title: Shifts in the age distribution and from acute to chronic coronary heart disease hospitalizations.
abstract: BACKGROUND
  Shifts in the burden of coronary heart disease (CHD) from an acute to chronic illness have important public health consequences.
  
  
  OBJECTIVE
  To assess age-sex-specific time trends in rates and characteristics of acute and chronic forms of CHD hospital admissions in the Netherlands.
  
  
  METHODS
  Using nationwide Dutch registers, we assessed time trends between 1998 and 2007 in hospitalization rates of 188,266 acute myocardial infarction (AMI, ICD-9 410), 294,374 unstable angina (ICD-9 411, 413) and 205,649 chronic forms of CHD (ICD-9 412, 414) admissions.
  
  
  RESULTS
  Between 1998 and 2007, the age-standardized CHD hospitalization rate declined from 688 to 545 per 100,000 in men and from 281 to 229 per 100,000 in women. Overall, hospitalization rates decreased at younger age (<75 years) but increased in very old age (≥85 years). The annual percentage change in hospitalization rates was larger for AMI (men:-5.1%, women:-4.4%) than for unstable angina patients (men:-2.0%, women:-2.0%). For chronic CHD, the average annual percentage change was +0.7% in men and +2.1% in women. The proportion of chronic CHD in the total of CHD admissions increased between 1998 and 2007 from 29% to 36% in men and from 23% to 30% in women. The proportion of AMI decreased from 30% to 24% in men and from 27% to 22% in women.
  
  
  CONCLUSIONS
  An increasing proportion of Dutch CHD hospital admissions was for chronic forms of CHD. The age at hospitalization was pushed towards older age: premature CHD admission declined over time and admission rates at very old age increased.
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands Dutch Heart Foundation, The Hague, the Netherlands C.Koopman-2@umcutrecht.nl.
authors: Carla
authors: C
authors: Koopman
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Michiel L
authors: ML
authors: Bots
authors: Dutch Heart Foundation, The Hague, the Netherlands.
authors: Ineke
authors: I
authors: van Dis
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Ilonca
authors: I
authors: Vaartjes
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D009426:Netherlands / Q000453:epidemiology; D012042:Registries
keywords: Coronary disease; Netherlands; age distribution; chronic disease; hospitalization; myocardial infarction; trends; unstable angina