International Journal of Epidemiology, Vol 18, S20-S28, Copyright © 1989 by International Epidemiological Association
TJ Thom
Mortality trends are described for heart disease, its main subgroup
coronary heart disease (CHD), and total mortality for men and women 45- 64
years of age from 1950 to 1985 in 27 countries. In contrast to the epidemic
rise in mortality from CHD prior to the 1960s, the death rate is declining
in most industrialized countries except in Eastern Europe where trends
remain upward. Mortality from CHD was upwards in 18 countries in the 1970s
and in only four countries in the 1980s. Peaks for CHD occurred earlier in
women than men. With some exceptions, declines were greater for higher than
lower rate countries. In many countries, CHD declines are accompanied by a
corresponding downward change in total mortality, which suggests that the
declines are real. Although in several countries there is substantial
mortality from heart diseases other than CHD, generally there is good
correspondence in trends between them over the 35-year period. There is
also a trend toward less intercountry variability in death rates and
proportionate mortality for CHD. But the North-South high-to-low gradient
in Europe continues in 1985, and there remains at least a fourfold
difference for men and an eightfold difference for women between the
highest and lowest CHD rates. The male/female ratios of the rates, while
narrowing in many countries, vary from 3:1 to 6:1 among the 27 countries.
ARTICLES
International mortality from heart disease: rates and trends
Division of Epidemiology and Clinical Applications, National Heart, Lung and Blood Institute, Bethesda, Maryland 20892.
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