Evidence for decline in coronary mortality in the United States

Evidence for decline in coronary mortality in the United States

Decline in coronary mortality: Data published in the current issue of Circulation [1] shows that coronary heart disease mortality has declined in the United States from 1979 through 2011. This is consistent with the dramatic fall in coronary mortality in the Western world over the past four decades. But concern has been raised over the lack of improvement in young women in the nineteen nineties and only a once percent decline since 2000. This would mean that cardiovascular risk profile of young women would have worsened disproportionately in recent decades.

Gupta A et al [2] suggested this could be partly explained by the marked decline in smoking US men compared to women from 1965 to 2011 as per data cited by them. They also mention that the relation between cardiovascular mortality and environmental exposure to cigarette smoke is non linear. The curve is steeper at low levels of exposure and plateaus off at higher levels of exposure.

Reference

1. Wilmot KA, O’Flaherty M, Capewell S, Ford ES, Vaccarino V. Coronary Heart Disease Mortality Declines in the United States From 1979 Through 2011: Evidence for Stagnation in Young Adults, Especially Women. Circulation. 2015 Sep 15;132(11):997-1002.
2. Gupta A, Rajagopalan S. Letter by Gupta and Rajagopalan Regarding Article, “Coronary Heart Disease Mortality Declines in the United States From 1979 Through 2011: Evidence for Stagnation in Young Adults, Especially Women”. Circulation. 2016 Mar 8;133(10):e432.