title: Sex and time trends in cardiovascular disease incidence and mortality: the Framingham Heart Study, 1950-1989.
abstract: Variations in cardiovascular disease mortality between sexes, over time, and across regions point to population differences in the biologic, behavioral, and environmental factors influencing cardiovascular health. The authors examined 20-year trends in risk factors, incidence, and mortality among women and men in Framingham, Massachusetts, who were members of the Framingham Heart Study and aged 50-59 years in 1950, 1960, and 1970. The incidence declined 21% between the female cohorts (p < 0.01 for trend) with the greatest decline occurring between the 1950 and 1960 cohorts. The 20-year incidence declined only 6% between the male cohorts despite an 18% decline (p < 0.05 for trend) during the first 10 years of follow-up. Cardiovascular disease mortality declined 59% between the female cohorts and 53% between the male cohorts (both p < 0.001 for trend). The largest mortality declines occurred between the 1950 and 1960 female cohorts during the second 10 years of follow-up and between the 1960 and 1970 male cohorts during both follow-up periods. Obesity, hypercholesterolemia, and high blood pressure were significantly lower at baseline and 10 years later in the 1970 female cohort compared with the 1950 cohort (all p < 0.001). Smoking and high blood pressure were significantly lower at baseline and 10 years later in the 1970 male cohort compared with the 1950 cohort (both p < 0.001). More than half of the 51% decline in coronary heart disease mortality observed in women between 1950 and 1989 and one third to one half of the 44% decline observed in men could be attributed to improvements in risk factors in the 1970 cohorts.
authors.affiliation: Framingham Heart Study, MA, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Sytkowski
authors.forename: R B
authors.initials: RB
authors.lastname: D'Agostino
authors.forename: A
authors.initials: A
authors.lastname: Belanger
authors.forename: W B
authors.initials: WB
authors.lastname: Kannel
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015982:Bias; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D017678:Sex Distribution