International Journal of Epidemiology, Vol 18, S58-S66, Copyright © 1989 by International Epidemiological Association
M Higgins and T Thom
Coronary heart disease (CHD) death rates increased in the United States
until the mid 1960s then declined. Declines were greater for acute
myocardial infarction (AMI), for younger age groups, for the white
population, and for higher socioeconomic groups. Trends in incidence are
uncertain but in-hospital fatality rates have decreased. There have been
major advances in diagnosis, prevention and treatment of CHD, and numbers
of internists and cardiologists, emergency medical services, and coronary
care units have increased. New potent medical and surgical treatments for
acute and chronic CHD have been introduced. Reductions in risk factors
include decreases in cigarette smoking especially among men, falls in mean
systolic blood pressure, rises in the proportion of hypertensive adults who
are treated and controlled, and reductions in plasma cholesterol.
Consumption of whole milk, butter, and eggs decreased whereas use of low
fat milk, cooking oils, poultry, fish, vegetables, and fruits increased.
However, the prevalence of obesity has increased. CHD is still the leading
cause of death, and its prevalence is expected to rise as the population
increases at older ages and treatment prolongs survival of patients with
CHD.
ARTICLES
Trends in CHD in the United States
Division of Epidemiology and Clinical Applications, National Heart, Lung and Blood Institute, Bethesda, Maryland 20892.
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