Decreasing mortality from pulmonary embolism in the United States, 1979-1996.

BACKGROUND: Mortality trends and patterns for pulmonary embolism may yield clues to its aetiology. Previous investigations had identified several mortality contrasts in pulmonary embolism mortality among US residents. These findings had been made in the context of a trend of increasing rates during 1962-1984.
METHODS: Annual age-specific and age-adjusted pulmonary embolism mortality rates for US residents during 1979-1996 were compiled from the US National Center for Health Statistics web site. These data were analysed for mortality contrasts and trends.
RESULTS: For all racial-gender groups, age-adjusted mortality declined throughout the period. The greatest rate of decline was found among black men, followed by (in decreasing order) black women, white men, other men, white women, and other women. In 1996, the previously observed demographic contrasts of blacks experiencing the highest pulmonary embolism mortality, followed by whites and then others, and the male rate being higher than the female one were still present despite this decline. Age-specific mortality from pulmonary embolism in the US during 1996 also mirrored that reported for the 1970s, with mortality increasing during the life span (the risk of death doubling with each decade of life). Specifically, the annual age-adjusted pulmonary embolism mortality rate in 1996 for white men was 2.4 per 100 000 persons; white women, 2.3 per 100 000 persons; black men, 6.0 per 100 000 persons; black women, 4.8 per 100 000 persons; non-black non-white men, 1.0 per 100 000 persons; and non-black non-white women, 0.7 per 100 000 persons.
CONCLUSIONS: Mortality from pulmonary embolism in the US declined significantly during 1979-1996. Several demographic contrasts, particularly an excess among men, continue to exist.