Intra-urban variations in incidence and mortality in myocardial infarction. A study from the myocardial infarction register in the city of Malmö, Sweden

Abstract

AimTo assess to what extent intra-urban variations and time trends of mortality in ischaemic heart disease are related to incidence of disease. Methods and ResultsIncidence and mortality data were retrieved from the myocardial infarction register in Malmö. Age-and sex-adjusted incidence varied between the 17 city areas from 469 to 681/10 5 (P=0·003), and mortality from 286 to 446/10 5 (P=0·017). Socio-demographic risk factors for ischaemic heart disease were more prevalent in high rate areas. About 70% of the variance in mortality was explained by the variance in incidence. From 1986 to 1992, incidence declined by 3·6%/year in men (P=0·004) and by 0·9%/year in women (P=0·31). Mortality decreased by 4·1%/year in men (P=0·01) and by 1·9%/year in women (P=0·15). Incidence and mortality changes were statistically significant only in men>65. In younger age groups, incidence and mortality decreased in men but increased in women. ConclusionsIn this urban population, there were large intra-city differences in mortality from ischaemic heart disease. During the period 1986-1992 there was a parallel decline in mortality and incidence. There were, however, substantial variations both in terms of residence and subject.

Influence of obesity on cardiovascular risk. Twenty-three-year follow-up of 22 025 men from an urban Swedish population

“…Vital status at the end of the follow-up was up dated on all individuals by data linkage with regional and national registers. 20 The completeness and validity of these registers have been documented in several other studies from the city. 20,31 Change of exposure is an inherent problem in long-term studies.…”

“…20 The completeness and validity of these registers have been documented in several other studies from the city. 20,31 Change of exposure is an inherent problem in long-term studies. Subjects who were diagnosed with hypertension, lipid disorders, diabetes mellitus or problematic drinking behaviour were referred for further evaluation and treatment, smokers were advised to quit, but received no further help to achieve that.…”

“…20 Death certificates used for the classification of the underlying cause of death had been coded in accordance with the ninth version of the International Classification of Diseases, Injuries and Causes of Death, ICD. 21 Every participant in the cohort was followed for mortality and incidence of coronary events until 31 December 1997.…”

Increasing Stroke Incidence and Decreasing Case Fatality, 1989–1998

“…3,33 In Malmö, the incidence of and mortality from MI have declined, 34 and 3-year survival after first MI has continuously improved. 6 Values are the age-adjusted annual incidence rates of first-ever stroke per 100 000 person-years (number of cases).…”

Country of birth and risk of hospitalization due to heart failure: a Swedish population-based cohort study

“…Previous studies from Malmö have shown that there are substantial differences in risk of CVD between residential areas with high and low proportion of immigrants (12)(13)(14)(15). The purpose of the present population-based study is to explore the relationship between country of birth and risk of HF hospitalizations after taking age, sex and socioeconomic indicators into account.…”