title: Changing patterns of acute myocardial infarction: decline in period prevalence and delay in onset.
abstract: The rural Pee Dee area of South Carolina has had the highest mortality rate in the nation for coronary heart disease. Community surveillance shows a 22.7% (p = 0.0008) decline in fatal and nonfatal acute myocardial infarction (AMI) rates during the period 1978 to 1985 in the Pee Dee area. Rates for white men decreased 32% (p = 0.001), whereas in other race-sex groups changes were not significant, although there was a downward trend (p = 0.18) among black men. Among white men decreases in the AMI rates occurred in each of the decades of age 35 to 64 years. In all race-sex groups there was a sharp increase in rates between 1978 and 1985 for those 65 to 74 years of age, suggesting that the incidence of AMI was delayed to a later age. Out-of-hospital AMI death rates declined markedly in all race-sex groups: 63% for white men, 62% for white women, 49% for black men, and 39% for black women. Overall case fatality rates declined from 14% (27 of 193) to 10% (23 of 232), but the decrease was not statistically significant.
authors: Department of Biometry and Medicine, Medical University of South Carolina, Charleston 29425.
authors: J E
authors: JE
authors: Keil
authors: P C
authors: PC
authors: Gazes
authors: M S
authors: MS
authors: Litaker
authors: D E
authors: DE
authors: Saunders
authors: M C
authors: MC
authors: Weinrich
authors: N B
authors: NB
authors: Baroody
authors: D T
authors: DT
authors: Lackland
authors: M B
authors: MB
authors: Hudson
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality; D012424:Rural Population; D012737:Sex Factors; D013022:South Carolina; D044465:White People