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Declining cardiovascular disease incidence and environmental components

B L Lloyd1

  • 1Sir Charles Gairdner Hospital, Perth, WA, Australia.

Australian and New Zealand Journal of Medicine
|February 1, 1994
PubMed
Summary

Mortality from ischaemic heart disease (IHD) declined due to lifestyle changes, particularly improved nutrition and reduced saturated fat intake. Socio-economic factors and blood pressure changes also contributed to this significant public health improvement.

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Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Ischaemic heart disease (IHD) mortality rose for decades before declining in many countries from the mid-1930s.
  • This decline encompassed both out-of-hospital and hospital deaths, alongside a reduction in non-fatal myocardial infarction (MI).

Purpose of the Study:

  • To review lifestyle and environmental factors contributing to the observed decline in IHD mortality and non-fatal MI.
  • To identify key drivers of the decreasing incidence of ischaemic heart disease.

Main Methods:

  • A comprehensive literature review was conducted.
  • Analysis focused on identifying correlations between lifestyle, environmental factors, and trends in IHD incidence and mortality.

Main Results:

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  • Approximately half of the IHD decline is attributed to lifestyle changes and modifications in major risk factors.
  • Improved nutrition, specifically an increased polyunsaturated to saturated fat ratio and reduced overall saturated fat intake, is a significant factor.
  • Reductions in blood pressure, potentially from lifestyle changes, and socio-economic factors also appear to influence the rate and extent of IHD decline.

Conclusions:

  • Changes in nutrition and lifestyle are primary drivers of the decline in ischaemic heart disease.
  • While smoking cessation is beneficial, its impact varies regionally; socio-economic factors and blood pressure changes also play roles in the observed trends.