Women's Cardiovascular Health Research Articles

Long-Term Trends in Incidence of and Mortality from Acute Myocardial Infarction and Stroke in Women

We studied the trends from 1969 to the mid-1980s in the incidence and mortality of acute myocardial infarction and stroke in Swedish women residing in the Uppsala Health Care Region. We used data from the Inpatient Care and Causes of Death registers to obtain total first event incidence and mortality rates. In our population, there were 20,182 acute myocardial infarctions and 30,462 stroke events, and 17,359 and 21,336 deaths, respectively. We found an average overall annual increase of 1.3% in the age-standardized incidence of acute myocardial infarction during the 1970s, followed by decreasing rates during the early 1980s. Mortality was virtually unchanged. Notably, among women 45-49 years of age, we observed a rising trend during the whole period, whereas in the oldest age groups, the increase slowed and reversed in the latter years. Both the incidence and mortality for stroke declined steadily: the age-standardized incidence fell by an average of 2.1% per year for all stroke and 7.8% for intracerebral hemorrhage. The falling rate of stroke was best explained by birth cohort effects, with a 30% reduction in women born in 1920 and later as compared with those born in 1890. We conclude that important changes in Swedish women's cardiovascular health have taken place and that increasing cigarette smoking and hypertensive treatment are major determinants.

Unique problems in cardiovascular health of women

Unique problems in cardiovascular health of women

Effect of mean circulatory filling pressure and other peripheral circulatory factors on cardiac output.

I P ONE studies curves which depict the relationship of cardiac output to mean right atria1 pressure (one of the forms of Starling’s curves), it is obvious that, within the normal range of function of the heart, cardiac output can change tremendously while the right atria1 pressure changes only slightly. This fact led to the early belief that it is not the function of the heart itself which controls cardiac output but instead that cardiac output is controlled by the various factors in the peripheral circulatory system which regulate the return of blood to the heart. Though it is not entirely true that cardiac output is independent of the function of the heart (I), nevertheless, it is hoped to emphasize in the present paper the special importance of the peripheral circulatory factors which affect venous return. In order to do this, a mathematical circuit analysis of the closed circuit circulatory system has been made. This circuit analysis has been specifically simplified so that the factors derived would be amenable to experimental test. Two of the factors which have proved to be of importance, as shown both by this circuit analysis and by experimental data, are a) ‘capacitance’ and b) ‘mean circulatory filling pressure.’ As used in these studies the term capacitance means dV/dP or, in other words, the change in volume of a particular part of the circulatory system with each unit change in pressure. This term has been used in the present paper because there is at present no term in common usage in hydrodynamics which means dV/dP. This is different from the term ‘distensibility’ which is commonly used to mean dV/dP + V. The term mean circulatory filling pressure (MCFP) has been defined previously (2), and it means ,__-