Project: Research project

Project Details


DESCRIPTION: (Adapted from Investigator's Abstract) The proposed study will
test hypotheses related to gender differences in cardiovascular mortality
trends between 1980 and 1991 in two southeastern New England communities.
The Specific Aims are organized under four major topic areas: 1) gender
differences in trends from 1980 to 1991 in total event rates, hospital
discharge rates, in-hospital case-fatality and out of hospital deaths for
coronary heart disease (CHD) and stroke; 2) gender specific analyses of
methodological issues which may affect the interpretation of morbidity and
mortality surveillance data; 3) gender differences in the presentation,
diagnosis, and treatment of CHD and stroke which may influence morbidity and
mortality trends; and 4) gender differences in the association between
population trends in risk factors and morbidity and mortality trends.

These aims will be accomplished using morbidity and mortality data collected
by the Pawtucket Heart Health Program between 1980 and 1993, and risk factor
data obtained through biennial cross-sectional household health surveys
conducted in random samples of residents in the two study communities.
Morbidity and mortality data were obtained according to standardized
epidemiologic surveillance methods. Hospitalized cases of coronary heart
disease and stroke were identified through hospital discharge records and
were validated using a standardized diagnostic algorithm based on data
abstracted from medical records. Out-of-hospital deaths identified through
death certificate data were validated using an algorithm based upon medical
history data and information concerning the circumstances of death obtained
from informant interviews.

Gender specific trends in both age-adjusted and age specific morbidity and
mortality will be compared. Trends in rates estimated from events
classified according to ICD-9 discharge and death certificate codes will be
contrasted with those estimated from cases validated by standardized
diagnostic algorithms. Data regarding circumstances of death and
in-hospital treatment will be assessed in relation to potential influences
on morbidity and mortality trends. Absolute changes over time and average
annual percent change over time will be evaluated using linear and
log-linear regression techniques. Other analytic methods will include
logistic regression and analysis of variance. Expected annual event rates
in men and women will be estimated from risk factor data using equations
based upon accelerated failure time Weibull models, and the impact of risk
factor on mortality rates will be assessed by comparing predicted with
actual rates.
Effective start/end date7/1/966/30/01


  • Cardiology and Cardiovascular Medicine


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