International Trends in Coronary Heart Disease Mortality and Incidence Rates

World Health Organisation. The World Health Report 1997. Geneva: WHO; 1997.

This important annual review of the world health situation summarises the latest estimates of the global burden of disease.

Stallones RA . The rise and fall of ischemic heart disease. Scientific American 1980;243: 43–49.

This historical overview of the origins and evolution of the CHD epidemic in the USA uses the broader category diseases of the heart' to overcome problems caused by changes in diagnostic, certification and coding practices. This paper is the most convincing documentation of the origin of the CHD mortality epidemic in the USA in 1920s.

Uemura K Pisa Z . Trends in cardiovascular disease mortality in industrialised countries since 1950. World Health Stat Q 1988; 41: 165–178.

Osmond C . Coronary heart disease mortality trends in England and Wales, 1952–1991. J Publ Health Med 1995; 17: 404–410.

This paper examines the contributions of period (cross-sectional) and cohort (generation) effects to the CHD mortality trends in England and Wales. The analysis concludes that CHD death rates are determined by factors linked both to period of death in adulthood and to period of birth providing some support to the foetal ‘programming’ hypothesis for the causation of heart disease.

Tao S Huang Z Wu X Zhou B Hao J Li Y CHD and its risk factors in the People's Republic of China. Int J Epidemiol 1989; 18: 159–163.

Yoshinaga A Horibe H . Serum lipid concentrations in Japanese children: a synthesis of 27 studies. CVD Prevention 1998; 1: 55–70.

This paper represents the most systematic review of all studies of serum lipid levels in Japanese children and finds higher mean values for total cholesterol concentration in the more recent time period.

Sans S Kesteloot H Kromhout D . The burden of cardiovascular diseases mortality in Europe. Eur Heart J 1997; 18: 1231–1248.

This paper reviews the levels and trends of CVD in Europe using routine mortality data for the period 1970–1992. The important point is made that despite the decreasing mortality rates in western European countries there has been no decrease in the absolute number of people dying from CVD. The increasing trend in CVD mortality in central and eastern European countries is described.

Leon DA Chenet L Shkolnikov VM Zakharov S Shapiro J Rakhmanova G Huge variation in Russian mortality rates 1984–1994: artefact, alcohol or what? Lancet 1997, 350: 383–388.

The paper describes the mortality experience in Russia in the period 1984–1994 and explores the reason for the increase in mortality in the period from 1987 to 1994.

Zatonski WA McMichael AJ Powles JW . Ecological study of reasons for sharp decline in mortality from ischaemic heart disease in Poland since 1991. BMJ 1998; 316: 1047–1051.

Tunstall-Pedoe H Kuulasmaa K Amouyel P Arveiler D Rajakangas A Pajak A . Myocardial infarction and coronary deaths in the World Health Organisation MONICA project: registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation 1994; 90: 583–612.

This paper reports cross-sectional results on coronary event registration from the WHO MONICA project using data for the period 1985–1987. Major differences were found between populations in non-fatal as well as fatal coronary event rates. In particular, the data are used to relate rates of validated CHD deaths to non-fatal myocardial infarction rates across 38 population from 21 countries.

Renaud S de Lorgeril M . Wine, alcohol, platelets and the French paradox for coronary heart disease. Lancet 1992; 339: 1523–1526.

Beaglehole R Stewart AW Jackson R Dobson AJ McElduff P D'Este K Declining rates of coronary heart disease in New Zealand and Australia, 1983–1993. Am J Epidemiol 1997; 145: 707–713.

This paper presents the final results of 10 years of monitoring of CHD in the three Australasian MONICA project collaborating centres. Myocardial infarction rates declined significantly in all three centres in parallel with the declining mortality rates. Twenty-eight day case fatality also declined, especially in the two Australian centres.

Jackson R Graham P Beaglehole R De Boer GK . Validation of coronary heart disease death certificates diagnoses. NZ Med J 1988; 101: 658–660.

Boyle CA Dobson AJ . The accuracy of hospital records and death certificates for acute myocardial infarction. Aust NZ J Med 1995; 25: 316–323.

Zhao D Goff DC Herra C Ramsey DJ Chan FA Ortiz C Evaluation of the accuracy of coronary heart disease coding on death certificates: The Corpus Christi Heart Project. CVD Prevention 1998; 1: 48–54.

Beaglehole R Stewart AW Wlaker P . Validation of coronary heart disease hospital discharge data. Aust NZ J Med 1987; 17: 43–46.

Pladevall M Goff DC Nichaman MZ Chan F Ramsey D Ortiz C An assessment of the validity of ICD Code 410 to identify hospital admissions for myocardial infarction: The Corpus Christi Heart Project. Int J Epidemiol 1996; 25: 948–952.

McGovern PG Pankow JS Shahar E Doliszny KM Folsom AR Blackburn H Recent trends in acute coronary heart disease, mortality, morbidity, medical care, and risk factors. N Engl J Med 1996; 334: 884–890.

This is a recent paper from the long term Minnesota Heart Survey which has been examining trends in CHD mortality and morbidity, medical care, and the CVD risk factor profile of the population of Minneopolis-St Paul. The paper concludes that the decline in CHD mortality in the period 1985–1990 can be explained by both the declining incidence of myocardial infarction in the population and the improved survival of patients with myocardial infarction.

Goldberg RJ Gorak EJ Yarzebski J Hosmer DW Dalen P Gore JM A communitywide perspective of sex differences and temporal trends in the incidence and survival rates after acute myocardial infarction and out-of-hospital deaths caused by coronary heart disease. Circulation 1993; 87: 1947–1953.

Chambless L Keil U Dobson A Mahonen M Kuulasmaa K Rajakangas A . Population versus clinical view of case fatality from acute coronary heart disease: results from the WHO MONICA project 1985–1990. Circulation 1997; 96: 3849–3859.

This paper from the MONICA project provides a population perspective on CHD case fatality patterns using cross-sectional data for the period 1985–1990. Approximately two-thirds of 28-day CHD death in both men and women occurred before hospitalisation. It is clear that opportunities for reducing overall case fatality through improved hospital care are limited.

Sonke G Beaglehole R Stewart A Jackson R . Sex differences in case fatality before and after admission to hospital after acute cardiac events: analysis of community based coronary heart disease register. BMJ 1996; 313: 853–855.

Norris RM . Fatality outside hospital from acute coronary events in three British health districts, 1994–1995. BMJ 1998; 316: 1065–1070.

Bonneux L Looman CWN Barendregt JJ Van der Mass PJ . Regression analysis of recent changes in cardiovascular morbidity and mortality in the Netherlands. BMJ 1997; 314: 789–792.

Murray CJL Lopez AD (editors). Global burden of disease. A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Global burden of disease and injury series. Boston: Harvard School of Public Health, WHO and The World Bank, Harvard University Press; 1996.

Hunink MGM Goldman L Tosteson ANA Mittleman MA Goldman PA Williams LW The recent decline in mortality from coronary heart disease, 1980–1990. JAMA 1997; 277: 535–542.

This paper, based on a computer-simulation state-transition model of the population of the USA, explores explanations for the decline in CHD mortality in the period 1980–1990. In contrast to earlier estimates, the authors conclude that reductions in primary and secondary risk factors explain about 50% of the decline in CHD mortality and that most of the decline occurred among patients with CHD.

Vartiainen E Puska P Pekkanen J Tuomilehto J Jousilahti P . Changes in risk factors explain changes in mortality from ischaemic heart disease in Finland. BMJ 1994; 309: 23–27.