Change in the prevalence of coronary heart disease among Finnish elderly men and women in the 1990s

Mortality from coronary heart disease has decreased by 60% in Finland during the past 25 years. The prevalence of coronary heart disease decreased during the 1990s among the elderly. Silent myocardial infarction was common, especially in elderly women. The number of coronary angioplasty or bypass operations has increased considerably, especially in men. Objective &#114 - &#114 To characterise the prevalence of, and changes in, coronary heart disease (CHD) among men and women aged between 64 and 71 years in the 1990s. Design &#114 - &#114 A study of clinical epidemiology involving two cohorts of elderly persons in 1990 - 1991 and 1998 - 1999. Setting &#114 - &#114 Primary health care in the municipality of Lieto in southwestern Finland. Subjects &#114 - &#114 Persons between 64 and 71 years of age in the southwest of Finland in 1990-1991 and 1998-1999. Main outcome measures &#114 - &#114 The occurrences of CHD were estimated using the history of a previous myocardial infarction or coronary revascularisation procedure evident in the medical records and with ischaemia or infarction as established on ECG according to the Whitehall criteria. Results &#114 - &#114 The prevalence of 'probable' CHD decreased among men and women aged between 64 and 71 years, whereas the prevalence of 'possible' CHD decreased among women alone. Silent myocardial infarctions were common among women of both cohorts. Many more men of the second cohort, compared to the first one, had undergone a coronary angioplasty or bypass operation. Conclusion &#114 - &#114 The prevalence of CHD decreased among elderly women more clearly than among young elderly men. The favourable development illustrating a decrease in the prevalence of CHD among women should be sustained, while health promotion activities will need to be directed more actively towards men.