Summary

This report provides results from Australia’s two MONICA centres in Newcastle and Perth. Death rates from coronary heart disease began to fall in Australia in the late 1960s. The Australian MONICA data is consistent with data from the Australian Bureau of Statistics showing that the fall continued during the late 1980s and early 1990s. The reduction occurred for both men and women and for all age groups up to 69 years. During the same period there was also a reduction in non-fatal definite acute myocardial infarctions.

Case fatality declined significantly in Newcastle but not in Perth. New drug therapies, such as thrombolytic therapy and angiotensin-converting enzyme inhibitors, were introduced during the period. These therapies were quickly accepted and their use increased rapidly. The use of aspirin also increased rapidly and by 1993 aspirin was used by over 80% of patients who were treated in hospital.

The risk factor profile of the population showed some improvements between 1983 and 1994. In both centres there was a substantial reduction in the prevalence of smoking. There was a reduction in systolic blood pressure and serum cholesterol and an increase in high-density lipoprotein cholesterol. Unfortunately, there was a large increase in the prevalence of obesity and an increase in the prevalence of diabetes.

The use of aspirin in the general population increased substantially from 1983 to 1994. In 1994, approximately 28% of men aged 65–69 years in Newcastle were taking aspirin on a daily basis. There was also an increase in the use of angiotensin-converting enzyme inhibitors and calcium channel blockers in the general population and a reduction in the use of diuretics and other antihypertensive medications.