Risk factors of coronary heart disease: West German data

While death rates of myocardial infarction are largely constant in the United States, there has been a continuous increase since the war in the Federal Republic of Germany as well as other European countries. This applies to males and females, although the increase is especially high in younger women. In contrast to falling death rates due to hypertension in the U.S. and some European countries, there is no change in Germany. In conjunction with a study by WHO in which Heidelberg is one center, the time interval between the onset of the myocardial infarction and death is investigated. The mortality rate is extremely high in the first few minutes and hours. Within one month after the attack, 59% of males and 54% of females have died, about half of the deaths occurring within the first hour. During the first hour, 65% of the patients decide to call a doctor. In a group of male cases below age 40, the risk factors of cigarette smoking, hyperuricemia, hypertension, and diabetes are more prevalent than in controls. In smokers, myocardial infarction occurs at a younger age than in nonsmokers. Cases with myocardial infarction have a lower job-related physical activity score than controls. A psychological pattern was found in patients with myocardial infarction, showing them to be anxious, inflexible, and socially over-adaptive, while, at the same time, fearing contact.