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Understanding the Decline in Coronary Heart Disease Mortality

Richard J. Havlik, MD, MPH
JAMA. 1982;247(11):1605-1606. doi:10.1001/jama.1982.03320360055035.
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Over a ten-year period, the United States has experienced a dramatic decline in coronary heart disease mortality, which has resulted in an overall reduction in total mortality and increased life expectancy. In this period between 1968 and 1978, the reduction has been about 25% and has occurred in both sexes, all races, and at all ages. The United States is virtually unique in the world in terms of the magnitude of the decline. Unfortunately, when 1980 age-adjusted rates are compared with 1979 rates, there has been a leveling off of the decline, perhaps as a result of unusually high influenza rates and record-breaking temperatures in many cities.1 The cause of the decline has been a topic of much speculation. A conference sponsored by the National Heart, Lung, and Blood Institute (NHLBI) in 1978 concluded that both risk-factor reduction and improved medical care contributed to the decline.2 It has


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