An Epidemiological Model for Coronary Heart Disease (CHD)

Abstract

Mortality from CHD has been on the increase in most countries until in the late sixties the trend reversed in a few countries such as the USA, Canada, and Australia (Cooper 1978, Nicholls 1981, Epstein 1979). Ever since then CHD mortality has been on the decline in these countries. Since it is not known whether the incidence of CHD has declined or whether the prognosis of patients with CHD has improved, several studies have been initiated to determine the cause of the trend reversal. The data emanating from these studies will be difficult to interpret unless one is cogniscant of the inherent dynamics of the CHD system. The aim of this communication is to propose a dynamic model for the CHD system and to perform some preliminary system analysis. The benefits to be derived from such a model extend beyond the interpretation of mortality observations. It should be particularly useful in simulating intervention programs, since they are not only difficult to conduct but also require a very long observation period.