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The Role of Natural Consequences in the Changing Death Patterns *
Author(s) -
BARNES BRODA O.,
RATZENHOFER MAX,
GISI RICHARD
Publication year - 1974
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1974.tb02164.x
Subject(s) - medicine , myocardial infarction , tuberculosis , autopsy , cause of death , disease , lung cancer , surgery , cardiology , pathology
A comparison of the causes of death listed in autopsy protocols at Graz, Austria, for 1930 and 1970 showed that the major change was a marked decrease in deaths from tuberculosis and a marked rise in deaths from myocardial infarction. In 1930, patients over 50 years of age dying with tuberculosis had advanced coronary atherosclerosis which soon would have caused death if tuberculosis had not won the race. Myocardial infarction did not start its explosive rise until the introduction of specific drugs against the tubercle bacillus. This began in 1946 at a time when the diet was low in cholesterol, smoking was at a low ebb, sedentary life was unknown, and stress was decreasing as the war ended. Moreover, during the early years of the rise in myocardial infarction there was evidence of active or healed tuberculosis in postmortem studies. It appears that a major factor in the rise of coronary disease was prolongation of the life of patients with tuberculosis or a susceptibility to it. Coronary disease and emphysema accounted for 90 per cent of the increase in degenerative diseases. Prostatic cancer, juvenile cancer and lung cancer together accounted for 86 per cent of the rise in malignant diseases. Thus the law of chance did not control the distribution of the causes of death among those escaping death from infections. In myocardial infarction, the preponderance of males is similar to that in tuberculosis, indicating that supply and demand may be to blame. Any theory about the changing death patterns should take into account the factor of natural consequences, as may be revealed in autopsy studies.