Epidemiology of ischemic heart disease among white males: II. Autopsy incidence of ischemic heart disease and autopsy prevalence of coronary atherosclerosis

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Abstract

  • 1.

    1. An epidemiologic study, based on the findings in 2,731 white males 40 or more years of age on whom autopsies were performed at the Grace-New Haven Community Hospital, New Haven, Connecticut, from 1935 through 1955, showed that the autopsy incidence of ischemic heart disease increased over the 21 year period of time. The rate per 100 autopsies increased from 11.66 for the period, 1935–1944, to 16.98 for the period, 1945–1955.

  • 2.

    2. The autopsy records of accident victims and cancer patients were pooled to form a group of records of persons whose coronary arteries were thought to be reasonably representative of the coronary arteries of the general population. On the basis of these records, the autopsy prevalence of coronary atherosclerosis increased from 1935–1944 to 1945–1955. A higher percentage of patients in every age group was entirely free of coronary atherosclerosis in 1935–1944 than in 1945–1955. Furthermore, the prevalence of advanced (50 to 100 per cent) coronary atherosclerotic blockage was higher during the latter period, 1945–1955. The ratios of cases of advanced atherosclerosis in 1935–1944 compared with 1945–1955 were: 1 to 3.5 at ages 40–49; 1 to 1.3 at ages 50–59; 1 to 1.5 at ages 60–69; and 1 to 2.3 at ages 70 or more. It was concluded that there has been a “real” rather than an “apparent” increase in the incidence of ischemic heart disease and in the prevalence of coronary atherosclerosis.

  • 3.

    3. The prevalence of coronary atherosclerosis increased with age. The percentage of patients showing macroscopic evidence of coronary atherosclerosis increased from 46 at ages 40–49 to 65 at ages 50–59 to 82 at ages 60–69, to 88 at age 70 or more.

  • 4.

    4. Hypertension was found to affect the development of coronary atherosclerosis. The percentage of nonhypertensive patients versus hypertensive patients with coronary atherosclerosis by age groups were: 43 versus 75 at ages 40–49; 62 versus 79 at ages 50–59; 81 versus 85 at ages 60–69; and 85 versus 94 at age 70 or more. The atherogenic effects of obesity were not as straightforward as those of hypertension. Because of inherent limitations in the use of autopsy data, no conclusions could be reached about the association between body weight and coronary atherosclerosis.

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  • Cited by (0)

    This paper is based on a study of the epidemiology of ischemic heart disease in partial fulfillment of the requirements for the degree of Doctor of Public Health from Yale University School of Medicine, New Haven, Conn.

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