Circulation. 2010 Mar 23;121(11):1280-2. doi: 10.1161/CIR.0b013e3181d98478. Epub 2010 Mar 8.
Following a peak in the mid 1960s, there has been a steady decline in coronary heart disease (CHD) mortality in the United States of 2.8%/y to 5.1%/y. This shift in mortality patterns is most dramatic in the age-adjusted rates. Age adjustment compensates for the transition of CHD in older age groups and the increase in the aged population. The absolute number of total CHD deaths showed little change until recently (Figure 1). Life expectancy of adults dramatically increased, largely as a result of these improved CHD outcomes. However, the reduction in mortality was not associated with a decline in hospital morbidity as CHD was pushed into the older age groups. Prevalence actually increased with more individuals diagnosed, treated, and surviving. CHD hospitalizations for those >65 years of age increased from 1965 to 2000 while declining in younger age groups.
20 世纪 60 年代中期达到峰值后，美国的冠心病死亡率呈稳步下降趋势，每年下降 2.8%至 5.1%。这种死亡率模式的转变在年龄调整率上最为明显。年龄调整可以补偿年龄较大人群中冠心病的转变和老年人口的增加。直到最近，冠心病总死亡人数的绝对数量几乎没有变化（图 1）。成年人的预期寿命大幅增加，这主要是由于这些改善的冠心病结果。然而，死亡率的降低与医院发病率的下降无关，因为冠心病已被推向老年人群。随着更多的人被诊断、治疗和存活，患病率实际上有所增加。65 岁以上人群的冠心病住院率从 1965 年到 2000 年增加，而在年轻人群中则下降。
