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MMWR articles are embargoed until 4 p.m. Eastern time on Thursday. |
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| MMWR Synopsis | |
| Fact Sheet | Achievements in Public Health, 1900-1999: Decline in Deaths from Heart Disease & Stroke |
Click here
for MMWR home page. Synopsis August 6, 1999
Decline in Deaths from Heart Disease and Stroke —
United States, 1900-1999 |
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| PRESS CONTACT: Kurt Greenlund, Ph.D. CDC, National Center for Chronic Disease Prevention & Health Promotion (770) 488-2424 |
In one of the major public health achievements of the 20th century, age-adjusted death rates from cardiovascular diseases have declined 60% since 1950 and account for approximately 73% of the decline in all causes of deaths during the same period. In 1996, there were 621,000 fewer deaths from coronary heart disease than would have been expected had the rate remained at its 1963 peak. Trends associated with fewer deaths from heart disease and stroke include the decline in cigarette smoking, decreases in blood pressure levels in the U.S. population, an increase in the percentage of people with hypertension who have the condition under control, and decreased levels of cholesterol in the blood. Despite this remarkable progress, significant challenges in battling heart disease and stroke remain to be addressed to reduce racial, ethnic, gender, and socioeconomic gaps in heart disease and stroke deaths. |
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Geographic Variation in Penicillin Resistance in
Streptococcus pneumoniae — Selected Sites, United States, 1997 The prevalence of penicillin-resistance in S. pneumoniae varies among U.S. regions and among institutions within a region. |
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| PRESS CONTACT: Daniel Feikin, M.D. CDC, Epidemiology Program Office (303) 692-2701 |
Using data collected in 1997 from a population-based surveillance system from 7 regions in the United States, CDC found that overall 25 percent of S. pneumoniae isolated from invasive sites, such as blood or cerebrospinal fluid, were not susceptible to penicillin. The proportion of nonsusceptible isolates ranged from 15.3% in Maryland to 38.3% in Tennessee. Despite the regional variation in resistance, all regions showed a wide range of resistance among individual hospitals. For example, in Connecticut hospitals, the proportion of nonsusceptible S. pneumoniae ranged from 0 to 39.1%. Drug-resistant S. pneumoniae has become more common the United States, increasing from 14 percent in 1993-94 to 25 percent in 1997. Clinicians and public health practitioners should be aware of such regional and local variation in resistance. |
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Primary Multidrug-Resistant Tuberculosis — Ivanovo
Oblast, Russia, 1999 New data on primary multidrug-Resistant TB in Russia points to need for increased vigilance. |
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| PRESS CONTACT: Office of Communications CDC, National Center for HIV, STD, and TB Prevention (404) 639-8895 |
This article presents the findings of an investigation of primary multidrug-resistant tuberculosis (P-MDRTB) in Ivanovo (Russia) from 1995 to 1998. As part of an international collaboration with the World Health Organization and others, CDC investigated high levels of treatment failure and drug resistance to two or more first-line therapies (isoniazid and rifampin) among 514 reported never-treated cases in this community. The percentage of P-MDRTB cases more than doubled from 3.8% to 9.4% between 1996 and 1998. This study underscores the need for additional program strategies in areas with drug resistance, including improved TB treatment supervision and greater availability of second-line TB therapies. These efforts have already been initiated to improve treatment outcomes in current TB patients and prevent the further spread of MDR-TB. Global efforts to reach such cases remain critical to worldwide control of TB. |
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Mortality Patterns — United States, 1997 Improvements in U.S. mortality result in a record high life expectancy in 1997. |
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| PRESS CONTACT: Donna Hoyert, Ph.D. CDC, National Center for Health Statistics (301) 436-8884 (Alternate: Harry Rosenberg, Ph.D., same phone number) |
In 1997, overall life expectancy at birth increased to 76.5 years, primarily because of declines in mortality from HIV infection, heart disease, cancer, stroke, and homicide (these declines were originally reported in preliminary data released in October 1998). The overall age-adjusted death rate was at the lowest level ever, 479.1 per 100,000 standard population, and between 1996 and 1997, death rates decreased for all age groups except for persons aged 85 years and over. Mortality also decreased between 1996 and 1997 for 8 of the 15 leading causes. The information on causes of death in this report is recorded on death certificates by physicians, medical examiners, and coroners; the death certificates are filed in state vital statistics offices. |
Achievements in Public Health, 1900-1999: Decline in Deaths from Heart Disease & StrokeAugust 6, 1999 The decline in deaths from heart disease and stroke during the 20th century is an important public health achievement. Dramatic improvements in health and overall life expectancy have been observed as a result of the overall 60 percent decline in cardiovascular disease death rates since 1950.
Prevention efforts and improvements in early detection, treatment and care are associated with the declining rates. Trends which have contributed to the decline in deaths from heart disease and stroke include the following:
Despite these advances, cardiovascular disease remains the leading cause of deaths and a major cause of disability in the United States. The overall decline masks important differences in death rates by race-ethnicity, sex, socioeconomic status and geographic region. Also, evidence suggests that some important trends have leveled off or are reversing. For example, death rates from stroke have remained stable or have even slightly increased during the 1990s. |
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