Trends in mortality from myocardial infarction. A comparative study between Spain and the United States: 1990-2006

Abstract

Introduction and objectives: Mortality from myocardial infarction is declining in high income countries, but the magnitude of this decline could differ between countries. We sought to compare the mortality trends from myocardial infarction between Spain and the United States.

Methods: This was an observational retrospective study. Crude data were obtained from public databases. Standardized mortality rates were calculated for the last 17 years available for both countries (1990 to 2006), and stratified by age and sex. Joinpoint regression analysis was used for the trends analysis and projections.

Results: There has been a steady decline in mortality from myocardial infarction in both countries from 1990 to 2006. However, the magnitude of this decline was greater in the United States (relative reductions in men: 42.7% [Spain] and 59.7% [United States], and in women: 40% [Spain] and 57.4% [United States]). The estimated annual percentages of decline in mortality were greater in the United States (men: -10.7%, women: -5.1%) than in Spain (men: -1.9%, women: -5.1%). Projections for 2012 suggest that the mortality from myocardial infarction will be lower in men in the United States (53.33/100,000) than in Spain (81.52/100,000), while for women it will be equal (32.56/100,000 in the United States and 33.56/100,000 in Spain).

Conclusions: The decline in mortality from myocardial infarction has been more pronounced in the United States than in Spain, and projections for upcoming years suggest in the United States it will evolve to rates below those expected in Spain for men and equal rates for women.