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Discordant age and sex-specific trends in the incidence of a first coronary heart disease event in Western Australia from 1996 to 2007
  1. Tom Briffa1,
  2. Lee Nedkoff1,
  3. Anna Peeters2,
  4. Andrew Tonkin2,
  5. Joseph Hung3,
  6. Stephen C Ridout1,
  7. Matthew Knuiman1
  1. 1School of Population Health, University of Western Australia, Crawley, Western Australia, Australia
  2. 2Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
  3. 3Sir Charles Gairdner Hospital Unit and University of Western Australia, Perth, Australia
  1. Correspondence to Professor Tom Briffa, M431, School of Population Health, University of Western Australia, 35 Stirling Hwy, Crawley WA 6009, Australia; tom.briffa{at}


Objective To determine age- and sex-specific population trends in fatal and non-fatal first coronary heart disease (CHD) events in Western Australia from 1996 to 2007.

Design Longitudinal retrospective population study.

Setting State-wide population.

Patients All residents aged 35–84 years during 1996–2007 who died or were hospitalised with a principal diagnosis of acute CHD.

Data sources Person-linked file of mortality and morbidity records.

Main outcome measures Age-standardised (35–84 years) and age-specific (35–54, 55–69, 70–84 years) rates by gender for a first CHD event were calculated with a 10-year lead-in period to define first events.

Results From 1996 to 2007 there were 36 631 first CHD events, including 8518 (23%) fatal cases in those aged 35–84 years. Overall, age-adjusted rates for fatal first CHD declined 5.3%/year in men (95% CI −6.1% to −4.6%) and 6.5%/year in women (95% CI −7.5% to −5.5%). However, age-specific fatal first CHD rates were neutral in both men aged 35–54 years (0.1%/year; 95% CI −1.8% to 2.1%) and women of the same age, (−1.6%/year; 95% CI −5.6% to 2.5%). Age-specific trends in non-fatal CHD rates reflected the same trends in fatal CHD events in men and women, with rates reportedly increasing in women aged 35–54 years (2.5%/year (95% CI 1.1% to 3.9%).

Conclusion The age-specific decline in fatal and non-fatal first CHD rates in older men and women was not observed in those aged 35–54 years. These novel findings provide evidence for a levelling in the CHD incidence rates in younger adults and puts renewed importance on primary prevention in this group.

  • Coronary heart disease
  • incidence
  • mortalityage-specific
  • primary prevention
  • epidemiology

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  • Funding This work was supported by University of Western Australia and the National Health and Medical Research Council.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Human Research Ethics Committee of the University of Western Australia and the Confidentiality of Health Information Committee of the Western Australian Department of Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.