The good news: heart disease deaths are down in the U.S. The fine print: that decline is softer in some groups -- especially women and the elderly -- than others.

Make no mistake; heart disease is still a leading cause of death for men and women alike. But a study in the journal Circulation shows that women and elderly people may be more likely to die of heart problems than others.

The study tracked cardiovascular disease in Olmsted County, Minn., from 1979 to 2003. The biggest town in Olmsted County is Rochester, Minn., where the Mayo Clinic is located.

Mayo Clinic researchers including Yariv Gerber, PhD, got their data from Olmsted County’s death certificates. They focused on coronary heart disease, other heart diseases, and noncardiac diseases of the circulatory system, using the term “cardiovascular disease” (CVD) for the grand total of all of those deaths.

Study’s Findings

From 1979 to 2003, 6,378 Olmsted County residents aged 25 and older died of CVD. Their causes of death are as follows:

--Most (57 percent) died of coronary heart disease.

--18 percent died of other heart diseases.

--A quarter died of noncardiac diseases of the circulatory system.

Overall, the county’s CVD deaths dropped by half from 1979 to 2003. But the declines were a bit uneven. The details:

--Women had a lower annual decline in CVD deaths than men (2.5 percent for women; 3.3 percent for men).

--Older people had a lower annual decline in CVD deaths than younger people (1.5 percent for people aged 85 and older; 3.9 percent for those up to 74 years old).

--Out-of-hospital CVD deaths had a lower annual decline than in-hospital CVD deaths (1.8 percent for out-of-hospital CVD deaths; 4.8 percent for in-hospital CVD deaths).

--Out-of-hospital deaths included deaths occurring in emergency rooms as well as people who were declared dead on arrival at a hospital.

Coronary heart disease remained the leading cause of CVD death during the years that were studied despite declining by 3.3 percent per year, the study shows.

However, other types of CVD death showed slower annual declines (2.1 percent for other heart diseases such as heart failure and 2.4 percent for noncardiac circulatory system diseases such as stroke).

The overall drop in CVD deaths is “encouraging,” the researchers write. They call for these steps:

Further reduce CVD deaths for women and the elderly. Highlight CVD deaths not caused by coronary heart disease. Stress CVD prevention.

OlmstedCountyis mainly white, but the findings seem in line with other national studies, write Gerber and colleagues.

By Miranda Hitti, reviewed by Louise Chang, MD

SOURCES: Gerber, Y. Circulation, May 16, 2006; vol 113. News release, American Heart Association.