Roger V L, Jacobsen S J, Weston S A, Bailey K R, Kottke T E, Frye R L
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic Rochester, Minn. 55905, USA.
Mayo Clin Proc. 1999 Jul;74(7):651-7. doi: 10.4065/74.7.651.
Although age-adjusted heart disease mortality has declined since the 1960s, this decline may not have applied equally to all subgroups.
To examine recent trends in heart disease mortality, specifically in women and in the elderly.
Age- and sex-specific heart disease mortality (International Classification of Diseases, Ninth Edition, Clinical Modification [ICD-9-CM] codes 390-398, 402, 404-429) in Olmsted County, Minnesota, between 1979 and 1994 were studied.
The total number of heart disease deaths was 3095; 1578 (51%) occurred in women and 1984 (64%) in persons aged 75 years or older. Most heart disease deaths (77%) were coronary disease deaths (ICD-9-CM codes 410-414). Age-adjusted heart disease mortality rates declined from 123 per 100,000 (95% confidence interval [CI], 102-144/100,000) in 1979 to 81 per 100,000 (95% CI, 67-95/100,000) in 1994. Poisson regression analyses indicated that the trends differed according to sex and age. For women, the relative risk (RR) of heart disease death in 1994 compared with 1979 was 0.69 vs 0.53 for men (P = .06). This equates to a decline in heart disease mortality of 2.5% per year in women or 32% over the period and 4.2% per year in men or 47% over the period. The decline was less pronounced as age increased (P < .001). For 60-year-old women, the RR for 1994 compared with 1979 was 0.59, whereas for 80-year-old women, the RR for 1994 compared with 1979 was 0.76. For men, the RR for 1994 compared with 1979 was 0.60 for 80-year-old men vs 0.46 for 60-year-old men.
Between 1979 and 1994, in Olmsted County, the decline in heart disease mortality was of lesser magnitude in women and in the elderly, emphasizing the importance of age- and sex-specific trends to characterize time patterns in heart disease deaths to target preventive measures.
尽管自20世纪60年代以来，年龄调整后的心脏病死亡率有所下降，但这种下降可能并非在所有亚组中都同样适用。
研究心脏病死亡率的近期趋势，特别是女性和老年人的趋势。
对明尼苏达州奥尔姆斯特德县1979年至1994年间按年龄和性别分类的心脏病死亡率（国际疾病分类第九版临床修订本[ICD-9-CM]编码390 - 398、402、404 - 429）进行了研究。
心脏病死亡总数为3095例；1578例（51%）发生在女性中，1984例（64%）发生在75岁及以上人群中。大多数心脏病死亡（77%）为冠心病死亡（ICD-9-CM编码410 - 414）。年龄调整后的心脏病死亡率从1979年的每10万人123例（95%置信区间[CI]，102 - 144/10万）下降到1994年的每10万人81例（95%CI，67 - 95/10万）。泊松回归分析表明，趋势因性别和年龄而异。1994年与1979年相比，女性心脏病死亡的相对风险（RR）为0.69，男性为0.53（P = 0.06）。这相当于女性心脏病死亡率每年下降2.5%，在此期间下降32%；男性每年下降4.2%，在此期间下降47%。随着年龄增长，下降趋势不那么明显（P < 0.001）。对于60岁女性，1994年与1979年相比的RR为0.59，而对于80岁女性，1994年与1979年相比的RR为0.76。对于男性，80岁男性1994年与1979年相比的RR为0.60，60岁男性为0.46。
1979年至1994年间，在奥尔姆斯特德县，女性和老年人的心脏病死亡率下降幅度较小，这强调了按年龄和性别划分的趋势对于描述心脏病死亡时间模式以确定预防措施的重要性。
