Sex differences in coronary heart disease mortality trends: The minnesota heart survey, 1970–1988

Recent U.S. national statistics indicate a slowing of the rate of decline in coronary heart disease (CHD) deaths among women. To examine recent sex-specific rates of mortality decline in the Minnesota Heart Survey, we computed the average annual percentage change in age-adjusted CHD death rate for the periods 1970–1978 and 1979–1988. We fit a log-linear regression model to the yearly CHD death rates, with separate sex-specific slopes estimated simultaneously for the two calendar periods. The average annual percentage decline in age-adjusted CHD death rate among men was slightly greater in the period 1979–1988 [4.8%; 95% confidence interval (CI) = 5.2–4.3] than in the period 1970–1978 (3.9%; 95% CI = 4.6–3.1). In contrast, among women, the rate of decline was less in the period 1979–1988 (3.6%; 95% CI = 4.8–2.3) than in 1970–1978 (4.8%; 95% CI = 5.6–4.0). We found a slowing of the rate of decline in out-of-hospital CHD deaths in both men and women. We observed a large increase in the rate of decline in the CHD death rate in hospital among men in the period 1979–1988 (8.3%; 95% CI = 9.3–7.2), compared with the period 1970–1978 (2.4%; 95% Cl = 3.2–1.7). This increase did not occur among women (4.1%; 95% CI = 5.7–2.5 in 1970–1980 vs 3.8%; 95% CI = 4.9–2.7 in 1970–1978); this difference is a major factor in the steeper recent decline in overall CHD mortality among men compared with women.