Cardiovascular disease mortality trends in the western Pacific, 1968-1984

Much attention has been paid in recent years to the declining cardiovascular disease mortality rates in western industrialised countries; far less attention has been paid to other countries. A comparison of 1984 age standardised mortality rates in five western Pacific countries indicates a wide variation for all cause mortality and all cardiovascular disease mortality, with Singapore having rates twice as great as Japan which has the lowest rates. New Zealand has the highest rate of coronary heart disease, and with Australia the lowest rate of stroke mortality. Mortality rates for each disease category studied were lower among women than men for each country. In the period 1968-1984 all countries experienced a decline in all cause mortality. All cardiovascular disease mortality rates have declined in all countries except Singapore; coronary heart disease mortality rates have increased in Singapore. The improvements in stroke mortality in Japan have been dramatic in comparison with the other four countries. These marked variations in absolute levels and secular trends raise intriguing research questions and indicate the potential for prevention in all countries.