Coronary heart disease in black populations I. Mortality and morbidity

Abstract

Coronary heart disease is the leading cause of death among black Americans (57,999 deaths in 1977) despite the widely held belief that CHD is not common in blacks. CHD death rates were lower in black men than in white men in the United States in the 1940s but rose rapidly until they exceeded those of whites in 1968. Since 1968 CHD death rates in blacks have fallen by about 30%, to levels similar to whites but still higher than 1940 rates. Black women have higher CHD mortality than white women. The few population studies of myocardial infarction in the 1970s suggest similar or lower age-specific incidence in black than white men but higher case fatality and more out-of-hospital deaths. Trends in death certification practice and access to medical care may be of particular importance in these differences between blacks and whites.