The pattern of ischemic heart disease 1931–1980

The rise in ischemic heart disease in the U.S. after 1920 has been described in the literature both as a 20th century epidemic and as an artifact of the decline of competing causes of death, particularly the infectious, parasitic and diarrheal diseases. Shifting medical terminology and occasional major revisions in cause of death codes have aggravated efforts to resolve the debate. Through regression analysis and ordinary and cause‐deleted life tables we trace the course of the disease. The accumulated evidence points to a major epidemic but one largely confined to males. Reversals in patterns are now beginning.