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Trends in coronary heart disease event rates in New Zealand
Insights
Sudden cardiac death rates declined significantly in New Zealand between 1974 and 1981. This reduction, particularly in younger individuals and those with prior myocardial infarction, contributed to falling coronary heart disease mortality.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Coronary heart disease (CHD) mortality rates have shown recent declines in New Zealand.
- Understanding the specific causes of this decline is crucial for public health initiatives.
Purpose of the Study:
- To investigate the factors contributing to the observed decrease in CHD death rates in New Zealand.
- To analyze changes in myocardial infarction and sudden death event rates between 1974 and 1981.
Main Methods:
- Established a myocardial infarction and sudden death register in the Auckland region.
- Utilized routine and nonroutine case-finding methods.
- Compared event rates from March 1, 1981, to estimates from a 1974 study.
Main Results:
- In 1981, 1,093 myocardial infarction and/or sudden death events were registered in individuals aged 25-69.
- Age-standardized event rates for total myocardial infarction and sudden death were 506/100,000 for men and 139/100,000 for women.
- No significant change in myocardial infarction event rates or 28-day case fatality was observed.
- A significant decline in the sudden death rate was noted, decreasing from 139/100,000 to 117/100,000.
- The decline in sudden death rates was most pronounced in individuals under 50 and those with a history of myocardial infarction.
Conclusions:
- The decline in overall CHD mortality is primarily attributable to a reduction in sudden cardiac death rates.
- Interventions targeting sudden cardiac death prevention appear effective, especially in younger populations and those with previous heart attacks.
Abstract:
To examine the reasons for the recent decline in coronary heart disease death rates in New Zealand, a register of definite myocardial infarction and sudden death was established in the Auckland region (1981 population 829,464). Both routine and nonroutine case finding sources were used and event rates for the 12 months from March 1, 1981, were compared with estimates from an earlier study conducted in 1974. In 1981, 1,093 myocardial infarction and/or sudden death events in people 25-69 years of age were registered. The age standardized event rates for the total of myocardial infarction and sudden death were 506/100,000 and 139/100,000 for men and women, respectively. Over the seven-year period from 1974 there was no change in the event rate or 28-day case fatality of definite myocardial infarction, but a significant decline in the rate of sudden death occurred from 139/100,000 to 117/100,000. The decline in the sudden death rate was particularly marked in people under the age of 50 years and in subjects with a prior history of myocardial infarction.