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Coronary heart disease epidemics
University of Sao Paulo, Sao Paulo, Brazil
Correspondence to:
Dr P A Lotufo, University of Sao Paulo, av Lineu Prestes 2565 Sao Paulo, 05508-000 Brazil; palotufo@hu.usp.br
| The first 150 words of the full text of this article appear below. |
To the editor: We have some comments about the paper by Mirzaei and colleagues.1 The authors pointed out correctly that differences in coronary heart disease (CHD) among countries might be due to variations in classification for cause of death certification and in coding practices. To avoid the influence of ascertainment biases in death certification, we propose a parallel analysis of the broader category of "non-rheumatic heart disease and hypertension" to compare with CHD mortality trends, as applied by Epstein.2 In our opinion, the most important challenge to be faced when describing CHD epidemics is to take into account stroke as a competing cause of death. An example of this was seen in Brazil (a federation of 26 states), where the peak of CHD deaths was first seen in states where the magnitude of stroke rates was lower than that of CHD.3
Additionally, other epidemiological factors must be taken into
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- The authors’ reply:
- M Mirzaei, A S Truswell, R Taylor, and S R Leeder
Heart 2009 95: 1192.[Extract] [Full Text] [PDF]
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