Sex differences in coronary heart disease mortality trends: the Minnesota Heart Survey, 1970-1988.

Recent U.S. national statistics indicate a slowing of the rate of decline in coronary heart disease (CHD) deaths among women. To examine recent sex-specific rates of mortality decline in the Minnesota Heart Survey, we computed the average annual percentage change in age-adjusted CHD death rate for the periods 1970-1978 and 1979-1988. We fit a log-linear regression model to the yearly CHD death rates, with separate sex-specific slopes estimated simultaneously for the two calendar periods. The average annual percentage decline in age-adjusted CHD death rate among men was slightly greater in the period 1979-1988 [4.8%; 95% confidence interval (CI) = 5.2-4.3] than in the period 1970-1978 (3.9%; 95% CI = 4.6-3.1). In contrast, among women, the rate of decline was less in the period 1979-1988 (3.6%; 95% CI = 4.8-2.3) than in 1970-1978 (4.8%; 95% CI = 5.6-4.0). We found a slowing of the rate of decline in out-of-hospital CHD deaths in both men and women. We observed a large increase in the rate of decline in the CHD death rate in hospital among men in the period 1979-1988 (8.3%; 95% CI = 9.3-7.2), compared with the period 1970-1978 (2.4%; 95% CI = 3.2-1.7). This increase did not occur among women (4.1%; 95% CI = 5.7-2.5 in 1970-1980 vs 3.8%; 95% CI = 4.9-2.7 in 1970-1978); this difference is a major factor in the steeper recent decline in overall CHD mortality among men compared with women.