American Journal of Epidemiology Vol. 151, No. 3: 283-292
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
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Social Patterning of Myocardial Infarction and Stroke in Sweden: Incidence and Survival
1Department of Medicine, Umeå University Umeå;, Sweden
2Center for Epidemiology, National Swedish Board of Health and Welfare Stockholm, Sweden
3Department of Medicine, Kalix Hospital Kalix, Sweden
Reprint requests to Dr. Markku Peltonen, SOS Secretariat, Institute of Internal Medicine, Sahlgrenska University Hospital, SE- 413 45 Goteborg, Sweden
Cardiovascular disease morbidity and mortality rates show marked social patterning in industrialized countries. The aim of this study was to analyze if not only incidence but also survival after acute myocardial infarction (AMI) and stroke differ among socioeconomic groups. Within the framework of the population-based World Health Organization's Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) Project, all first-ever AMI (ages 25–64 years) and stroke (ages 25–74 years) events were recorded in northern Sweden during the period 1985–1994. The numbers of first-ever AMI and stroke patients included in the study were 3, 466 and 4, 215, respectively. Incidence rates for both AMI and stroke showed a distinct social pattern, with high rates in workers and self-employed nonprofessionals and low rates in professionals. The pattern was similar in men and women. In men, early survival after an AMI follows the same socioeconomic pattern, whereas it is less clear if socioeconomic differences in survival contribute to explain differences in mortality in AMI among women and mortality in stroke (both sexes). The high case fatality among male workers and self-employed professionals with AMI is, in turn, attributed to a very marked increase in the risk for sudden death. Am J Epidemiol 2000; 151: 283–92.
cardiovascular diseases; cerebrovascular disorders; incidence; myocardial infarction; social class; survival rate
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