Regional Inequality in the Risk of Acute Myocardial Infarction in Finland: A Case Study of 35- to 74-Year-Old Men

Abstract

In this paper, the spatial distribution of the first event of acute myocardial infarction among 35- to 74-year-old men in Finland was examined for the cross-section years 1983, 1988 and 1993. The analysis was performed using a Bayesian hierarchical spatial approach to the geographically referenced data. The population data and case data received from nationwide registries were aggregated into 10 × 10 km cells. The estimated maps show that along with the overall decreasing incidence, the high-risk area withdrew deeper into the northeast, with an incidence 7–12% higher in rural than in urban areas. It could be concluded that eastern Finland is likely to remain a high-risk area in the future due to the concentration of certain risk factors.

Spatial Clustering and Temporal Trends in Coronary Heart Disease

“…The finding of the declining incidence of acute myocardial infarction may very well be interpreted as reflecting an effect of the Finnish coronary heart disease prevention programmes established in the 1970s. In this respect, the study of Karvonen et al [1] confirms what was already known. To some extent, this also applies to the finding of a skewed spatial distribution that remained virtually unchanged during the study period, with an increasing incidence from south-western to north-eastern Finland.…”

“…In this issue of Heart Drug, Karvonen et al [1] report an analysis of the spatial distribution and temporal trends in acute myocardial infarction among men aged 35-74 years in Finland, a country known to feature record high levels of coronary heart disease. The authors have, in a sophisticated way, combined the application of geographical information systems with advanced Bayesian statistical modelling.…”

“…Karvonen et al [1] demonstrate that whereas the overall incidence of acute myocardial infarction declined considerably in Finland from 1983 to 1993, the skewed spatial distribution of the disease remained roughly constant over the same period. In addition, the authors found that the incidence of acute myocardial infarction was somewhat higher in rural settings as compared with urbanized areas.…”

“…What can be learned from the study of Karvonen et al [1]? The finding of the declining incidence of acute myocardial infarction may very well be interpreted as reflecting an effect of the Finnish coronary heart disease prevention programmes established in the 1970s.…”

Calcium and Magnesium in Drinking Water as Risk Factors for Ischemic Heart Disease

“…In Serbia, the mortality rate from ischemic heart disease is highest in Vojvodina, while in central Serbia it is somewhat lower than the national average. The existence of areas with high risk for IHD, especially for acute myocardial infarction (AMI), points to the fact that it is very likely that environmental factors are involved in the pathogenesis of cardiovascular disease, and therefore it is necessary to study them carefully [12]. Many authors believe the current evidence to be preliminary but promising, with an ongoing need to take on this issue [13].…”