Trends in heart disease in the United States.

The twentieth century in the United States has witnessed a "heart disease epidemic" with a dramatic increase in ischemic heart disease (IHD) among men, particularly, beginning shortly after World War I. The epidemic reached its peak mortality among men in the 1960s and among women about two decades earlier. Highest mortality rates were observed in the Northeast at mid-century, but by 1990 the highest rates occur in the Southeast. With improvements in survival during the past few decades, prevalence of IHD has been increasing in the population. Identification of risk factors for IHD through longitudinal epidemiologic studies has led to prevention programs that have improved the risk profile of the population.