Incidence of major coronary heart disease events: the experience of the Project "Community Control of Chronic Diseases".

Data on incidence of first major coronary heart disease (CHD) event have been collected in a population sample studied in the control area, the municipality of Priverno in Central Italy, 100 km South-East of Rome as part of a Community Control Project of Chronic Diseases run in nearby communities. Men and women aged 40-69 years, examined in population screenings, were followed-up for variable periods of time ranging from 1 month to 11 years, after exclusion of those already carrier of a previous major CHD event. A total of 1427 men and 1675 women corresponding to a maximum of 9590 and 11499 person/years respectively were followed-up. Diagnostic criteria were based on a number of different items including history and ECG data, from screening examinations; discharge records from local hospitals; causes of death from death certificates; and information from mail questionnaires. Four hundred and forty-six men and 501 women were considered partially non respondent since they were examined only once, they did not answer the postal questionnaire, although they were surely alive at the end of the observation period. Incidence estimates were based on different denominators, including or excluding these non respondents. The age adjusted lower incidence estimate was of 40.7 per 10000 person/years among men and 19.7 among women; the higher estimate was of 51.3 and 24.4 per 10000 person/years respectively. Rates were higher among men than among women and were increasing with aging. These incidence rates were slightly lower than those reported from other population studies conducted in Italy in the 1970's and the 1980's, but were in line with the hypothesis of a declining incidence paralleling the decline in CHD mortality. These data, including also estimates in women, represent a reference point for the early 1990's of the frequency and distribution of major CHD events.