title: Age and gender differences in incidence and case fatality trends for myocardial infarction: a 30-year follow-up. The Tromso Study.
abstract: BACKGROUND
  Although the mortality of coronary heart disease (CHD) has declined in Western countries during the last decades, studies have suggested that the prevention and treatment of CHD may not have been as effective in women as in men. We examined gender- and age-specific trends in incidence, case fatality and the severity of first myocardial infarction (MI) in a large Norwegian population-based study.
  
  
  METHODS
  Prospective population-based cohort study.
  
  
  METHODS
  A total of 31,323 participants enrolled between 1974 and 2001 were followed throughout 2004 for a total of 400,572 person-years. Suspected coronary events were adjudicated by a review of hospital records and death certificates. A total of 1669 events fulfilled standardized criteria of first-ever fatal or non-fatal MI.
  
  
  RESULTS
  In the age group 35-79 years, the age-adjusted incidence of MI declined significantly in men, whereas an increase was observed in women. For men and women ≥ 80 years the incidence rates remained unchanged. The severity of MI and the 28-day and 1-year case fatality rates declined significantly and similarly in men and women.
  
  
  CONCLUSIONS
  Trends in MI incidence differed by sex and age; in the age group 35-79 years a marked decrease was observed among men but an increase was observed among women, while no change was observed among older patients. MI severity and case fatality were clearly reduced for both sexes. These data suggest that the burden of CHD is shifting from middle-aged men toward middle-aged women and elderly patients.
authors.affiliation: Department of Heart Disease, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway. jan.mannsverk@unn.no
authors.forename: Jan
authors.initials: J
authors.lastname: Mannsverk
authors.forename: Tom
authors.initials: T
authors.lastname: Wilsgaard
authors.forename: Inger
authors.initials: I
authors.lastname: Njølstad
authors.forename: Laila Arnesdatter
authors.initials: LA
authors.lastname: Hopstock
authors.forename: Maja-Lisa
authors.initials: ML
authors.lastname: Løchen
authors.forename: Ellisiv B
authors.initials: EB
authors.lastname: Mathiesen
authors.forename: Dag S
authors.initials: DS
authors.lastname: Thelle
authors.forename: Knut
authors.initials: K
authors.lastname: Rasmussen
authors.forename: Kaare Harald
authors.initials: KH
authors.lastname: Bønaa
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003644:Death Certificates; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006323:Heart Arrest / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D009664:Norway / Q000453:epidemiology; D011159:Population Surveillance; D011446:Prospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D055815:Young Adult