Objective: To present national trends in mortality rates for myocardial infarction and cardiovascular disease.
Design: Observational study using mortality statistics and hospital separation data from Statistics Canada for the period 1976 to 1991.
Results: Despite ageing of the population, there has been a substantial decrease in the number of deaths attributed to ischemic heart disease, from 51,000 in 1976 to 44,000 in 1991, with most of the decrease due to fewer deaths from myocardial infarction. Although age-adjusted death rates remain higher for men, the observed mortality decline has been more pronounced in men than in women. Age-adjusted separation rates have also decreased, suggesting a decrease in the incidence of myocardial infarction, particularly in the 45 to 64 year age group. The duration of hospital stay has shortened dramatically.
Conclusions: From 1976 to 1991, mortality rates for ischemic heart disease in Canada decreased sharply, suggesting that advancements observed in clinical trials are being translated to the population level. The decrease appears to be due to both preventive measures and improved hospital care, but further studies are necessary to define better the relative contribution of each factor. The extent of this progress over the past 15 years is similar to the American experience.