Trends in mortality from ischaemic heart disease in Singapore, 1959 to 1983

Mortality from ischaemic heart disease in Singapore has been studied from vital statistics for the 25 years from 1959 to 1983. The age-standardized rates for ages 30 to 69 years increased in men from 106.8 per 100 000 in 1959-1963 to 204.5 in 1979-1983, while for women they increased from 30.7 to 72.0 per 100 000. The male to female ratios in the age-standardized rates for ischaemic heart disease fell from 3.5 to 2.8 in the period, while remaining steady for all causes. However, while mortality rates for ischaemic heart disease have increased steadily over the period in the older age groups, they have recently declined in the younger ages with a birth cohort effect. For males the decline started with the 1932-1936 birth cohort (men now aged around 50 years), while for females it was the 1937-1941 birth cohort (women now aged around 45 years). The reasons for this decline are discussed but no clear explanation is at present apparent and it would be useful to have future monitoring of lifestyles and coronary risk factors.