Demirovic J, Blackburn H, McGovern P, Sprafka J M, Doliszny K
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015.
Epidemiology. 1993 Jan;4(1):79-82. doi: 10.1097/00001648-199301000-00015.
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.
美国近期的全国统计数据表明，女性冠心病（CHD）死亡人数的下降速度有所放缓。为了研究明尼苏达心脏调查中近期按性别划分的死亡率下降情况，我们计算了1970 - 1978年和1979 - 1988年期间年龄调整后的冠心病死亡率的年均变化百分比。我们对年度冠心病死亡率拟合了对数线性回归模型，同时针对两个日历时间段分别估计了按性别划分的斜率。1979 - 1988年期间，男性年龄调整后的冠心病死亡率年均下降百分比[4.8%；95%置信区间（CI）= 5.2 - 4.3]略高于1970 - 1978年期间（3.9%；95% CI = 4.6 - 3.1）。相比之下，女性在1979 - 1988年期间的下降率（3.6%；95% CI = 4.8 - 2.3）低于1970 - 1978年期间（4.8%；95% CI = 5.6 - 4.0）。我们发现男性和女性院外冠心病死亡人数的下降速度均有所放缓。与1970 - 1978年期间（2.4%；95% CI = 3.2 - 1.7）相比，1979 - 1988年期间男性医院内冠心病死亡率的下降率大幅上升（8.3%；95% CI = 9.3 - 7.2）。女性中未出现这种上升情况（1970 - 1980年为4.1%；95% CI = 5.7 - 2.5，1970 - 1978年为3.8%；95% CI = 4.9 - 2.7）；这一差异是近期男性总体冠心病死亡率下降幅度大于女性的一个主要因素。
