Explaining the Decrease in U.S. Deaths from Coronary Disease, 1980–2000

• Published in: The New England journal of medicine Vol. 356; no. 23; pp. 2388 - 2398
• Main Authors: Ford, Earl S, Ajani, Umed A, Croft, Janet B, Critchley, Julia A, Labarthe, Darwin R, Kottke, Thomas E, Giles, Wayne H, Capewell, Simon
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 07.06.2007
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular disease; Coronary Disease - mortality; Coronary Disease - therapy; Coronary heart disease; Female; General aspects; Heart; Humans; Male; Medical sciences; Medical treatment; Middle Aged; Mortality; Mortality - trends; Myocardial Infarction - mortality; Myocardial Infarction - prevention & control; Myocardial Infarction - therapy; Myocardial Revascularization - statistics & numerical data; Risk; Risk Factors; United States - epidemiology; United States; Medicine; Cardiovascular disease; 2000; Death; Coronary heart disease; Mortality
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMsa053935

Mortality due to coronary heart disease has declined substantially in the United States in recent decades. A previously validated model was used to estimate the roles of specific cardiac treatments and changes in risk factors in this decline. Approximately 47% of the decrease in mortality was attributed to therapeutic interventions and 44% to changes in risk factors. Mortality due to coronary heart disease has declined substantially in the United States in recent decades. Approximately 47% of the decrease in mortality was attributed to therapeutic interventions and 44% to changes in risk factors. Rates of death from coronary heart disease in the United States underwent profound secular changes during the 20th century. 1 , 2 After peaking around 1968, age-adjusted rates were cut in half. Two factors may have contributed to this decline. First, there have been substantial decreases in the prevalence of some major cardiovascular risk factors, including smoking, elevated total cholesterol, and high blood pressure. 3 – 8 However, the prevalence of both obesity and diabetes has increased alarmingly. 9 – 11 Second, there has been a revolution in the treatments for established coronary heart disease, with major breakthroughs in evidence-based therapies, including the use of thrombolysis, . . .