title: Trends in community mortality due to coronary heart disease.
abstract: BACKGROUND
  Relatively little data are available, particularly from the more generalizable perspective of a population-based investigation, describing recent trends in death rates due to coronary heart disease (CHD). The objectives of this observational study were to describe changes over a twelve year period (1990-2001) in death rates due to CHD and acute myocardial infarction (AMI) in residents of the Worcester, Massachusetts, metropolitan area (2000 census = 478,000). A secondary study goal was to describe changes in death rates attributed to CHD over time separately in men and in women, in persons of different ages, and according to location of death.
  
  
  METHODS
  Death datatapes were obtained from the Massachusetts Department of Public Health for greater Worcester residents who died over the period 1990 to 2001.
  
  
  RESULTS
  Marked declines were observed in the population death rates (per 100,000) due to CHD (1990 death rate = 322; 2001 death rate = 224) and AMI (1990 death rate = 137; 2001 death rate = 87) in the greater Worcester population. Declines in the annual death rates attributed to CHD were observed in both the hospital (4.4% decline) and out-of-hospital setting (1.6% decline) as well as for patients dying from AMI (annual declines of 4.8% and 1.9% respectively). Reductions in CHD death rates over time were observed in men and in women and in persons of all ages.
  
  
  CONCLUSIONS
  The present results demonstrate encouraging declines in community death rates due to CHD and AMI over time and the impact of evolving primary and secondary prevention efforts.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA. goldberr@ummhc.org
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
authors.forename: Karen
authors.initials: K
authors.lastname: Glatfelter
authors.forename: Emma
authors.initials: E
authors.lastname: Burbank-Schmidt
authors.forename: Darleen
authors.initials: D
authors.lastname: Lessard
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gore
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009203:Myocardial Infarction / Q000401:mortality; D009735:Nursing Homes / Q000706:statistics & numerical data; D017678:Sex Distribution