Declining mortality rates from ischemic heart disease in Australia.

Ischemic heart disease is the major cause of death in Australia. Australian attack and mortality rates from this disease are high compared with most other countries. Over the last thirty years there have been remarkable changes in heart disease death rates which rose from the 1950's until around 1965-7 and then declined by about 40% over the period 1965-7 to 1980-81. Although the pattern of this decline was similar for most age groups and both sexes it varied among subgroups of the population defined by country of birth, geographic region and occupation. For example, Australian-born men initially had higher death rates than immigrants and they experienced relatively greater declines; Perth and Adelaide (with low initial rates) had similar declines to Sydney and Brisbane (with high rates); professionals (with the lowest rates) had the greatest decline among occupational groups. While the decline in mortality is encouraging the cause is still unclear so control programmes must proceed, to some extent, by guesswork. If the subpopulations with high mortality can achieve rates comparable with subpopulations with low rates further substantial decline in heart disease mortality is possible.