Abstract
Objective—To compare the long-term trends in mortality and attack rate of ischaemic heart disease in North Karelia, Finland, and in Kaunas, Lithuania, from 1971 to 1987.
Design—Data on routine mortality statistics were obtained from the Central Statistical Office of Finland and from the Central City Archives of Kaunas. In addition, data from the community based myocardial infarction registers were used. The registers used similar diagnostic criteria and had operated in both areas during the entire study period.
Setting—The province of North Karelia in Finland and the city of Kaunas in Lithuania.
Subjects—The target populations were the people of North Karelia and Kaunas aged 35–64 years.
Main outcome measures—Mortality from ischaemic heart disease and the attack rate of acute myocardial infarction.
Results—In North Karelia mortality from ischaemic heart disease and the attack rate of acute myocardial infarction declined steeply both in men and women. This decline was accompanied by a decrease in total mortality. In Kaunas, both mortality and the attack rate increased in men but remained unchanged in women. In 1985 to 1987, age standardised total mortality per 100 000 inhabitants was similar in the two populations in men (1081 (95% confidence interval (CI) 1013 to 1149), in North Karelia; 1082 (95% CI 1032 to 1132), in Kaunas). The proportional mortality from ischaemic heart disease was considerably higher in North Karelia (40%) than in Kaunas (28%). In women, age standardised total mortality was lower in North Karelia (350 (95% CI 312–388)) than in Kaunas (440 (95% CI 413 to 467)). The proportional mortality from ischaemic heart disease in women was also higher in North Karelia (28%) than in Kaunas (13%).
Conclusions—Despite the remarkable decline in the occurrence of ischaemic heart disease, it still remains the most important cause of premature mortality in North Karelia. In Kaunas ischaemic heart disease mortality and attack rate increased in men. Experiences from successful cardiovascular disease prevention programmes in western countries, such as the North Karelia Project, should be exploited to prevent an increasing epidemic of ischaemic heart disease in eastern Europe.
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Beaglehole R., Stewart A. W., Butler M. Comparability of old and new World Health Organization criteria for definite myocardial infarction. Int J Epidemiol. 1987 Sep;16(3):373–376. doi: 10.1093/ije/16.3.373. [DOI] [PubMed] [Google Scholar]
- Burke G. L., Edlavitch S. A., Crow R. S. The effects of diagnostic criteria on trends in coronary heart disease morbidity: the Minnesota Heart Survey. J Clin Epidemiol. 1989;42(1):17–24. doi: 10.1016/0895-4356(89)90021-8. [DOI] [PubMed] [Google Scholar]
- Keys A., Aravanis C., Blackburn H. W., Van Buchem F. S., Buzina R., Djordjević B. D., Dontas A. S., Fidanza F., Karvonen M. J., Kimura N. Epidemiological studies related to coronary heart disease: characteristics of men aged 40-59 in seven countries. Acta Med Scand Suppl. 1966;460:1–392. [PubMed] [Google Scholar]
- Martin C. A., Hobbs M. S., Armstrong B. K., de Klerk N. H. Trends in the incidence of myocardial infarction in Western Australia between 1971 and 1982. Am J Epidemiol. 1989 Apr;129(4):655–668. doi: 10.1093/oxfordjournals.aje.a115182. [DOI] [PubMed] [Google Scholar]
- Puska P., Mustaniemi H. Incidence and presentation of myocardial infarction in North Karelia, Finland. Acta Med Scand. 1975 Mar;197(3):211–216. doi: 10.1111/j.0954-6820.1975.tb04904.x. [DOI] [PubMed] [Google Scholar]
- Tuomilehto J., Arstila M., Kaarsalo E., Kankaanpä J., Ketonen M., Kuulasmaa K., Lehto S., Miettinen H., Mustaniemi H., Palomäki P. Acute myocardial infarction (AMI) in Finland--baseline data from the FINMONICA AMI register in 1983-1985. Eur Heart J. 1992 May;13(5):577–587. doi: 10.1093/oxfordjournals.eurheartj.a060219. [DOI] [PubMed] [Google Scholar]
- Uemura K., Pisa Z. Recent trends in cardiovascular disease mortality in 27 industrialized countries. World Health Stat Q. 1985;38(2):142–162. [PubMed] [Google Scholar]
- Uemura K., Pisa Z. Trends in cardiovascular disease mortality in industrialized countries since 1950. World Health Stat Q. 1988;41(3-4):155–178. [PubMed] [Google Scholar]