Gillum R F, Jacobs D R, Luepker R V, Prineas R J, Hannan P, Baxter J, Gomez-Marin O, Kottke T E, Blackburn H
J Chronic Dis. 1984;37(4):301-9. doi: 10.1016/0021-9681(84)90138-3.
Age-adjusted mortality rates from coronary heart disease (CHD) and other causes were examined in Minnesota for the years 1960-1978. Regions differed in CHD mortality levels and time trends. The greatest decline in CHD mortality occurred in the Twin Cities. The Northeast region had the highest CHD mortality. Influenza and pneumonia death rates were unrelated to CHD trends. Stroke mortality, which also declined sharply, showed no regional differences. Cancer mortality was highest in the Twin Cities and Northeast regions and increased significantly over the period; most of this increase was due to a striking increase in lung cancer mortality. The authors conclude that: (1) the CHD mortality decline in Minnesota was similar to that in the United States; (2) regional differences within the state in CHD mortality levels and trends were statistically significant; (3) CHD trends were not explained by influenza epidemics; (4) regions differed in mortality rates for hypertension in the same way as they did in CHD mortality, but differed little in stroke mortality. This leaves unclear the role of hypertension in regional CHD differences. (5) Trends in cancer mortality indicate that a general decline in mortality, due to factors affecting a wide variety of diseases does not explain the downward trends in CHD mortality.
1960年至1978年间，明尼苏达州对冠心病（CHD）和其他病因的年龄调整死亡率进行了研究。各地区的冠心病死亡率水平和时间趋势存在差异。冠心病死亡率下降幅度最大的是双子城。东北地区的冠心病死亡率最高。流感和肺炎死亡率与冠心病趋势无关。中风死亡率也大幅下降，未显示出地区差异。癌症死亡率在双子城和东北地区最高，且在此期间显著上升；这种上升大部分归因于肺癌死亡率的显著增加。作者得出以下结论：（1）明尼苏达州冠心病死亡率的下降与美国相似；（2）该州内冠心病死亡率水平和趋势的地区差异具有统计学意义；（3）冠心病趋势无法用流感流行来解释；（4）各地区高血压死亡率的差异与冠心病死亡率的差异方式相同，但中风死亡率差异不大。这使得高血压在地区性冠心病差异中的作用尚不明确。（5）癌症死亡率趋势表明，由于影响多种疾病的因素导致的总体死亡率下降并不能解释冠心病死亡率的下降趋势。
