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. 1988 Nov;78(11):1422–1427. doi: 10.2105/ajph.78.11.1422

Divergence of the recent trends in coronary mortality for the four major race-sex groups in the United States.

C Sempos 1, R Cooper 1, M G Kovar 1, M McMillen 1
PMCID: PMC1350232  PMID: 3177717

Abstract

Since 1976 there has been a leveling off or slowdown in the rate of decline in coronary heart disease (CHD) mortality. The age-adjusted absolute annual rate of decline in CHD mortality rates during 1968-75 (delta rate/100,000 population/year) was virtually identical for White males (-7.54), Black males (-7.85), and Black females (-7.20), and somewhat lower for White females (-4.25). During 1976-85, however, the secular trends diverged considerably. Age-adjusted rates continued to decline at the same annual rate for White males, while the decline was approximately half as steep for the other three race-sex groups. During 1976-85 there was also a leveling off in the average annual per cent change in age-adjusted CHD mortality for Black males and females and White females when compared to 1968-75, while there was no change for White males. As a result, more than 40,000 White and Black females and Black males died of CHD in 1985 than would have died if CHD rates would have continued to decline at the 1968-75 trends. All comparisons were based on a reclassification of cause-of-death codes to maximize comparability between the 8th and 9th Revisions of the International Classification of Disease. These results suggest that the factors which have led to the continued decline in coronary heart disease may not have influenced all the demographic groups in this country equally over the last decade.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brenner M. H. Economic changes and heart disease mortality. Am J Public Health. 1971 Mar;61(3):606–611. doi: 10.2105/ajph.61.3.606. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cooper R. S., Simmons B., Castaner A., Prasad R., Franklin C., Ferlinz J. Survival rates and prehospital delay during myocardial infarction among black persons. Am J Cardiol. 1986 Feb 1;57(4):208–211. doi: 10.1016/0002-9149(86)90892-1. [DOI] [PubMed] [Google Scholar]
  3. Cooper R. A note on the biologic concept of race and its application in epidemiologic research. Am Heart J. 1984 Sep;108(3 Pt 2):715–722. doi: 10.1016/0002-8703(84)90662-8. [DOI] [PubMed] [Google Scholar]
  4. Cooper R., Cohen R., Amiry A. Is the period of rapidly declining adult mortality in the United States coming to an end? Am J Public Health. 1983 Sep;73(9):1091–1093. doi: 10.2105/ajph.73.9.1091. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cooper R. Rising death rates in the Soviet Union: the impact of coronary heart disease. N Engl J Med. 1981 May 21;304(21):1259–1265. doi: 10.1056/NEJM198105213042103. [DOI] [PubMed] [Google Scholar]
  6. Cooper R., Schatzkin A., Sempos C. Rising death rates among Polish men. Int J Health Serv. 1984;14(2):289–302. doi: 10.2190/BX3T-U5X7-GCEB-TPMQ. [DOI] [PubMed] [Google Scholar]
  7. Cooper R., Stamler J., Dyer A., Garside D. The decline in mortality from coronary heart disease, U.S.A., 1968--1975. J Chronic Dis. 1978;31(12):709–720. doi: 10.1016/0021-9681(78)90055-3. [DOI] [PubMed] [Google Scholar]
  8. Cooper R., Tsong Y., Hoeksema R., Liu K. Is the recent decline in coronary disease mortality in the United States attributable to lower rates of influenza and pneumonia? Prev Med. 1980 Jul;9(4):559–568. doi: 10.1016/0091-7435(80)90051-1. [DOI] [PubMed] [Google Scholar]
  9. Elveback L. R., Connolly D. C., Kurland L. T. Coronary heart disease in residents of Rochester, Minnesota. II. Mortality, incidence, and survivorship, 1950-1975. Mayo Clin Proc. 1981 Nov;56(11):665–672. [PubMed] [Google Scholar]
  10. Enstrom J. E. Trends in mortality among California physicians after giving up smoking: 1950-79. Br Med J (Clin Res Ed) 1983 Apr 2;286(6371):1101–1105. doi: 10.1136/bmj.286.6371.1101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gillum R. F., Blackburn H., Feinleib M. Current strategies for explaining the decline in ischemic heart disease mortality. J Chronic Dis. 1982;35(6):467–474. doi: 10.1016/0021-9681(82)90061-3. [DOI] [PubMed] [Google Scholar]
  12. Gillum R. F. Coronary heart disease in black populations. I. Mortality and morbidity. Am Heart J. 1982 Oct;104(4 Pt 1):839–851. doi: 10.1016/0002-8703(82)90021-7. [DOI] [PubMed] [Google Scholar]
  13. Gillum R. F., Feinleib M., Margolis J. R., Fabsitz R. R., Brasch R. C. Community surveillance for cardiovascular disease: the Framingham cardiovascular disease survey. Some methodological problems in the community study of cardiovascular disease. J Chronic Dis. 1976 May;29(5):289–299. doi: 10.1016/0021-9681(76)90090-4. [DOI] [PubMed] [Google Scholar]
  14. Gillum R. F., Folsom A., Luepker R. V., Jacobs D. R., Jr, Kottke T. E., Gomez-Marin O., Prineas R. J., Taylor H. L., Blackburn H. Sudden death and acute myocardial infarction in a metropolitan area, 1970-1980. The Minnesota Heart Survey. N Engl J Med. 1983 Dec 1;309(22):1353–1358. doi: 10.1056/NEJM198312013092203. [DOI] [PubMed] [Google Scholar]
  15. Gillum R. F., Jacobs D. R., Jr, Luepker R. V., Prineas R. J., Hannan P., Baxter J., Gomez-Marin O., Kottke T. E., Blackburn H. Cardiovascular mortality trends in Minnesota, 1960-1978. The Minnesota Heart Survey. J Chronic Dis. 1984;37(4):301–309. doi: 10.1016/0021-9681(84)90138-3. [DOI] [PubMed] [Google Scholar]
  16. Goldberg R. J., Gore J. M., Alpert J. S., Dalen J. E. Recent changes in attack and survival rates of acute myocardial infarction (1975 through 1981). The Worcester Heart Attack Study. JAMA. 1986 May 23;255(20):2774–2779. [PubMed] [Google Scholar]
  17. Goldman L., Cook E. F. The decline in ischemic heart disease mortality rates. An analysis of the comparative effects of medical interventions and changes in lifestyle. Ann Intern Med. 1984 Dec;101(6):825–836. doi: 10.7326/0003-4819-101-6-825. [DOI] [PubMed] [Google Scholar]
  18. Goldman L., Cook F., Hashimotso B., Stone P., Muller J., Loscalzo A. Evidence that hospital care for acute myocardial infarction has not contributed to the decline in coronary mortality between 1973-1974 and 1978-1979. Circulation. 1982 May;65(5):936–942. doi: 10.1161/01.cir.65.5.936. [DOI] [PubMed] [Google Scholar]
  19. Gomez-Marin O., Folsom A. R., Kottke T. E., Wu S. C., Jacobs D. R., Jr, Gillum R. F., Edlavitch S. A., Blackburn H. Improvement in long-term survival among patients hospitalized with acute myocardial infarction, 1970 to 1980. The Minnesota Heart Survey. N Engl J Med. 1987 May 28;316(22):1353–1359. doi: 10.1056/NEJM198705283162201. [DOI] [PubMed] [Google Scholar]
  20. Hagstrom R. M., Federspiel C. F., Ho Y. C. Incidence of myocardial infarction and sudden death from coronary heart disease in Nashville, Tennessee. Circulation. 1971 Nov;44(5):884–890. doi: 10.1161/01.cir.44.5.884. [DOI] [PubMed] [Google Scholar]
  21. Keil J. E., Saunders D. E., Jr, Lackland D. T., Weinrich M. C., Hudson M. B., Gastright J. A., Baroody N. B., O'Bryan E. C., Jr, Zmyslinski R. W. Acute myocardial infarction: period prevalence, case fatality, and comparison of black and white cases in urban and rural areas of South Carolina. Am Heart J. 1985 Apr;109(4):776–784. doi: 10.1016/0002-8703(85)90638-6. [DOI] [PubMed] [Google Scholar]
  22. Kleinman J. C. State trends in infant mortality, 1968-83. Am J Public Health. 1986 Jun;76(6):681–688. doi: 10.2105/ajph.76.6.681. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Marmot M. G., McDowall M. E. Mortality decline and widening social inequalities. Lancet. 1986 Aug 2;2(8501):274–276. doi: 10.1016/s0140-6736(86)92085-4. [DOI] [PubMed] [Google Scholar]
  24. Pell S., Fayerweather W. E. Trends in the incidence of myocardial infarction and in associated mortality and morbidity in a large employed population, 1957-1983. N Engl J Med. 1985 Apr 18;312(16):1005–1011. doi: 10.1056/NEJM198504183121601. [DOI] [PubMed] [Google Scholar]
  25. Rosenman R. H., Friedman M., Straus R., Jenkins C. D., Zyzanski S. J., Wurm M. Coronary heart disease in the Western Collaborative Group Study. A follow-up experience of 4 and one-half years. J Chronic Dis. 1970 Sep;23(3):173–190. doi: 10.1016/0021-9681(70)90094-9. [DOI] [PubMed] [Google Scholar]
  26. Rowland M. L., Fulwood R. Coronary heart disease risk factor trends in blacks between the first and second National Health and Nutrition Examination Surveys, United States, 1971-1980. Am Heart J. 1984 Sep;108(3 Pt 2):771–779. doi: 10.1016/0002-8703(84)90670-7. [DOI] [PubMed] [Google Scholar]
  27. Ruberman W., Weinblatt E., Goldberg J. D., Chaudhary B. S. Psychosocial influences on mortality after myocardial infarction. N Engl J Med. 1984 Aug 30;311(9):552–559. doi: 10.1056/NEJM198408303110902. [DOI] [PubMed] [Google Scholar]
  28. Shekelle R. B., Ostfeld A. M., Paul O. Social status and incidence of coronary heart disease. J Chronic Dis. 1969 Dec;22(6):381–394. doi: 10.1016/0021-9681(69)90002-2. [DOI] [PubMed] [Google Scholar]
  29. Stallones R. A. The rise and fall of ischemic heart disease. Sci Am. 1980 Nov;243(5):53–59. doi: 10.1038/scientificamerican1180-53. [DOI] [PubMed] [Google Scholar]
  30. Stamler J. Coronary heart disease: doing the "right things". N Engl J Med. 1985 Apr 18;312(16):1053–1055. doi: 10.1056/NEJM198504183121609. [DOI] [PubMed] [Google Scholar]
  31. Trends in serum cholesterol levels among US adults aged 20 to 74 years. Data from the National Health and Nutrition Examination Surveys, 1960 to 1980. National Center for Health Statistics-National Heart, Lung, and Blood Institute Collaborative Lipid Group. JAMA. 1987 Feb 20;257(7):937–942. [PubMed] [Google Scholar]
  32. 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]
  33. Weinblatt E., Goldberg J. D., Ruberman W., Frank C. W., Monk M. A., Chaudhary B. S. Mortality after first myocardial infarction. Search for a secular trend. JAMA. 1982 Mar 19;247(11):1576–1581. [PubMed] [Google Scholar]
  34. Weisse A. B., Abiuso P. D., Thind I. S. Acute myocardial infarction in Newark, N.J. A study of racial incidence. Arch Intern Med. 1977 Oct;137(10):1402–1405. [PubMed] [Google Scholar]

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