Time trends in the prevalence of atherosclerosis: A population-based autopsy study

Veronique Lee Roger, Susan A. Weston, Jill M. Killian, Eric A. Pfeifer, Paul G. Belau, Thomas E. Kottke, Robert L. Frye, Kent R Bailey, Steven J. Jacobsen

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

PURPOSE: Mortality from coronary heart disease is declining but little is known about trends in the prevalence of atherosclerosis. Autopsy rates in Olmsted County, Minnesota, are higher than the national average, offering an opportunity to address this matter. In this study, we determined the prevalence of anatomic coronary disease among autopsied Olmsted County residents and examined the generalizability of these findings. SUBJECTS AND METHODS: Reports of the 2,562 autopsies performed between 1979 and 1994 on Olmsted County residents ≥20 years of age were reviewed for the presence of coronary disease. RESULTS: Among autopsied decedents less than 60 years old at death and among coroner's cases, the prevalence of anatomic coronary disease declined with time (P for trend = 0.05); no trend was detected among older persons or noncoroner's cases. By logistic regression analysis, the crude odds ratio ([OR] per 5 years) for the association between time and anatomic coronary disease was 0.94 (95% confidence interval [CI]: 0.86 to 1.03; P = 0.18]. Age, sex, and antemortem diagnosis of heart disease were also strongly related to the presence of disease. After adjustment for sex and antemortem diagnosis of heart disease, the prevalence of anatomic coronary disease decreased more in younger people than in older people (age 40 years: OR 0.43 [95% CI: 0.24 to 0.80]; age 60 years: OR 0.62 [95% CI: 0.45 to 0.87]; age 80 years: OR 0.89 [95% CI: 0.64 to 1.23]). CONCLUSION: The prevalence of anatomic coronary disease at autopsy decreased between 1979 and 1994, particularly among younger people, supporting the notion that the burden of coronary disease has shifted toward the elderly. These results suggest that the decreased incidence of coronary artery disease has contributed to the recent decrease in coronary mortality, particularly among younger people.

Original languageEnglish (US)
Pages (from-to)267-273
Number of pages7
JournalAmerican Journal of Medicine
Volume110
Issue number4
DOIs
StatePublished - 2001

Fingerprint

Coronary Disease
Autopsy
Atherosclerosis
Population
Odds Ratio
Confidence Intervals
Heart Diseases
Coroners and Medical Examiners
Mortality
Coronary Artery Disease
Logistic Models
Regression Analysis
Incidence

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Roger, V. L., Weston, S. A., Killian, J. M., Pfeifer, E. A., Belau, P. G., Kottke, T. E., ... Jacobsen, S. J. (2001). Time trends in the prevalence of atherosclerosis: A population-based autopsy study. American Journal of Medicine, 110(4), 267-273. https://doi.org/10.1016/S0002-9343(00)00709-9

Time trends in the prevalence of atherosclerosis : A population-based autopsy study. / Roger, Veronique Lee; Weston, Susan A.; Killian, Jill M.; Pfeifer, Eric A.; Belau, Paul G.; Kottke, Thomas E.; Frye, Robert L.; Bailey, Kent R; Jacobsen, Steven J.

In: American Journal of Medicine, Vol. 110, No. 4, 2001, p. 267-273.

Research output: Contribution to journalArticle

Roger, VL, Weston, SA, Killian, JM, Pfeifer, EA, Belau, PG, Kottke, TE, Frye, RL, Bailey, KR & Jacobsen, SJ 2001, 'Time trends in the prevalence of atherosclerosis: A population-based autopsy study', American Journal of Medicine, vol. 110, no. 4, pp. 267-273. https://doi.org/10.1016/S0002-9343(00)00709-9
Roger, Veronique Lee ; Weston, Susan A. ; Killian, Jill M. ; Pfeifer, Eric A. ; Belau, Paul G. ; Kottke, Thomas E. ; Frye, Robert L. ; Bailey, Kent R ; Jacobsen, Steven J. / Time trends in the prevalence of atherosclerosis : A population-based autopsy study. In: American Journal of Medicine. 2001 ; Vol. 110, No. 4. pp. 267-273.
@article{e387b2f385a2461f880890bf4bc3c965,
title = "Time trends in the prevalence of atherosclerosis: A population-based autopsy study",
abstract = "PURPOSE: Mortality from coronary heart disease is declining but little is known about trends in the prevalence of atherosclerosis. Autopsy rates in Olmsted County, Minnesota, are higher than the national average, offering an opportunity to address this matter. In this study, we determined the prevalence of anatomic coronary disease among autopsied Olmsted County residents and examined the generalizability of these findings. SUBJECTS AND METHODS: Reports of the 2,562 autopsies performed between 1979 and 1994 on Olmsted County residents ≥20 years of age were reviewed for the presence of coronary disease. RESULTS: Among autopsied decedents less than 60 years old at death and among coroner's cases, the prevalence of anatomic coronary disease declined with time (P for trend = 0.05); no trend was detected among older persons or noncoroner's cases. By logistic regression analysis, the crude odds ratio ([OR] per 5 years) for the association between time and anatomic coronary disease was 0.94 (95{\%} confidence interval [CI]: 0.86 to 1.03; P = 0.18]. Age, sex, and antemortem diagnosis of heart disease were also strongly related to the presence of disease. After adjustment for sex and antemortem diagnosis of heart disease, the prevalence of anatomic coronary disease decreased more in younger people than in older people (age 40 years: OR 0.43 [95{\%} CI: 0.24 to 0.80]; age 60 years: OR 0.62 [95{\%} CI: 0.45 to 0.87]; age 80 years: OR 0.89 [95{\%} CI: 0.64 to 1.23]). CONCLUSION: The prevalence of anatomic coronary disease at autopsy decreased between 1979 and 1994, particularly among younger people, supporting the notion that the burden of coronary disease has shifted toward the elderly. These results suggest that the decreased incidence of coronary artery disease has contributed to the recent decrease in coronary mortality, particularly among younger people.",
author = "Roger, {Veronique Lee} and Weston, {Susan A.} and Killian, {Jill M.} and Pfeifer, {Eric A.} and Belau, {Paul G.} and Kottke, {Thomas E.} and Frye, {Robert L.} and Bailey, {Kent R} and Jacobsen, {Steven J.}",
year = "2001",
doi = "10.1016/S0002-9343(00)00709-9",
language = "English (US)",
volume = "110",
pages = "267--273",
journal = "American Journal of Medicine",
issn = "0002-9343",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Time trends in the prevalence of atherosclerosis

T2 - A population-based autopsy study

AU - Roger, Veronique Lee

AU - Weston, Susan A.

AU - Killian, Jill M.

AU - Pfeifer, Eric A.

AU - Belau, Paul G.

AU - Kottke, Thomas E.

AU - Frye, Robert L.

AU - Bailey, Kent R

AU - Jacobsen, Steven J.

PY - 2001

Y1 - 2001

N2 - PURPOSE: Mortality from coronary heart disease is declining but little is known about trends in the prevalence of atherosclerosis. Autopsy rates in Olmsted County, Minnesota, are higher than the national average, offering an opportunity to address this matter. In this study, we determined the prevalence of anatomic coronary disease among autopsied Olmsted County residents and examined the generalizability of these findings. SUBJECTS AND METHODS: Reports of the 2,562 autopsies performed between 1979 and 1994 on Olmsted County residents ≥20 years of age were reviewed for the presence of coronary disease. RESULTS: Among autopsied decedents less than 60 years old at death and among coroner's cases, the prevalence of anatomic coronary disease declined with time (P for trend = 0.05); no trend was detected among older persons or noncoroner's cases. By logistic regression analysis, the crude odds ratio ([OR] per 5 years) for the association between time and anatomic coronary disease was 0.94 (95% confidence interval [CI]: 0.86 to 1.03; P = 0.18]. Age, sex, and antemortem diagnosis of heart disease were also strongly related to the presence of disease. After adjustment for sex and antemortem diagnosis of heart disease, the prevalence of anatomic coronary disease decreased more in younger people than in older people (age 40 years: OR 0.43 [95% CI: 0.24 to 0.80]; age 60 years: OR 0.62 [95% CI: 0.45 to 0.87]; age 80 years: OR 0.89 [95% CI: 0.64 to 1.23]). CONCLUSION: The prevalence of anatomic coronary disease at autopsy decreased between 1979 and 1994, particularly among younger people, supporting the notion that the burden of coronary disease has shifted toward the elderly. These results suggest that the decreased incidence of coronary artery disease has contributed to the recent decrease in coronary mortality, particularly among younger people.

AB - PURPOSE: Mortality from coronary heart disease is declining but little is known about trends in the prevalence of atherosclerosis. Autopsy rates in Olmsted County, Minnesota, are higher than the national average, offering an opportunity to address this matter. In this study, we determined the prevalence of anatomic coronary disease among autopsied Olmsted County residents and examined the generalizability of these findings. SUBJECTS AND METHODS: Reports of the 2,562 autopsies performed between 1979 and 1994 on Olmsted County residents ≥20 years of age were reviewed for the presence of coronary disease. RESULTS: Among autopsied decedents less than 60 years old at death and among coroner's cases, the prevalence of anatomic coronary disease declined with time (P for trend = 0.05); no trend was detected among older persons or noncoroner's cases. By logistic regression analysis, the crude odds ratio ([OR] per 5 years) for the association between time and anatomic coronary disease was 0.94 (95% confidence interval [CI]: 0.86 to 1.03; P = 0.18]. Age, sex, and antemortem diagnosis of heart disease were also strongly related to the presence of disease. After adjustment for sex and antemortem diagnosis of heart disease, the prevalence of anatomic coronary disease decreased more in younger people than in older people (age 40 years: OR 0.43 [95% CI: 0.24 to 0.80]; age 60 years: OR 0.62 [95% CI: 0.45 to 0.87]; age 80 years: OR 0.89 [95% CI: 0.64 to 1.23]). CONCLUSION: The prevalence of anatomic coronary disease at autopsy decreased between 1979 and 1994, particularly among younger people, supporting the notion that the burden of coronary disease has shifted toward the elderly. These results suggest that the decreased incidence of coronary artery disease has contributed to the recent decrease in coronary mortality, particularly among younger people.

UR - http://www.scopus.com/inward/record.url?scp=0035119826&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035119826&partnerID=8YFLogxK

U2 - 10.1016/S0002-9343(00)00709-9

DO - 10.1016/S0002-9343(00)00709-9

M3 - Article

C2 - 11239844

AN - SCOPUS:0035119826

VL - 110

SP - 267

EP - 273

JO - American Journal of Medicine

JF - American Journal of Medicine

SN - 0002-9343

IS - 4

ER -