Sex-specific trends in validated coronary heart disease rates in southeastern New England, 1980-1991.

Although the national decline in coronary heart disease mortality began earlier and was steeper in women relative to men, recent data suggest that the decline in women has slowed. The purpose of this study was to document sex-specific trends in coronary disease morbidity and mortality for the period 1980-1991 in two southeastern New England communities, and to determine whether temporal trends have been similar in men and women aged 35-74 years. Analyses were based on 6,282 validated in-hospital and out-of-hospital coronary disease events ascertained by the retrospective surveillance system of the Pawtucket Heart Health Program. Total (fatal plus non-fatal) coronary disease rates remained stable during this period. The flat trend was the result of an increase in non-fatal hospitalizations and a simultaneous decrease in both in-hospital and out-of-hospital mortality. The decline in fatal coronary disease was steeper for men, for both in- and out-of-hospital mortality, although the sex difference was statistically significant only for out-of-hospital deaths. In-hospital case-fatality for validated coronary disease declined for both men and women. The steeper decline in coronary disease mortality for men suggests the need for more information regarding sex differential trends in prevention, diagnosis, classification, and treatment.