Mortality Rates in a Cardiovascular ‘Low-risk’ Population in Rural Crete

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Abstract
A research project in primary health care has been in progress since 1988 in an agricultural area of Crete, with the aim of surveying the cardiovascular risk profile and following the incidence of cardiovascular disease in the population over time. In the present paper we have investigated the mortality rates and the causes of death in 1989 and 1990 of the population of the Agios Vassilios county (n = 7758). Furthermore, whenever possible, we have checked the accuracy of the certified causes of death against the case record system introduced in 1988 in the health centre. During 1989 and 1990, 267 subjects died in the research area, 234 of whom were >65 years old. Diseases of the circulatory system (mostly congestive heart failure) accounted for 46% of all deaths. The corresponding figure for neoplasms was 18%. The standardized mortality from ischaemic heart disease was found to be very low in both men and women, 37.9 and 41.9 per 100 000 per year, respectively, in comparison with that of Greece as a whole in 1989, 140.0 and 59.5, respectively. These figures were considerably lower than those reported in 1988 from for example Sweden, 303.6 and 153.3, respectively. The standardized mortality from cerebrovascular disease in Agios Vassilios county was found to be somewhat lower than the national figures in 1989, 118.1 and 107.0 in males and females versus 135.7 and 142.1, respectively. In our analyses we did not find any under- representation of deaths in circulatory diseases when the death certificates were checked against the available information in the case record system at the health centre, in those patients where this type of in formation was available (n = 128, 48%). In conclusion, the mortality from ischaemic heart disease still seems to be low in Cretans, as previous reports have shown. An upward trend may, however, be expected in the future, maybe as a result of the change in lifestyle now taking place in Crete. The longitudinal observation of the mortality of the Agios Vassilios population is expected to elucidate this further in the future.

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