ABSTRACT
Coronary heart disease (CHD) is the leading cause of death in industrialized societies, and it is rapidly becoming a major cause of death in developing countries, imposing an enormous burden on the social and economic welfare of each country (1, 2). There are two striking features of the epidemiology of CHD that are of major scientific and practical significance. The first is the marked contrast between the countries of Western Europe, where CHD is now showing welcome declines in mortality, and those of Central and Eastern Europe, where CHD rates are rising dramatically. Figure 3.1 shows that countries of the West, with the exception of Ireland, all show decreases; the countries of Central and Eastern Europe, which were at the time all under communist governments, all show increases (3). The second feature is the sharp socioeconomic gradient in CHD (higher rates in lower socioeconomic groups) that is now seen in most Western industrialized countries, but may be different in the countries of Central and Eastern Europe. Understanding reasons for the variations in the socioeconomic gradient in CHD mortality is crucial to public health. Percentage change 1970–1985 in age-standardized death rates from heart disease (ages 30–69). https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780203774014/2eccb7f2-be81-482a-ba87-27e6c76eebcc/content/fig3_1_B.tif" xmlns:xlink="https://www.w3.org/1999/xlink"/>
