Change in mortality from coronary heart disease and stroke in Arkansas (1979 to 2007)

Area of Science:

• Public Health and Epidemiology
• Cardiovascular Disease Research

Background:

• Southern states historically exhibit higher coronary heart disease (CHD) and stroke mortality rates compared to the rest of the US.
• While national CHD and stroke mortality have declined over three decades, the trend in Southern states remained unclear.

Purpose of the Study:

• To investigate CHD and stroke mortality trends in Arkansas from 1979 to 2007.
• To explore potential contributing factors to observed mortality changes in the region.

Main Methods:

• Analysis of CHD and stroke-related death records in Arkansas between 1979 and 2007.
• Examination of concurrent trends in obesity, hypertension, diabetes mellitus, physical inactivity, poverty, and per capita cigarette sales.

Main Results:

• Observed a marked and steady decrease in both CHD and stroke death rates in Arkansas during the study period.
• Concurrent increase in obesity, hypertension, and diabetes mellitus prevalence, alongside decreased physical inactivity and poverty.
• A significant decrease in per capita cigarette sales closely paralleled the decline in CHD and stroke mortality.

Conclusions:

• While cardioprotective drugs and revascularization may have contributed, reduced cigarette smoking is strongly suggested as a primary driver of decreased CHD and stroke mortality in Arkansas.
• This study highlights the significant public health impact of smoking cessation on cardiovascular and cerebrovascular disease outcomes in a historically high-mortality region.