In spite of an apparently increasing mortality rate from coronary heart disease in Puerto Rico, the age-specific mortality rate from this illness is considerably lower in the island than in the U. S. mainland. Examination of 9,814 Puerto Rican urban and rural men in the 45 to 64-year age group revealed sizable and statistically significant differences in monthly income, cigarette smoking, ingestion of fats, blood pressure, heart rate, relative weight, serum cholesterol, serum glycerides, prevalence of diabetes, and prevalence of hypertension (lower in rural dwellers), and also in vital capacity, consumption of calories per unit body weight, and physical activity (higher in rural area). No urban-rural difference in coronary heart disease prevalence was found, but the prevalence of definite myocardial infarction, established on basis of electrocardiographic criteria alone, was significantly higher in the 45 to 54-year urban group. Follow-up of this population to study incidence of disease and the influence of the various factors upon the development of disease is being conducted.

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A study was made of groups of urban and rural Puerto Rican men, aged 45-64, to determine differences in coronary heart disease risk factors. The results reported here indicate significant differences in blood pressure, relative weights, mean serum cholesterol, and per cent cigarette smokers. These findings suggest the possibility of studying selected hypotheses about coronary heart disease in these populations in a prospective study.