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Ischemic heart disease mortality declining since 1940.

Ischemic heart disease mortality declining since 1940. to the Editor that non-White males under age 40 and even White males under age 30 experienced a decline in IHD mortality during this period. By 1969, the decline had spread to all age, sex, and color groups, with a tendency toward greater percentage declines among those with the lowest rates, i.e., the young and women. Absolute declines have been greater in the groups with the highest rates, i.e., the old and men. Moriyama, Krueger, and Stamler noted the differential trends among men and women, Blacks and Whites, in the 1940s and 1950s in their monograph and suggested the differential effects of hypertension on IHD risk and mortality as a possible explanation.2 Since then, little attention has been given to this important question. The hypertension hypothesis remains attractive after examination of mortality trends since 1960, a period when the introduction and dissemination of effective pharmacotherapy has accelerated the decline in mortality and morbidity from hypertension and hypertensive heart disease.4 What other factors would have affected first White females, then younger members of other groups to produce a decline in IHD mortality by the 1940s? The greater per cent declines in IHD mortality in females compared to males and Blacks compared to Whites in the 1970s are consistent with the greater relative improvements in hypertension control among these groups.4 A greater emphasis on future research on IHD in Blacks and White women may bear rich fruit in enhancing understanding of the etiology of IHD and the determinants of population trends. Richard F. Gillum, MD Laboratory of Physiological Hygiene School of Public Health University of Minnesota 1. Blackburn H, Gillum R: Heart disease. In: Last J (ed): Public Health and Preventive Medicine. New York: AppletonCentury-Crofts, 1980. 2. Moriyama 1, Krueger DE, Stamler J: Cardiovascular Diseases in the United States. Cambridge: Harvard University 3. Rosenberg HM, Klebba J: Trends in cardiovascular mortality with a focus on ischaemic heart disease: United States 1950-1976. In: Havlik R, Feinleib M (eds): Conference on the Decline in Coronary Heart Disease Mortality. Washington, DC: US Govt Printing Office, 1978, pp 1 1-22. 4. Apostolides AY, Cutter G, Kraus JF, Oberman A, Blaszkowski T, Borhani NO, Entwisle G: Impact of hypertension information on high blood pressure control between 1973 and 1978. Hypertension 1980; 2:708-713. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Public Health American Public Health Association

Ischemic heart disease mortality declining since 1940.

R F Gillum
American Journal of Public Health , Volume 72 (2) – Feb 1, 1982
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Publisher
American Public Health Association
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Copyright © by the American Public Health Association
ISSN
0090-0036
eISSN
1541-0048
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Abstract

to the Editor that non-White males under age 40 and even White males under age 30 experienced a decline in IHD mortality during this period. By 1969, the decline had spread to all age, sex, and color groups, with a tendency toward greater percentage declines among those with the lowest rates, i.e., the young and women. Absolute declines have been greater in the groups with the highest rates, i.e., the old and men. Moriyama, Krueger, and Stamler noted the differential trends among men and women, Blacks and Whites, in the 1940s and 1950s in their monograph and suggested the differential effects of hypertension on IHD risk and mortality as a possible explanation.2 Since then, little attention has been given to this important question. The hypertension hypothesis remains attractive after examination of mortality trends since 1960, a period when the introduction and dissemination of effective pharmacotherapy has accelerated the decline in mortality and morbidity from hypertension and hypertensive heart disease.4 What other factors would have affected first White females, then younger members of other groups to produce a decline in IHD mortality by the 1940s? The greater per cent declines in IHD mortality in females compared to males and Blacks compared to Whites in the 1970s are consistent with the greater relative improvements in hypertension control among these groups.4 A greater emphasis on future research on IHD in Blacks and White women may bear rich fruit in enhancing understanding of the etiology of IHD and the determinants of population trends. Richard F. Gillum, MD Laboratory of Physiological Hygiene School of Public Health University of Minnesota 1. Blackburn H, Gillum R: Heart disease. In: Last J (ed): Public Health and Preventive Medicine. New York: AppletonCentury-Crofts, 1980. 2. Moriyama 1, Krueger DE, Stamler J: Cardiovascular Diseases in the United States. Cambridge: Harvard University 3. Rosenberg HM, Klebba J: Trends in cardiovascular mortality with a focus on ischaemic heart disease: United States 1950-1976. In: Havlik R, Feinleib M (eds): Conference on the Decline in Coronary Heart Disease Mortality. Washington, DC: US Govt Printing Office, 1978, pp 1 1-22. 4. Apostolides AY, Cutter G, Kraus JF, Oberman A, Blaszkowski T, Borhani NO, Entwisle G: Impact of hypertension information on high blood pressure control between 1973 and 1978. Hypertension 1980; 2:708-713.

Journal

American Journal of Public Health – American Public Health Association

Published: Feb 1, 1982

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