CHD in Australia and New Zealand

Death rates from coronary heart disease (CHD) have been declining in Australia and New Zealand for 20 years. Data from the three MONICA Project Centres in Newcastle (Australia), Perth (Australia), and Auckland (New Zealand) show similar trends for fatal CHD but differing trends for non-fatal myocardial infarction (MI). In Auckland, there has been a consistent decline in out-of-hospital death rates but no decline in non-fatal MI rates. In Perth, the greater contribution to the overall decline has been from out-of-hospital deaths, but in-hospital death rates and non-fatal MI rates have also declined. There is also some evidence of an increase in survival following MI in Perth. In Newcastle, both death rates and non-fatal MI rates have declined. The limited data available suggest that at least one-half of the decline in mortality can be attributed to improvements in population risk-factor levels. Improvements in medical management of both risk factors and established disease are also making contributions to the decline.