title: Geographical variation in the incidence of acute myocardial infarction in eastern Finland--a Bayesian perspective.
abstract: BACKGROUND
  Large geographical variation in the incidence and mortality of cardiovascular disease (CHD) has been repeatedly reported in Finland with persistent difference between east and west. We undertook this study to estimate the geographical distribution of Acute Myocardial Infarction (AMI) incidence in the high-risk province of North Karelia and in the province of Kuopio.
  
  
  METHODS
  Data on men aged 25-64 years with first event of acute myocardial infarction (AMI) were obtained from the FINMONICA AMI register, which recorded detailed information of AMI events during the period 1983 to 1992. The geographical pattern of AMI incidence was studied in two five-year periods 1983 to 1987 and 1988 to 1992 separately in 10 km x 10 km grid cells employing the Geographical Information System (GIS) and a Bayesian hierarchical approach.
  
  
  RESULTS
  In both periods Bayesian modeling revealed a geographical pattern of AMI incidence and high risk (probability that incidence exceeds the observed mean incidence) in the remote rural areas.
  
  
  CONCLUSIONS
  Detection of high-risk areas in both provinces showed that underlying environmental and/or genetic risk factors of AMI are not evenly distributed within the province but enriched in certain geographical non-administratively defined locations in eastern Finland.
authors.affiliation: National Public Health Institute, Helsinki, Finland.
authors.forename: Maarit
authors.initials: M
authors.lastname: Viik-Kajander
authors.forename: Elena
authors.initials: E
authors.lastname: Moltchanova
authors.forename: Veikko
authors.initials: V
authors.lastname: Salomaa
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: Matti
authors.initials: M
authors.lastname: Ketonen
authors.forename: Pertti
authors.initials: P
authors.lastname: Palomäki
authors.forename: Heikki
authors.initials: H
authors.lastname: Miettinen
authors.forename: Kalevi
authors.initials: K
authors.lastname: Pyörälä
authors.forename: Marjatta
authors.initials: M
authors.lastname: Karvonen
mesh_terms: D000328:Adult; D017677:Age Distribution; D001499:Bayes Theorem; D005260:Female; D005387:Finland / Q000453:epidemiology; D005843:Geography; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis