Trends in the incidence of acute myocardial infarction and stroke:: a 21-year follow-up of the Oslo study

Objectives-To explore changes in the incidence of fatal and nonfatal myocardial infarction (MI) and stroke in the same male population over two decades. Design-Men aged 40-49 born in the years 1923-1932 (N = 16 209) resident in Oslo participated in a cardiovascular screening programme in 1972-1973. Nonfatal cases of MI and stroke were obtained from hospital records and causes of death were ascertained by linkage to Statistics Norway. The closing date was December 31, 1993. Results-The cohort had a lower mortality rate than the general Norwegian population. First nonfatal and fatal MIs declined in each age and birth cohort during the entire follow-up. The incidence of nonfatal and fatal stroke decreased about 10 years after the initial screening. The risk of men with Rose questionnaire-based symptoms of angina or claudication was between that of healthy men and men with established cardiovascular disease or diabetes. Conclusions-There has been a reduction in both nonfatal and fatal incident cases of MI and stroke 10 years later indicating a pronounced change in all age groups and a lasting change throughout the period of follow-up. The Rose questionnaire predicted both future stroke and MI.