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Sex difference in the mortality trends of acute myocardial infarction in Taiwan, 1974 to 1993
1Department of Internal Medicine (Cardiology), National Taiwan University College of Medicine, Taipei, Taiwan.
Insights
Acute myocardial infarction (AMI) mortality in Taiwan increased significantly for both men and women between 1974 and 1993. However, birth cohort analysis reveals diverging mortality trends between sexes, particularly for men born later.
Area of Science:
- Cardiovascular epidemiology
- Public health research
- Mortality statistics
Background:
- Coronary heart disease (CHD) mortality patterns differ globally, with rising trends in developing nations.
- Acute myocardial infarction (AMI) mortality trends in Taiwan remain underreported.
- Understanding demographic influences on AMI mortality is crucial for public health interventions.
Purpose of the Study:
- To analyze age, period, and birth cohort effects on AMI mortality in Taiwan.
- To investigate trends in AMI mortality from 1974 to 1993.
- To identify sex-specific differences in AMI mortality patterns.
Main Methods:
- Utilized computerized vital statistics data from 1974–1993.
- Applied a log-linear Poisson model for simultaneous analysis.
- Examined age-adjusted mortality rates and relative risks by birth cohort and time period.
Main Results:
- AMI mortality rates in Taiwan increased 2.4-fold for men and 2.2-fold for women from 1974 to 1993.
- Birth cohort analysis showed a 2.5-fold increased relative risk of AMI death for men in later cohorts (1955-1959) versus earlier ones (1890-1894).
- Conversely, the relative risk of AMI death declined by 3.7-fold for women in later birth cohorts compared to earlier ones.
Conclusions:
- Significant increases in AMI mortality occurred in Taiwan during the study period.
- Substantial sex-based differences exist in AMI mortality trends when analyzed by birth cohort.
- Findings provide a basis for generating hypotheses on factors influencing AMI mortality and guiding prevention strategies in Taiwan.
Abstract:
The mortality patterns of coronary heart disease (CHD) vary among countries. Although the mortality rates from this disease are decreasing in the majority of developed nations, most developing countries are experiencing upward trends, especially among men. The mortality trends of acute myocardial infarction (AMI) in Taiwan have not been reported. The purpose of this study was to investigate the effects of age, chronicle period, and birth cohort on the AMI mortality rates using computerized vital statistics data from 1974 through 1993. Compared with the age-adjusted AMI mortality rates in 1974, the mortality rates in 1993 were 2.4 times higher for men and 2.2 times higher for women. When the log-linear Poisson model was used to assess age, birth cohort, and chronicle period simultaneously, women had no elevated relative risk of dying from AMI in different periods. The relative risk of dying from AMI increased 2.5 times for men in the 1955-1959 birth cohort compared with those in the 1890-1894 birth cohort, while the relative risk for females declined by 3.7 times for the corresponding birth cohorts. Based on birth cohort, the trends in mortality differ substantially between sexes in Taiwan. These results may help to generate hypotheses regarding the possible factors, prevention, and control of mortality from AMI in Taiwan.