title: Discordant age and sex-specific trends in the incidence of a first coronary heart disease event in Western Australia from 1996 to 2007.
abstract: OBJECTIVE
  To determine age- and sex-specific population trends in fatal and non-fatal first coronary heart disease (CHD) events in Western Australia from 1996 to 2007.
  
  
  METHODS
  Longitudinal retrospective population study.
  
  
  METHODS
  State-wide population.
  
  
  METHODS
  All residents aged 35-84 years during 1996-2007 who died or were hospitalised with a principal diagnosis of acute CHD.
  
  
  METHODS
  Person-linked file of mortality and morbidity records.
  
  
  METHODS
  Age-standardised (35-84 years) and age-specific (35-54, 55-69, 70-84 years) rates by gender for a first CHD event were calculated with a 10-year lead-in period to define first events.
  
  
  RESULTS
  From 1996 to 2007 there were 36 631 first CHD events, including 8518 (23%) fatal cases in those aged 35-84 years. Overall, age-adjusted rates for fatal first CHD declined 5.3%/year in men (95% CI -6.1% to -4.6%) and 6.5%/year in women (95% CI -7.5% to -5.5%). However, age-specific fatal first CHD rates were neutral in both men aged 35-54 years (0.1%/year; 95% CI -1.8% to 2.1%) and women of the same age, (-1.6%/year; 95% CI -5.6% to 2.5%). Age-specific trends in non-fatal CHD rates reflected the same trends in fatal CHD events in men and women, with rates reportedly increasing in women aged 35-54 years (2.5%/year (95% CI 1.1% to 3.9%).
  
  
  CONCLUSIONS
  The age-specific decline in fatal and non-fatal first CHD rates in older men and women was not observed in those aged 35-54 years. These novel findings provide evidence for a levelling in the CHD incidence rates in younger adults and puts renewed importance on primary prevention in this group.
authors.affiliation: School of Population Health, University of Western Australia, 35 Stirling Hwy., Crawley, WA 6009, Australia. tom.briffa@uwa.edu.au
authors.forename: Tom
authors.initials: T
authors.lastname: Briffa
authors.forename: Lee
authors.initials: L
authors.lastname: Nedkoff
authors.forename: Anna
authors.initials: A
authors.lastname: Peeters
authors.forename: Andrew
authors.initials: A
authors.lastname: Tonkin
authors.forename: Joseph
authors.initials: J
authors.lastname: Hung
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Ridout
authors.forename: Matthew
authors.initials: M
authors.lastname: Knuiman
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D014904:Western Australia / Q000453:epidemiology