Demographic characteristics and trends in arteriosclerotic heart disease mortality: Sudden death and myocardial infarction.

The Baltimore Study of Sudden Death and Myocardial Infarction was a two-year project to investigate the epidemiological, clinical and pathological characteristics of sudden death and myocardial infarction in a defined population. The incidence of sudden death was much higher in men than women for both blacks and whites. Blacks and white women had a similar incidence of transmural myocardial infarction, but white men had a much higher incidence of transmural myocardial infarction than black men. White men who died suddenly had twice as many coronary thrombi at postmortem examination than black men and a greater extent of coronary artery stenosis than the other three race-sex groups. Black men had a higher prevalence of heart weights greater than 500 grams. Women who died suddenly were more often not married and smoked more cigarettes than neighborhood controls. Nine of 39 white women who died suddenly due to ASHD had a definite prior psychiatric history. The ASHD death rates have been declining in the 45 to 64 age groups, especially for white men. However, a comparison of the 1964 and 1970-72 sudden death studies in Baltimore reveals that the same percentage of ASHD deaths were sudden unwitnessed, occurred in a hospital or had a prior history of heart disease in both time periods.