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J Am Coll Cardiol, 2007; 50:2128-2132, doi:10.1016/j.jacc.2007.05.056 (Published online 12 November 2007).
© 2007 by the American College of Cardiology Foundation
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CLINICAL RESEARCH: CORONARY ARTERY DISEASE

Coronary Heart Disease Mortality Among Young Adults in the U.S. From 1980 Through 2002

Concealed Leveling of Mortality Rates

Earl S. Ford, MD, MPH*,* and Simon Capewell, MD{dagger}

* Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
{dagger} Department of Public Health, University of Liverpool, Liverpool, United Kingdom.

Manuscript received February 14, 2007; revised manuscript received April 24, 2007, accepted May 14, 2007.

* Reprint requests and correspondence: Dr. Earl S. Ford, Centers for Disease Control and Prevention, 4770 Buford Highway, MS K66, Atlanta, Georgia 30341. (Email: eford{at}cdc.gov).

Objectives: The objective of our study was to examine age-specific mortality rates from coronary heart disease (CHD), particularly those among younger adults.

Background: Trends for obesity, diabetes, blood pressure, and metabolic syndrome among young adults raise concerns about the mortality rates from CHD in this group.

Methods: We used mortality data from 1980 to 2002 to calculate age-specific mortality rates from CHD for U.S. adults age ≥35 years.

Results: Overall, the age-adjusted mortality rate decreased by 52% in men and 49% in women. Among women age 35 to 54 years, the estimated annual percentage change (EAPC) in mortality was –5.4% (95% confidence interval [CI] –5.8 to –4.9) from 1980 until 1989, –1.2% (95% CI –1.6 to –0.8) from 1989 until 2000, and 1.5% (95% CI –3.4 to 6.6) from 2000 until 2002. Among men age 35 to 54 years, the EAPC in mortality was –6.2% (95% CI –6.4 to –5.9) from 1980 until 1989, –2.3% (95% CI –2.6 to –2.1) from 1989 until 2000, and –0.5% (95% CI –3.7 to 2.9) from 2000 until 2002. Among women and men age ≥55 years, the estimated annual percentage decrease in mortality from CHD accelerated in more recent years compared with earlier periods.

Conclusions: The mortality rates for CHD among younger adults may serve as a sentinel event. Unfavorable trends in several risk factors for CHD provide a likely explanation for the observed mortality rates.

Abbreviations and Acronyms
  CHD = coronary heart disease
  CI = confidence interval
  EAPC = estimated annual percentage change
  ICD = International Classification of Diseases


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