Interstate differences in trends in coronary mortality and risk factors in Australia

Mortality from coronary heart disease has declined by approximately 50% in Australia over the past 20 years and now accounts for approximately 25% of all deaths. Most of the decline in mortality from all causes in each State of Australia over the period 1972-1988 is due to the decline in mortality from coronary heart disease. In Tasmania, the rate of decline in mortality from all causes is significantly less in both sexes (P less than 0.01) than in the mainland States, and the discrepancy is due to a lesser decline in mortality from coronary heart disease (P less than 0.01). Trends in deaths related to hypertension show no differences between Tasmania and the other States, which suggests that the discrepancy with coronary heart disease is due to factors other than the prevalence and/or treatment of hypertension. Analysis of trends data on cigarette smoking prevalence, and cross-sectional data on plasma cholesterol levels and diet, shows that Tasmanian differences in food intake (including fat and cholesterol), in plasma cholesterol levels and (to a lesser extent) in cigarette smoking are consistent with, but are unlikely to explain completely, the slower rate of decline in mortality from coronary heart disease.