title: Time Trends in Incidence and Mortality of Acute Myocardial Infarction, and All-Cause Mortality following a Cardiovascular Prevention Program in Sweden.
abstract: BACKGROUND
  In 1988, a cardiovascular prevention program which combined an individual and a population-based strategy was launched within primary health-care in Sollentuna, a municipality in Stockholm County. The aim of this study was to investigate time trends in the incidence of and mortality from acute myocardial infarction and all-cause mortality in Sollentuna compared with the rest of Stockholm County during a period of two decades following the implementation of a cardiovascular prevention program.
  
  
  METHODS
  The average population in Sollentuna was 56,589 (49% men) and in Stockholm County (Sollentuna included) 1,795,504 (49% men) during the study period of 1987-2010. Cases of hospitalized acute myocardial infarction and death were obtained for the population of Sollentuna and the rest of Stockholm County using national registries of hospital discharges and deaths. Acute myocardial infarction incidence and mortality were estimated using the average population of Sollentuna and Stockholm in 1987-2010.
  
  
  RESULTS
  During the observation period, the incidence of acute myocardial infarction decreased more in Sollentuna compared with the rest of Stockholm County in women (-22% vs. -7%; for difference in slope <0.05). There was a trend towards a greater decline in Sollentuna compared to the rest of Stockholm County in the incidence of acute myocardial infarction (in men), acute myocardial mortality, and all-cause mortality but the differences were not significant.
  
  
  CONCLUSIONS
  During a period of steep decline in acute myocardial infarction incidence and mortality in Stockholm County the municipality of Sollentuna showed a stronger trend in women possibly compatible with favorable influence of a cardiovascular prevention program.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02212145.
authors.affiliation: Unit of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Journath
authors.affiliation: Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.|AstraZeneca R&D, Mölndal, Sweden.
authors.forename: Niklas
authors.initials: N
authors.lastname: Hammar
authors.affiliation: Department of Social Work, Stockholm University, Stockholm, Sweden.
authors.forename: Stig
authors.initials: S
authors.lastname: Elofsson
authors.affiliation: Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.|Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anette
authors.initials: A
authors.lastname: Linnersjö
authors.affiliation: Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Max
authors.initials: M
authors.lastname: Vikström
authors.affiliation: Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Walldius
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ingvar
authors.initials: I
authors.lastname: Krakau
authors.affiliation: Medical Management Center, MMC, Department of Learning, Information, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.|The Swedish Institute for Health Economics, Stockholm, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Lindgren
authors.affiliation: Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: de Faire
authors.affiliation: Unit of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mai-Lis
authors.initials: ML
authors.lastname: Hellénius
mesh_terms: D000293:Adolescent; D000328:Adult; D004522:Educational Status; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007182:Income; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000517:prevention & control*; D009313:National Health Programs; D010351:Patient Discharge / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors