Heart 2001;86:499-505 ( November )

Cardiovascular medicine

Is the prevalence of coronary heart disease falling in British men? F C Lampe^a, R W Morris^a, P H Whincup^b, M Walker^a, S Ebrahim^c, A G Shaper^a

^a Cardiovascular Research Unit, Department of Primary Care and Population Sciences, Royal Free and UCL Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK, ^b Department of Public Health Sciences, St Georges Hospital Medical School, London SW17 0RE, UK, ^c Department of Social Medicine, University of Bristol, Bristol BS8 2PR, UK

Correspondence to: F Lampe f.lampe{at}pcps.ucl.ac.uk

Accepted 11 July 2001

OBJECTIVETo assess whether long term trends over time in acute coronary heart disease (CHD) event rates have influenced the burden of prevalent CHD in British men.
DESIGNLongitudinal cohort study.
PARTICIPANTS7735 men, aged 40-59 at entry (1978-80), selected from 24 British towns.
METHODSThe prevalences of current angina symptoms and history of diagnosed CHD were ascertained by questionnaire in 1978-80, 1983-85, 1992, and 1996. New major CHD events (fatal and non-fatal) were ascertained throughout the study from National Health Service central registers and general practice record reviews. Age adjusted trends in CHD prevalence were compared with trends in major CHD event rates.
RESULTSFrom 1978-1996 there was a clear decline in the prevalence of current angina symptoms: the age adjusted annual percentage change in odds was -1.8% (95% confidence interval (CI) -2.8% to -0.8%). However, there was no evidence of a trend in the prevalence of history of diagnosed CHD (annual change in odds 0.1%, 95% CI -1.0% to 1.2%). Over the same period, the CHD mortality rate fell substantially (annual change -4.1%, 95% CI -6.5% to -1.6%); rates of non-fatal myocardial infarction, all major CHD events, and first major CHD event fell by -1.7% (95% CI -3.9% to 0.5%), -2.5% (95% CI -4.1% to -0.8%), and -2.4% (95% CI% -4.3 to -0.4%), respectively.
CONCLUSIONSThese results suggest that middle aged British men are less likely to experience symptoms of angina than in previous decades but are just as likely to have a history of diagnosed CHD. Despite falling rates of new major events and falling symptom prevalence, the need for secondary prevention among middle aged men with established CHD is as great as ever.


Keywords: coronary heart disease; angina; prevalence; trends

---

© 2001 by Heart
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• O'Flaherty, M, Ford, E, Allender, S, Scarborough, P, Capewell, S (2008). Coronary heart disease trends in England and Wales from 1984 to 2004: concealed levelling of mortality rates among young adults. Heart 94: 178-181 [Abstract] [Full Text]  
• Davies, A. R., Smeeth, L., Grundy, E. M. D. (2007). Contribution of changes in incidence and mortality to trends in the prevalence of coronary heart disease in the UK: 1996 2005. Eur Heart J 28: 2142-2147 [Abstract] [Full Text]  
• Capewell, S, Murphy, N F, MacIntyre, K, Frame, S, Stewart, S, Chalmers, J W T, Boyd, J, Finlayson, A, Redpath, A, McMurray, J J V (2006). Short-term and long-term outcomes in 133 429 emergency patients admitted with angina or myocardial infarction in Scotland, 1990-2000: population-based cohort study. Heart 92: 1563-1570 [Abstract] [Full Text]  
• Murphy, N F, Simpson, C R, MacIntyre, K, McAlister, F A, Chalmers, J, McMurray, J J V (2006). Prevalence, incidence, primary care burden and medical treatment of angina in Scotland: age, sex and socioeconomic disparities: a population-based study. Heart 92: 1047-1054 [Abstract] [Full Text]  
• Kattainen, A., Salomaa, V., Harkanen, T., Jula, A., Kaaja, R., Kesaniemi, Y. A., Kahonen, M., Moilanen, L., Nieminen, M. S., Aromaa, A., Reunanen, A. (2006). Coronary heart disease: from a disease of middle-aged men in the late 1970s to a disease of elderly women in the 2000s. Eur Heart J 27: 296-301 [Abstract] [Full Text]  
• Lampe, F. C, Morris, R. W, Walker, M., Shaper, A G., Whincup, P. H (2005). Trends in rates of different forms of diagnosed coronary heart disease, 1978 to 2000: prospective, population based study of British men. BMJ 330: 1046- [Abstract] [Full Text]  
• Fox, K. F (2005). Investigation and management of chest pain. Heart 91: 105-110 [Full Text]  
• Stewart, S, MacIntyre, K, Capewell, S, McMurray, J J V (2003). Heart failure and the aging population: an increasing burden in the 21st century?. Heart 89: 49-53 [Abstract] [Full Text]  
• MacIntyre, K, Pell, J P, Morrison, C E (2002). Is the prevalence of coronary heart disease falling in British men?. J. Epidemiol. Community Health 56: 404-404 [Full Text]