Changes in risk factors explain changes in mortality from ischaemic heart disease in Finland.

OBJECTIVES

To estimate the extent to which changes in the main coronary risk factors (serum cholesterol concentration, blood pressure, and smoking) explain the decline in mortality from ischaemic heart disease and to evaluate the relative importance of change in each of these risk factors.

DESIGN

Predicted changes in ischaemic heart disease mortality were calculated by a logistic regression model using the risk factor levels assessed by cross sectional population surveys, in 1972, 1977, 1982, 1987, and 1992. These predicted changes were compared with observed changes in mortality statistics.

SETTING

North Karelia and Kuopio provinces, Finland.

SUBJECTS

14,257 men and 14,786 women aged 30-59 randomly selected from the national population register.

MAIN OUTCOME MEASURES

Levels of the risk factors and predicted and observed changes in mortality from ischaemic heart disease.

RESULTS

The observed changes in the risk factors in the population from 1972 to 1992 predicted a decline in mortality from ischaemic heart disease of 44% (95% confidence interval 37% to 50%) in men and 49% (37% to 59%) in women. The observed decline was 55% (51% to 58%) and 68% (61 to 74) respectively.

CONCLUSION

An assessment of the data on the risk factors for ischaemic heart disease and mortality suggests that most of the decline in mortality from ischaemic heart disease can be explained by changes in the three main coronary risk factors.