Document Detail

Validation of reported myocardial infarction mortality in blacks and whites. A report from the Community Cardiovascular Surveillance Program.
MedLine Citation:
PMID:  1669485     Owner:  NLM     Status:  MEDLINE    
It is widely believed that blacks experience a higher mortality due to coronary heart disease (CHD) than do whites. To determine whether this reported difference in mortality between blacks and whites is real, we studied the question in the context of the Community Cardiovascular Surveillance Program (CCSP). Fatal and nonfatal cases of CHD were reviewed in 12 US communities. Standardized criteria were applied to classify these cases as possible CHD, definite CHD, possible myocardial infarction (MI), or definite MI. The annual age-adjusted mortality rate per 100,000 ascribed to definite MI by the CCSP criteria was higher in blacks than in whites: 47 in white men (95% confidence interval, 36 to 58), 18 in white women (95% confidence interval, 8 to 28), 95 in black men (95% confidence interval, 10 to 180), and 41 for black women (95% confidence interval, 0 to 99). The proportion of definite MI to all fatal CHD events was higher in blacks (16%) than in whites (12%). For nonfatal events, however, the rate of definite MI was higher in whites than in blacks: 322 in white men (95% confidence interval, 293 to 351), 225 in black men (95% confidence interval, 160 to 290), 82 in black women (95% confidence interval, 43 to 121), and 103 in white women (95% confidence interval, 88 to 118). The proportion of definite MI to all nonfatal CHD events was lower in blacks (16%) than in whites (30%). Thus, the overall rate for fatal and nonfatal definite MI was lower in blacks (215/100,000) than in whites (244/100,000). These observations suggest that a combination of high case-fatality ratio and misclassification of cause and death may contribute to the reported higher rate of CHD mortality among blacks.
M H Lee; N O Borhani; L H Kuller
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of epidemiology     Volume:  1     ISSN:  1047-2797     ISO Abbreviation:  Ann Epidemiol     Publication Date:  1990 Oct 
Date Detail:
Created Date:  1994-02-03     Completed Date:  1994-02-03     Revised Date:  2008-06-23    
Medline Journal Info:
Nlm Unique ID:  9100013     Medline TA:  Ann Epidemiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-12     Citation Subset:  IM    
Department of Community Health, School of Medicine, University of California, Davis 95616.
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MeSH Terms
African Continental Ancestry Group*
Age Factors
Cause of Death
Coronary Disease / complications,  epidemiology,  mortality*
Death Certificates
Epidemiologic Methods
European Continental Ancestry Group*
Middle Aged
Myocardial Infarction / complications,  epidemiology,  mortality*
Population Surveillance / methods*
Sex Factors
United States
Grant Support
Comment In:
Ann Epidemiol. 1990 Oct;1(1):97-100   [PMID:  1669492 ]

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