Coronary Heart Disease Mortality: A Community Perspective

A mortality survey was taken in an affluent suburban Maryland community of 250,000. During calendar year 1969, there were 719 recorded deaths for persons aged 35 to 74 years, of which 257 (36%) were due to coronary heart disease (CHD). Fifty-four (21%) of the CHD deaths were certified as occurring elsewhere than in a hospital. One hundred eighty-seven CHD victims reached local medical facilities; of these, 101 (54%) were either dead on arrival or pronounced dead in emergency rooms. Thus, in a minimum of 155 instances or 60% of the total CHD mortality experience, the patients died before receiving definitive medical care. The median patient delay, from onset of symptoms until hospital arrival, for the 66 persons with fatal CHD who were hospitalized locally was 5.6 hours. Public education and mobile and other ancillary medical facilities play a role in reducing premature CHD mortality.