Changing patterns of cardiovascular disease mortality in the United States

There is evidence indicating that the decline in cardiovascular mortality during the last 20 yr may be partly due to the lower case fatality rates brought about by improvements in specialized medical services. There is also evidence that large segments of the U.S. population have modified their life-styles in order to reduce their levels of adverse risk factors. However, it is still unclear whether the reduction in risk factor levels has resulted in a decrease in the number of heart attacks. Additional research is needed to resolve this issue so that proper emphasis can be given to those public health factors which may promote the continuation of the decline in cardiovascular mortality.