 |
|
Recent Trends in the Prevalence of Coronary DiseaseA Population-Based Autopsy Study of Nonnatural Deaths
Peter N. Nemetz, PhD;
Véronique L. Roger, MD, MPH;
Jeanine E. Ransom, BS;
Kent R. Bailey, PhD;
William D. Edwards, MD;
Cynthia L. Leibson, PhD
Arch Intern Med. 2008;168(3):264-270.
Background Despite increases in obesity and diabetes mellitus, mortality caused by coronary disease continues to decline. Recent trends in coronary disease prevalence are unknown.
Methods There were 3237 deaths among Olmsted County, Minnesota, residents aged 16 through 64 years during the 1981-2004 period. Of the 515 due to accident, suicide, homicide, or a manner that could not be determined, 425 individuals (82%) had coronary anatomy graded. Pathology reports were reviewed for the grade of coronary disease (range, 0-5) assigned each of 4 arteries: left anterior descending (LAD), left circumflex (LCx), right coronary artery (RCA), and left main artery (LMA). High-grade disease was defined as more than a 75% reduction in cross-sectional luminal area (grade  4) in any of LAD, LCx, or RCA or more than 50% reduction (grade 3) in LMA. Evidence of any disease was defined as a grade higher than 0 in any artery. Calendar-year trends were analyzed as linear and nonlinear functions.
Results Over the full period (1981-2004), 8.2% of the 425 individuals had high-grade disease, and 83% had evidence of any disease. Age- and sex-adjusted regression analyses revealed temporal declines over the full period (1981-2004) for high-grade disease, any disease, and grade of coronary disease. Declines in the grade of coronary disease ended after 1995 (P  .01 for every artery) and possibly reversed after 2000 (P = .06 for LCx).
Conclusions Declines in coronary disease prevalence overall (during 1981-2004) reinforce arguments that any increased prevalence resulting from improved survival among persons with disease was offset by reductions in disease incidence. Study findings suggest that declines in coronary disease prevalence have ended. The question of whether recent trends are attributable to increasing obesity and diabetes mellitus awaits further investigation.
Author Affiliations: Sauder School of Business, University of British Columbia, Vancouver, British Columbia, Canada (Dr Nemetz); and Departments of Health Sciences Research (Drs Nemetz, Roger, Bailey, Leibson and Ms Ransom), Internal Medicine (Dr Roger), and Laboratory Medicine (Dr Edwards), Mayo Clinic College of Medicine, Rochester, Minnesota.
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLE
The Canary in the Coal Mine of Coronary Artery Disease
S. Jay Olshansky and Victoria Persky
Arch Intern Med. 2008;168(3):261.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
New Forecasting Methodology Indicates More Disease And Earlier Mortality Ahead For Today's Younger Americans
Reither et al.
Health Aff (Millwood) 2011;30:1562-1568.
ABSTRACT
| FULL TEXT
Reproductive Hormones and Obesity: 9 Years of Observation From the Study of Women's Health Across the Nation
Sutton-Tyrrell et al.
Am J Epidemiol 2010;171:1203-1213.
ABSTRACT
| FULL TEXT
Novel therapeutic concepts * The epidemic of cardiovascular disease in the developing world: global implications
Gersh et al.
Eur Heart J 2010;31:642-648.
ABSTRACT
| FULL TEXT
Pace of change in coronary heart disease mortality in Finland, Ireland and the United Kingdom from 1985 to 2006
O'Hara et al.
Eur J Public Health 2008;18:581-585.
ABSTRACT
| FULL TEXT
Which Measures of Obesity Best Predict Cardiovascular Risk?
Litwin
J Am Coll Cardiol 2008;52:616-619.
FULL TEXT
The Canary in the Coal Mine of Coronary Artery Disease
Olshansky and Persky
Arch Intern Med 2008;168:261-261.
FULL TEXT
|
