June 29, 2016
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CHD rate decreasing in US

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CHD rates are falling among the U.S. population aged at least 40 years, dropping during a 12-year period mainly in those without established CHD risk factors, according to study findings published in the American Journal of Preventive Medicine.

“Reasons for a reduction ... could relate to general trends in lifestyle changes, such as improved diet, increased level of physical activity or ... prophylactic aspirin use,” Sung Sug (Sarah) Yoon, PhD, RN, with the NIH, said in a press release. “Furthermore, anti-smoking prevention efforts have resulted in a decreased prevalence of cigarette smoking.”

Researchers analyzed data on 21,472 adults aged at least 40 years from two 6-year National Health and Nutrition Examination Survey cycles from 2001 to 2012. The cohort was stratified by demographic and CHD risk factors.

The study showed overall instances of CHD decreased from 10.3% to 8% (P for trend < .05). The prevalence of angina fell from 7.8% to 5.5% (P for trend < .05), whereas instances of MI decreased from 5.5% to 4.7% (P for trend < .05). There was no statistical change in CHD incidence for those in high-risk subgroups, including hypercholesterolemia, hypertension, BMI of at least 30 kg/m2, diabetes and current smoking.

Researchers found a fall in CHD rates from 8.5% to 6.2% in women (P for trend < .05). The CHD risk also fell for non-Hispanic whites and blacks (P for trend < .05 for both groups) but not for Mexican Americans. A large portion of the drop in CHD rates for the whole cohort was seen in those aged at least 60 years, where it decreased from 19.5% in 2001-2002 to 14.9% in 2011-2012 (P for trend < .001).

The study also showed a lowered trend for CHD in those considered overweight (BMI, 25 kg/m2 to 30 kg/m2; P for trend = .01), but not in those classified as obese (BMI, 30 kg/m2; P for trend = .06).

Researchers noted one limitation of the study was some variables such as CHD, angina and MI were based on self-reporting. To minimize inaccuracies, they included those assigned anti-angina medications, as well as those with undiagnosed angina as determined by answers on the Rose questionnaire with grades of 1 or higher.
by James Clark

Disclosure: The researchers report no relevant financial disclosures.