Coronary heart disease and future expectation of life.

SUMMARY Mortality from coronary heart disease (CHD) has risen enormously over the last generation. Some regard the concomitant increase in life expectancy as the sole explanation; others maintain the increases at least in part to be real. Irrespective of the true causes, the question arises: If increases in CHD mortality continue in certain of the populations most affected, may not expectation of life ultimately decrease? An answer is sought by examining relevant information (1) on a large community of rural Indians having a low prevalence of CHD, and (2) on the offspring of Indian immigrants to South Africa, whose CHD mortality now exceeds that of the local whites. It is concluded that while promotive factors linked with urbanization and prosperity are chiefly responsible, the bearing of an ethnic propensity cannot be excluded. Continuation of the present CHD mortality trend in South African Indians almost undoubtedly will decrease their life expectancy, which, even at present, appears to compare unfavorably from youth onward with that of the rural Indian group described.