Descriptive epidemiology of acute myocardial infarction in Kuwait, 1978

In 1978 there were 428 cases of acute myocardial infarction (AMI) among the 18 000 patients admitted to the medical wards of the two main general hospitals in Kuwait; of these, 360 (84%) were males and 171 (40%) were Kuwaitis. The male crude incidence rate (13.1 per 10 000 population per year) was 3.7 times the female rate; male age-group specific rates were greater than corresponding female rates for all age groups, although the ratio of male to female rates decreased with increasing age. AMI incidence rates increased with increasing age in both sexes for Kuwaitis and non-Kuwaitis.Kuwaitis living in high or medium socioeconomic status areas had significantly higher AMI incidence rates (6.6 and 4.5 per 10 000 population per year, respectively) than Kuwaitis in low status areas (2.5 per 10 000 population per year). Managers, administrators, professionals, and technical workers had the highest AMI rates, though the mean age and socioeconomic status did not differ among those affected in these occupational groups. Twenty per cent of the patients had been admitted previously for AMI, 22% had a hypertension history, 30% a diabetes mellitus history, and 71% a smoking history. Female patients were more often hypertensive and diabetic, but less often smokers, than males. Kuwaitis, diabetics, and those with a previous admission for acute myocardial infarction had increased mean serum cholesterol levels. Of the 16% of patients who had died in the hospital, half died within 48 hours of admission. Those who died were older and had lower systolic and diastolic blood pressures and lower serum cholesterol levels than the survivors. Twenty-seven per cent of those with extensive anterior myocardial infarcts died compared with 12% of those with acute infarcts in other locations. Those who died within 48 hours of admission had lower systolic and diastolic blood pressures than those who died later.