TRENDS IN ISCHEMIC-HEART-DISEASE IN THE HUNTER REGION OF NEW-SOUTH-WALES 1985-1989

Objective: To find out whether trends in rates of non-fatal myocardial infarction (MI) parallel trends in rates of coronary death. Design: A population-based observational study involving continuous surveillance of all suspected heart attacks or coronary deaths from 1985 to 1989. Study population: Residents of the Hunter Region of New South Wales aged under 70 years. Main outcome measures: Rates of non-fatal definite or possible MI or fatal MI or coronary death, as defined by the diagnostic criteria of the WHO MONICA Project. Results: For men, mortality rates declined by an average of 16.2 per 100 000 per year (95% confidence interval [Cl]: -23.8, -8.7); rates of non-fatal definite MI declined by 16.2 per 100 000 (95% Cl: -27.8, -4.6); rates of non-fatal possible MI increased initially and then stabilised. For women smaller changes occurred in the same directions. Conclusion: In this population trends in rates for non-fatal definite MI paralleled the declines in mortality rates. Rates for less severe non-fatal possible MI did not follow this pattern, perhaps reflecting increased medical attention to chest pain.