CLINICAL STUDIES
Secular trends in cardiovascular disease mortality, incidence, and case fatality rates in adults in the United States
Section snippets
NHANES I epidemiologic follow-up study
The NHANES I comprised a representative sample of the civilian noninstitutionalized population of the United States. The NHANES I survey was conducted between 1971 and 1975, and data collection included medical history, standardized medical examination, dietary history, laboratory tests, and anthropometric measurements (22). The NHANES I Epidemiologic Follow-up Study cohort included 14,407 persons 25 to 74 years of age who had completed the NHANES I medical examination (23). Follow-up data were
Mortality
Overall, age-standardized mortality for cardiovascular disease, coronary heart disease, acute myocardial infarction, and stroke declined significantly between 1971–1982 and 1982–1992 (Figure 1, top panel). These declines were significant in all sex and race groups (Table 1), except for declines in myocardial infarction mortality among white women (−6.3%, P = 0.2). Age, race, and sex-adjusted mortality declined by 31% for cardiovascular disease, 33% for coronary heart disease, 37% for myocardial
Discussion
We found that cardiovascular disease mortality, incidence, and case fatality rates declined in a large national sample of adults from 1971–1982 to 1982–1992, and that age, race, and sex-adjusted cardiovascular disease mortality was 31% lower in the 1982–1992 cohort. This downward trend was similar among all race and sex groups. Further, that the decrease in cardiovascular disease mortality was accompanied by a decline in incidence and improvements in 28-day case fatality and long-term survival
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