EPIDEMIOLOGY OF DECLINE IN HEART DISEASE MORTALITY

心脏病死亡率下降的流行病学

• 批准号: 2216707
• 负责人: LEWIS H KULLER
• 金额: $ 12.79万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-04-01 至 1996-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2216707
• 关键词: cardiovascular disorder epidemiology; cardiovascular disorder prevention; coronary disorder; death certificates; disease /disorder proneness /risk; heart disorder diagnosis; human mortality; human subject; lifestyle; male; medical records; patient care management; postmortem; sudden cardiac death; young adult human (21-34)

We propose to continue our study of the trends in coronary heart disease mortality among white men aged 35-44 in Allegheny County. We have carefully evaluated the accuracy of the cause of death, the place of death, probable suddeness of death, prior history of heart disease, length of hospitalization, for all cardiovascular and coroner certified non-traumatic deaths between 1970 and 1981. This initial study was a retrospective review of all death certificates certified to coronary heart disease, all other cardiovascular deaths and all nontraumatic, possibly sudden deaths certified by the coroner. The review included autopsy records, coroners reports, hospital records, information from the certifying physician, and interviews with the next of kin or other witnesses. A total of 807 deaths were included in the study, including 556 due to coronary heart disease (CHD). The comparison was then done of the cause of death after the review of the record by the study physicians and the underlying cause of death on the death certificate. An autopsy report was available in about half of the deaths. Coroners records in 50.7%, hospital records in 31.3%, a physician's report in 6.4%, and information from the next of kin in 15.8%. There was agreement as to the cause of death in about 90% of the deaths. During the 12 years of follow-up, CHD death rate declined 50.3%. Approximately 70% of the deaths were outside of the hospital. Over 80% of the decline in the death rate was due to out of hospital deaths mostly sudden. The larger proportion of the decline was due to sudden deaths without a prior history of heart disease, falling from 40.3/1000 in 1972 to 19.6/1000 in 1979-81. The results of this initial study clearly demonstrate: 1) That the decline in CHD mortality is real. 2) That it was predominantly related to out of hospital deaths. 3) That the major factor in the decline is probably sudden deaths and that of the rate of decline of about 5% per year continues in Allegheny County that by the early 1990's or sooner coronary heart disease deaths will practically disappear.

我们建议继续研究冠心病的发展趋势。 阿勒格尼县35-44岁白人男性死亡率。我们有 仔细评估死因的准确性，死亡地点， 可能的意外死亡，有心脏病病史，持续时间 住院，适用于所有心血管疾病和验尸官证明为非创伤性的患者 1970年至1981年间的死亡人数。 这项最初的研究是对所有死亡证明的回顾。 被证明患有冠心病，所有其他心血管死亡和 都是非创伤性的，可能是验尸官证实的猝死。这个 审查包括尸检记录，验尸官报告，医院记录， 来自认证医生的信息，以及与下一位 亲属或其他目击者。共有807例死亡病例被纳入这项研究， 包括因冠心病(CHD)引起的556例。这个对比就是在那时 对研究记录进行审查后的死因 医生和死亡证明上的潜在死因。一个 大约一半的死亡病例都有尸检报告。死因裁判官纪录 50.7%，医院记录31.3%，医生报告6.4%， 来自近亲的信息占15.8%。就以下问题达成了一致： 死因约占死亡总数的90%。在过去的12年里 随访，冠心病死亡率下降50.3%。大约70%的死亡 都在医院外面。死亡率下降的80%以上 是由于医院外死亡，大多是突然死亡。较大比例的 这一下降是由于无心脏病史的猝死所致。 疾病，从1972年的40.3/1000下降到1979-81年的19.6/1000。这个 这项初步研究的结果清楚地表明：1) 冠心病死亡率是真实存在的。2)它主要与Out Out有关 医院死亡。3)下降的主要因素可能是 猝死和以每年约5%的速度下降 在阿勒格尼县持续到20世纪90年代初S或更早的冠心病 心脏病死亡人数将几乎消失。