Key Points
- To determine age- and sex-specific population trends in fatal and non-fatal first coronary heart disease events over an 11-year observation period.
- Conducted a retrospective statewide longitudinal population study of residents aged 35–84 years who died or were hospitalized with acute coronary heart disease between 1996 and 2007 (N=36,631 first events).
- Utilized person-linked mortality and hospital morbidity databases with a 10-year retrospective lead-in period to identify incident cases and calculate age-standardized and age-specific annual percentage changes.
- Overall age-adjusted fatal first coronary heart disease rates decreased by 5.3% per year in men (95% CI -6.1% to -4.6%) and 6.5% per year in women (95% CI -7.5% to -5.5%).
- Fatal event rates plateaued without significant change among adults aged 35–54 years (men: 0.1%/year, 95% CI -1.8% to 2.1%; women: -1.6%/year, 95% CI -5.6% to 2.5%).
- Non-fatal first event rates in women aged 35–54 years increased significantly by 2.5% per year (95% CI 1.1% to 3.9%).
Structured PICO
PPopulation36,631 residents aged 35-84 years in Western Australia during 1996-2007 who died or were hospitalised with a principal diagnosis of acute CHD (first event).
OOutcomeAge-standardised (35-84 years) and age-specific (35-54, 55-69, 70-84 years) rates by gender for a first CHD event (fatal and non-fatal)hard clinical
The incidence of first CHD events is no longer declining in younger adults (aged 35-54), with non-fatal events increasing in younger women, emphasizing the need for targeted primary prevention.