To analyse trends in mortality from coronary heart disease (CHD) and cerebrovascular disease (CVD) over the period 1965 to 1998 in the European Union, other European countries, the USA, and Japan.
Data were derived from the World Health Organization database. In the European Union, CHD mortality in men rose from 146/100 000 in 1965-9 to 163/100 000 in 1975-9 and declined thereafter to 99/100 000 in 1995-8 (-39%). In women, the fall was from 70 to 45/100 000 (-36%). A > 55% decline in CVD was registered in both sexes. In eastern Europe, mortality from both CHD and CVD rose up to the early 1990s but has declined over the past few years in Poland and the Czech Republic. In the Russian Federation during 1995-8, mortality rates from CHD reached 330/100 000 men and 154/100 000 women and mortality rates from CVD were 203/100 000 men and 150/100 000 women-that is, they were among the highest rates worldwide. In the USA and Japan, long term trends were favourable for both CHD and CVD.
Trends in mortality from CHD and CVD were favourable in several developed areas of the world, but there were major geographical differences. In a few eastern European countries, mortality from CHD and CVD remains exceedingly high.