A recent increase in asthma mortality in the northwestern United States

Epidemiologic studies have suggested a recent increase in asthma mortality in New Zealand and the United States. Vital statistics were used to calculate asthma mortality rates for Washington and Oregon from 1972 through 1983, adjusting for the nosologic redefinition of asthma in 1979. Between 1977 and 1983, age-adjusted mortality from asthma increased 82% in these two states. The combined age-specific asthma mortality rates for Washington and Oregon showed that the increase was concentrated in the greater than or equal to 75 age group, in which mortality increased from 4.7 to 12.0 per 100,000 between 1977 and 1983. A significant increasing trend in the proportion of death certificates listing a cardiac dysrhythmia along with asthma as a cause of death was observed overall, in the State of Washington alone, and in decedents 75 or more years of age. The same trend was not statistically significant in Oregon or among younger decedents. This increase in asthma mortality may be due to a change in therapy such as an increased reliance on beta-agonists and theophylline preparations in combination, a change in the clinical definition of asthma, or other as yet unrecognized factors. Further investigation of these findings is warranted.