Gillum R F, Folsom A R, Blackburn H
Am J Med. 1984 Jun;76(6):1055-65. doi: 10.1016/0002-9343(84)90857-x.
By 1979, mortality rates for coronary heart disease had declined for 14 consecutive years in the United States. Preliminary data indicate a continued decline. This review of reports published in the last five years documents the consistency of most data with the following hypotheses: (1) Reductions in population levels of hypertension and cigarette smoking have contributed to the decline in mortality from coronary heart disease. (2) Improved medical care for acute myocardial infarction has also contributed to the decline. Data are lacking to specify the contributions of changes in other risk factors, emergency medical services, medical care of chronic coronary heart disease, or other changes in the physical and social environment. Long-term, simultaneous surveillance of mortality, morbidity, medical care, and risk factors should be supported in five to 10 centers around the United States.
到1979年，美国冠心病死亡率已连续14年下降。初步数据表明这一下降趋势仍在持续。对过去五年发表的报告进行的这项综述证明，大多数数据与以下假设一致：（1）人群高血压水平和吸烟率的降低促成了冠心病死亡率的下降。（2）对急性心肌梗死医疗护理的改善也促成了这一下降。目前缺乏数据来明确其他风险因素的变化、急救医疗服务、慢性冠心病的医疗护理或身体及社会环境的其他变化所起的作用。应在美国五至十个中心支持对死亡率、发病率、医疗护理和风险因素进行长期同步监测。
