Key Points
- To confirm the existence of regional differences in coronary heart disease death rates in Australia and New Zealand and evaluate whether they correspond to parallel differences in the incidence of acute myocardial infarction.
- Descriptive epidemiological study of residents aged 25–64 years in Auckland, Newcastle, and Perth admitted to hospital or dying from coronary heart disease between 1983 and 1987.
- Identified and classified definite acute myocardial infarction and coronary deaths according to the criteria of the World Health Organization MONICA project.
- Newcastle had the highest rates for all coronary events, particularly among women, matching high official mortality rates from ischaemic heart disease.
- Auckland demonstrated substantially higher case fatality ratios than Newcastle and Perth, driven primarily by elevated rates of coronary deaths occurring outside of the hospital setting.
- Perth exhibited the lowest overall mortality rates and case fatality ratios across sexes, despite having hospital admission rates for acute myocardial infarction that were disproportionately high relative to mortality.
Structured PICO
PPopulationResidents of Auckland, Newcastle and Perth aged 25-64 years admitted to hospital for acute myocardial infarction or dying from coronary heart disease between 1983 and 1987.
OOutcomeDefinite acute myocardial infarction or coronary death classified according to the criteria of the World Health Organization MONICA projecthard clinical
There are marked regional variations in coronary death rates and acute myocardial infarction incidence between Australia and New Zealand, likely related to differences in the natural history of ischemic heart disease and medical management.