Trends and determinants of CHD mortality: changes in risk factors and their effects

Abstract

Cardiovascular disease risk factor and mortality data collected since the 1978 Conference on the Decline in Coronary Heart Disease Mortality were reviewed. Risk factor and disease trends were generally parallel and compatible with current hypotheses of cause and prevention. A few discrepancies between risk factors and disease change were noted and discussed. Models were presented for estimating effects of risk factor and medical care changes on disease trends. Their usefulness and limitations were considered. An ongoing need was elaborated for systematic and innovative surveillance research to expand and improve the capability to measure, explain, and predict disease trends. Rational public health policy depends on competent and sustained surveillance.