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Abstract
Aim To analyse the timing and scale of temporal changes in rates of hospitalised myocardial infarction (MI) in England by age and sex from 1968 to 2016.
Methods MI admissions for adults aged 15–84 years were identified from electronic hospital data. We calculated age-standardised and age-specific rates, and examined trends using joinpoint.
Results From 1968 to 2016, there were 3.5 million admissions for MI in England (68% men). Rates increased in the early years of the study in both men and women, peaked in the mid-1980s (355 per 100 000 population in men; 127 in women) and declined by 38.8% in men and 37.4% in women from 1990 to 2011. From 2012, however, modest increases were observed in both sexes. Long-term trends in rates over the study period varied by age and sex, with those aged 70 years and older having the greatest and most sustained increases in the early years (1968–1985). During subsequent years, rates decreased in most age groups until 2010–2011. The exception was younger women (35–49 years) and men (15–34 years) who experienced significant increases from the mid-1990s to 2007 (range +2.1%/year to 4.7%/year). From 2012 onwards, rates increased in all age groups except the oldest, with the most marked increases in men aged 15–34 years (7.2%/year) and women aged 40–49 (6.9%–7.3%/year) .
Conclusion Despite substantial declines in hospital admission rates for MI in England since 1990, the burden of annual admissions remains high. Continued surveillance of trends and coronary disease preventive strategies are warranted.
- epidemiology
- ischaemic heart disease
- record linkage
Data availability statement
Data may be obtained from a third party and are not publicly available. English hospital episode statistics can be obtained from NHS Digital at www.digital.nhs.uk.
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Data availability statement
Data may be obtained from a third party and are not publicly available. English hospital episode statistics can be obtained from NHS Digital at www.digital.nhs.uk.
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Footnotes
Contributors FLW and MJG conceptualised the study; all authors contributed to the design of the study, the interpretation of the results and reviewed the manuscript; MG provided statistical advice and conducted the joinpoint analyses; FLW and LN conducted the other data and statistical analyses; FLW wrote the original draft of the manuscript; MJG established the longstanding linked data sets in the Unit of Health-Care Epidemiology, University of Oxford, now part of the Big Data Institute.
Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The research was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, and by Health Data Research UK (OXFD1). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. LN is supported by a National Health and Medical Research Council of Australia Early Career Fellowship.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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