Incidence of Myocardial Infarction and Sudden Death from Coronary Heart Disease in Nashville, Tennessee

The incidence rates for myocardial infarction and sudden death attributable to coronary heart disease for adults between the ages of 35 and 74 years for black and white populations were studied in Nashville, Tennessee, for a l-year period, July 1, 1967 to June 30, 1968. The overall incidence rate for myocardial infarction was 3.42 and for sudden coronary death, 1.55 per 1,000 population. The male-to-female ratio for the white population for myocardial infarction was 3:1, and for the black population 2:1. Similar male-to-female ratios were found for those dying suddenly for both races. However, both black males and females died suddenly at a higher rate than did the white. Over half of the sudden deaths occurred within a 2-hour period after onset of symptoms. Fifty-two percent were dead on arrival at a hospital, 31% died at home, and 6% in a public place. Only 4% had either no contact with a source of medical care or had negative disease histories prior to sudden death. Thus, it would seem possible in further studies to identify a group of individuals at high risk of sudden death from coronary heart disease.