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American Journal of Epidemiology Vol. 142, No. 1: 45-52
Copyright © 1995 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Coronary Heart Disease Mortality and Sudden Death: Trends and Patterns in 35- to 44-Year-old White Males, 1970–1990

Neal D Traven1,, Lewis H Kuller1, Diane G lves1, Gale H Rutan2 and Leena Perper1,3

1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh Pittsburgh, PA.
2Medical Service (11C), Department of Veterans Affairs Medical Center Memphis, TN
3Medical Examiner's Office, Broward County Fort Lauderdale,FL

Reprint requests to Dr. Neal D. Traven, Department of Epidemiology,Graduate School of Public Health, University of Pittsburgh,Pittsburgh, PA 15261.

Trends in coronary heart disease mortality and sudden death were studied in 35- to 44-year-old white male residents of Allegheny County, Pennsylvania. Deaths coded as any cardiac or vascular disease, diabetes,unexplained sudden death, and other rubrics were eligible for investigation, and the cause of death was validated by physicians examining multiple data sources about the deaths. During 1970–1990, 1,424 white male deaths were investigated, with 903 validated as coronary heart disease. In that time span, white male coronary heart disease mortality fell from 93.4 to 36.7 per 100,000 population per year, a 60% decline. Little proportionate change was seen in characteristics of the deaths, which were predominantly sudden and out-of-hospital. Diabetes mellitus history increased proportionately over time, largely because diabetics' mortality rates, unlike those of all other subgroups, did not fall. These observations support the contention that the decline in coronary heart disease mortality relates to risk factor modification more than to improvements in the treatment of coronary heart disease. Differences in death certification practices must be considered when interpreting and comparing vital statistics data. Am J Epidemiol 1995;142:45–52.

adult; cause of death; coronary disease; death; sudden; mortality


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