[Changing trends of etiologic characteristics of cardiovascular diseases among inpatients in Shanghai: a retrospective observational study from 1948 to 1999].
OBJECTIVE
To investigate the trends in the change of etiologic types of cardiovascular disease among inpatients in Shanghai area from 1948 to 1999.


METHODS
The retrospective estimate was based on the data survey in two major general hospitals of Shanghai. Descriptive statistics were provided for all patients meeting the inclusion criteria. Trend of percentage change was compared using linear regression. Diagnoses were categorized using the International Classification of Diseases, 9th Revision.


RESULTS
(1) A total of 37 086 admissions with different etiologic types of heart diseases from 1948 to 1999 was reviewed. The percentage of heart diseases among the inpatients in medical wards was significantly increased during this period, being 9.89%, 15.69%, 20.91%, 23.54% and 24.24% (P < 0.05) for each decade respectively and reaching a peak in 1990s. (2) Patterns of different etiologic types of heart diseases changed markedly from 1948 to 1999. The percentage of coronary heart disease increased from 6.78% in 1940s to 39.19% in 1990s (P < 0.05), cardiac dysrhythmias from 0.63% to 18.84% (P < 0.05), cardiomyopathy from 0.05% to 5.01% (P < 0.05) and endocarditis from 0.02% to 0.69% (P < 0.05). The percentage of rheumatic heart disease decreased from 50.30% to 10.25% (P < 0.05). The percentage of hypertensive heart disease, myocarditis and congenital heart disease remained unchanged. (3) From 1948 to 1999 the overall in-hospital mortality of heart diseases in different decades decreased from 17.91%, 11.51%, 14.07%, 7.35% to 2.39% (P < 0.05). (4) Patients were slightly younger in 1950s (39.7 +/- 5.5) years than those in 1990s (60.1 +/- 12.7) years (P < 0.05). (5) The percentage of male patients increased (ranging from 50.7% in 1940s to 62.4% in 1990s, P < 0.05).


CONCLUSIONS
Hospitalization patterns of heart diseases have changed dramatically in the second half of the last century in Shanghai. Coronary heart disease is the most frequent condition requiring hospitalization nowadays and the rates of many age-related heart diseases are increasing and this has been paralleled by a substantial increase of the rates in the community survey. More attention should be paid to these heart diseases in Shanghai and in this century.
Chen
Hao-zhu
HZ
Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032 China. dulf@zshospital.com
Fan
Wei-hu
WH
Jin
Xue-juan
XJ
Wang
Qian
Q
Zhou
Jun
J
Shi
Zhi-ying
ZY
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D002681:China / Q000453:epidemiology; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors