Epstein F H
Postgrad Med J. 1984 Jan;60(699):15-9. doi: 10.1136/pgmj.60.699.15.
The marked decline in coronary heart disease mortality in the United States since the late 1960s is most likely due in large part to successful efforts at primary prevention, attributable in turn to improved eating habits, better control of blood pressure and a reduction in smoking. Another part of the decline can probably be explained by an improvement in prognosis. It remains to be established if there has been a reduction in morbidity as well as mortality. There are other countries which have experienced declines, though of a lesser degree, while several countries have recorded increases in coronary heart disease mortality. These downward and upward turns, in general, are likewise compatible with the theory that they are caused by corresponding favourable or unfavourable changes in life styles.
自20世纪60年代末以来，美国冠心病死亡率显著下降，这很可能在很大程度上归功于一级预防工作的成功，而这又反过来归因于饮食习惯的改善、血压控制的加强以及吸烟率的降低。死亡率下降的另一部分原因可能是预后的改善。发病率和死亡率是否都有所下降仍有待确定。其他一些国家也出现了死亡率下降的情况，不过降幅较小，而有几个国家冠心病死亡率却有所上升。总体而言，这些升降变化同样符合这样一种理论，即它们是由生活方式相应的有利或不利变化所导致的。
