Gompertzian analysis of ischemic heart disease mortality in Spain, 1951-1992

Introduction and objectives. In Spain ischemic heart disease mortality was increasing prior to 1975 and has decreased since 1975. This trend is common to both genders. The goal of this paper is to separate the genetic, environmental and competitive risk factors influencing this evolution. Methods. The Gompertz function was adjusted cross-sectionally to age-specific mortality due to ischemic heart disease for each year from 1951 to 1992. The Gompertzian longitudinal analysis was applied to the coefficients obtained to estimate the effect due to environmental and competitive factors. Results. Ischemic heart disease in Spain is a Gompertzian disease with an intersection point at 67 years for men and 40 years for women. Environmental factors were increasing before 1975 and have decreased since then. However, the competitive factors decreased in men since 1980 and in women since 1951 on. Conclusion. The evolution of risk factors (smoking, hypercholesterolemia and hypertension) is responsible for the major proportion of ischemic disease mortality changes. Treatment of instaured ischemic disease has a low influence.