Social patterning of myocardial infarction and stroke in Sweden: Incidenceand survival

Cardiovascular disease morbidity and mortality rates show marked social pat terning in industrialized countries. The aim of this study was to analyze i f not only incidence but also survival after acute myocardial infarction (A MI) and stroke differ among socioeconomic groups. Within the framework of t he population-based World Health Organization's Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) Project, all fi rst-ever AMI (ages 25-64 years) and stroke (ages 25-74 years) events were r ecorded in northern Sweden during the period 1985-1994. The numbers of firs t-ever AMI and stroke patients included in the study were 3,466 and 4,215, respectively. Incidence rates for both AMI and stroke showed a distinct soc ial pattern, with high rates in workers and self-employed nonprofessionals and low rates in professionals. The pattern was similar in men and women. I n men, early survival after an AMI follows the same socioeconomic pattern, whereas it is less clear if socioeconomic differences in survival contribut e to explain differences in mortality in AMI among women and mortality in s troke (both sexes). The high case fatality among male workers and self-empl oyed professionals with AMI is, in turn, attributed to a very marked increa se in the risk for sudden death.