Trends of acute myocardial infarction morbidity and case fatality in East Germany since 1970.

Because of the high risk factor levels and the high morbidity and mortality of cardiovascular diseases, a Myocardial Infarction Control Programme was implemented in East Germany in the 1970s. To measure its effect, many myocardial infarction registers have operated in the country ever since, and despite some methodological problems the results of these registers now make trend estimations possible. In recent years, we observed no decline in the acute myocardial infarction attack rates in the population aged 25-64 years, and in men there was even a slight increase towards the late 1980s. These somewhat different sex-specific trends run parallel to the trends of the risk factor levels, as well as the cardiovascular mortality rates in men and women. There was no decline in the case fatality rate either during that period. We have to conclude, therefore, that the aims of the Myocardial Infarction Control Programme have not been reached, and both primary and secondary myocardial infarction prevention must be intensified. Cardiovascular morbidity and mortality, under the new conditions existing in East Germany after unification, must be reduced at least to the level observed in West Germany.