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A comparison of trends of coronary heart disease mortality in australia usa and england and wales uk with reference to 3 major risk factors hypertension cigarette smoking and diet



A comparison of trends of coronary heart disease mortality in australia usa and england and wales uk with reference to 3 major risk factors hypertension cigarette smoking and diet



International Journal of Epidemiology 9(1): 65-71



Recent changes in coronary heart disease mortality in Australia, the USA and in the UK (England and Wales were compared. Sharp declines in mortality dating from 1966 in Australia and from 1968 in the USA in both sexes contrast with a persistent increase in men in England and Wales until 1972 (after which a slight fall occurred) and a consistent slight fall in women since 1950. Changes in 3 major risk factors (hypertension, cigarette smoking and diet) in the 3 countries were investigated to determine to what extent such changes might correlate with the different patterns of mortality. There was a progressive and similar fall in mortality due to hypertension in both sexes in all 3 countries since 1950. There was a rise in cigarette smoking in all 3 countries from 1947 followed by a fall in the USA from 1963 and a more recent fall in men in Australia. There was a leveling off of smoking in the UK in middle-aged and older men but not in women where smoking rates increased from 1950. There was a progressive slight fall in overall coronary heart disease mortality (although there is evidence of a recent rise in younger women). Changes in dietary constituents (meat, eggs, milk and cheese, butter or margarine) were examined by reference to aggregate consumption data. In Australia and the USA increases in vegetable fat consumption occurred since 1950 with a reduction in animal fat in Australia but not in the USA. In the UK increases in vegetable fat were not observed while there was some increase in animal fat. The different patterns of coronary heart disease mortality in the 3 countries correlate to some extent with changes in diet and cigarette smoking.

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