To the Editor.—
I read with great interest the excellent report of Weinblatt et al (1982;247:1576) and the accompanying editorial by Havlik (1982;247:1605). I agree that the decline in coronary heart disease mortality rates is likely due both to change in coronary risk factors and improved hospital care of acute myocardial infarction (MI), with no change in long-term post-MI survival.1 One point that both articles failed to mention is that more than half of the total decline in coronary heart disease mortality rates is due to declining incidence of sudden coronary death. This has been reported in two areas of Minnesota; a small city, Rochester,1 and a large metropolitan area, the Twin Cities.2 It has also been observed in Seattle (Leonard Cobb, MD, personal communication). This decline seems primarily due to decreasing prevalence and improved management of coronary risk factors among persons without a history of coronary
Gillum RF. The Decline in Coronary Heart Disease Mortality. JAMA. 1982;248(10):1180. doi:10.1001/jama.1982.03330100020018
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