title: Cohort-specific trends in stroke mortality in seven European countries were related to infant mortality rates.
abstract: OBJECTIVE
  To assess, in a population-based study, whether secular trends in cardiovascular disease mortality in seven European countries were correlated with past trends in infant mortality rate (IMR) in these countries.
  
  
  METHODS
  Data on ischemic heart disease (IHD) and stroke mortality in 1950-1999 in the Netherlands, England & Wales, France, and four Nordic countries were analyzed. We used Poisson regression to describe trends in mortality according to birth cohort, for the cohorts born between 1860 and 1939. Pearson correlation coefficients were calculated to determine associations between IMR and IHD, or stroke mortality.
  
  
  RESULTS
  IHD mortality increased for successive cohorts up to 1900, and then started to decline. Stroke mortality levels were virtually stable among birth cohorts up to 1880, but declined rapidly among later cohorts. A strong positive association was found between cohort-specific IMR levels and stroke mortality rates. There were no strong cohort-wise associations between IMR and IHD mortality.
  
  
  CONCLUSIONS
  These results support other studies in suggesting that living conditions in early childhood may influence population levels of stroke mortality. Future studies should determine the contribution of specific early life factors to the mortality decline in IHD and especially stroke.
authors.affiliation: Department of Public Health, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. m.amiri@erasmusmc.nl
authors.forename: M
authors.initials: M
authors.lastname: Amiri
authors.forename: A E
authors.initials: AE
authors.lastname: Kunst
authors.forename: F
authors.initials: F
authors.lastname: Janssen
authors.forename: J P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality*; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D017678:Sex Distribution; D020521:Stroke / Q000401:mortality*; D006113:United Kingdom / Q000453:epidemiology