Copyright © 1998 by the European Society of Cardiology.
Intra-urban variations in incidence and mortality in myocardial infarction. A study from the myocardial infarction register in the city of Malmö, Sweden
a Department of Community Medicine, Malmö University Hospital, Lund University, Malmö, Sweden
b Department of Cardiology, Malmö University Hospital, Lund University, Malmö, Sweden
accepted July 12, 1998
Aim
To assess to what extent intra-urban variations and time trends of mortality in ischaemic heart disease are related to incidence of disease.
Methods and Results
Incidence and mortality data were retrieved from the myocardial infarction register in Malmö. Age- and sex-adjusted incidence varied between the 17 city areas from 469 to 681/105(P=0·003), and mortality from 286 to 446/105(P=0·017). Socio-demographic risk factors for ischaemic heart disease were more prevalent in high rate areas. About 70% of the variance in mortality was explained by the variance in incidence. From 1986 to 1992, incidence declined by 3·6%/year in men (P=0·004) and by 0·9%/year in women (P=0·31). Mortality decreased by 4·1%/year in men (P=0·01) and by 1·9%/year in women (P=0·15). Incidence and mortality changes were statistically significant only in men>65. In younger age groups, incidence and mortality decreased in men but increased in women.
Conclusions
In this urban population, there were large intra-city differences in mortality from ischaemic heart disease. During the period 1986–1992 there was a parallel decline in mortality and incidence. There were, however, substantial variations both in terms of residence and subject.
Key Words: Myocardial • infarction • incidence • mortality • urban • variations
f1 Correspondence:Dr Patrik Tydén, Department of Community Medicine, Unit of Epidemiology, Malmö University Hospital, 205 02 Malmö, Sweden.
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