First myocardial infarction in a Dutch general practice population: trends in incidence from 1975-2003
Carel Bakx1, Judith Schwarte, Henk van den Hoogen
1Department of Family Medicine, University Medical Centre, Nijmegen, The Netherlands. C.Bakx@hag.umcn.nl
Insights
The incidence of first myocardial infarctions has declined since 1986, particularly in men, suggesting primary prevention efforts may be effective. This study tracked first-time heart attacks in a general practice population.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Morbidity registrations often do not differentiate between first and subsequent myocardial infarctions (MIs).
- The extent to which falling MI rates are due to lower first MI incidences remains unclear.
Purpose of the Study:
- To investigate the incidence of first myocardial infarctions (MIs) within a general practice population.
- To analyze trends in first MI incidence and related mortality.
Main Methods:
- Utilized data from the Continuous Morbidity Registration (CMR) Nijmegen (1975-2003).
- Calculated sex-specific and age-specific yearly incidence rates.
- Employed Poisson regression to analyze trends in first MI incidence.
Main Results:
- Identified 827 first myocardial infarctions (MIs) during the study period.
- First MI incidence declined since 1986 to 2.1/1000 (men) and 1.5/1000 (women).
- Sudden cardiac death from first MI significantly decreased since 1986.
Conclusions:
- A significant decline in first myocardial infarction (MI) incidence was observed, more pronounced in men.
- A mean annual decline of 3.5% in first MI deaths since the mid-1980s suggests potential primary prevention impact.
- The average age for a first MI increased in men, indicating a shift in risk factors or protective effects.
Background:
As morbidity registrations generally do not make distinct first and following myocardial infarctions, it is still unclear as to what extent the falling rates of myocardial infarctions are caused by lower incidences of first myocardial infarctions.
Aim:
To investigate the incidence of first myocardial infarctions in a general practice population.
Method:
Data were taken from the Continuous Morbidity Registration (CMR) Nijmegen, which has been collecting data from four general practices since 1971. For the 1975-2003 period, sex-specific and age-specific yearly incidence rates were obtained from the registration data of the CMR. Trends were studied with Poisson regression.
Results:
During the study period, 827 patients with a first myocardial infarction were identified. The incidence of first myocardial infarctions has declined since 1986 to 2.1 per 1000 for men and to 1.5 per 1000 for women. The average age of getting a first myocardial infarction increased with 3 years for men and slightly decreased for women. Since 1986, the incidence of sudden cardiac death from a first myocardial infarction has considerably declined for men and women to 0.9 and 0.7 per 1000 respectively.
Conclusion:
A slight, significant, decline in incidence of first myocardial infarctions was found. From the mid eighties a mean annual decline of 3.5% in death from first myocardial infarction was observed. Though the variance in rates of coronary heart diseases is not unambiguous, this may indicate an effect of primary prevention. The decline was more pronounced in men, with an increasing age of getting a first myocardial infarction.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:29Angina III: Clinical Manifestations and Assessment
01:30Coronary Artery Disease III: Clinical Manifestations
01:27Coronary Artery Disease V: Interprofessional Care