral infarction decreased significantly during the observation period, with intracerebral hemorrhage impact rate decreasing from 13.21% to 6.12% and cerebral infarction impact rate decreasing from 11.32% to 5.02%. The impact rate of acute myocardial infarction decreased but remained at a high level, from 9.70% to 6.99%. The impact rate of sequelae of cerebrovascular disease and other coronary heart diseases increased significantly, with the impact rate of sequelae of cerebrovascular disease increasing from 0.54% to 14.42% and the impact rate of other coronary heart diseases rising from 1.35% to 6.34%. The impact of sequelae of cerebrovascular disease deaths on the gender difference in life expectancy was greater in urban areas compared to rural areas, with an increase of 2 101.41% in urban areas and 1 898.51% in rural areas. Conclusions: The gender difference in life expectancy attributable to cardiovascular and cerebrovascular diseases among Tianjin residents is widening. Attention should be paid to the prevention of cerebrovascular disease sequelae and other coronary heart diseases among males aged of 40-74 years in urban areas.