In order to review the epidemiological data of acquired heart disease including primary hypertension, the sex and, age; incidences of- various types of, the .disease were analysed in 5, 000 well-studied cardiac$,, aged over 15, seen at the Department of Internal Medicine of the Kyungpook.National. University Hospital between January 1958 and December 1975. In addition, in order to estimate the actual number of various cardiacs, a correction off the observed numbers was made, -by a formula derived from the sex ratios of each group of the general census of Koreans and the census of all patients who visited our department with diverse problems. The estimated number of the various cardiacs were also analysed in regard to sex and type incidences of the disease. In the observed cases, heart diseases as a whole were more common in males in all age groups except in the thirties where no appreciable sex difference was noted. The age, incidence was highest in the fifties followed by the sixties and forties. In the estimated cases, however, the incidence of heart diseases was higher in females in all age groups, except in teenagers. The overall male to female ratio of heart diseases was .1. 2 : 1 in the observed cases and 1 : 1.4 in the estimated cases. Hypertension, rheumatic valvular heart disease and arteriosclerotic heart disease were three major conditions accounting for approximately 60, 20 and 10 per cent of all cardiacs, respectively, thus. these three conditions comprised about 90 per cent of ´all the cases. The remainder, . namely pericarditis, chronic cor pulmonale, postpartum myocardiopathy, myocarditis, syphilitic aortic insufficiency, thyrotoxic heart disease, etc.. were not common and each accounted for only about two per cent or less of all the cases. Hypertension was most common in
die fifties and approximately 80 per cent were in the forties and above age group. The male to female ratio of hypertension in the observed cases was 1. 21 but was reversed in the estimted cases to 1 1.4. Rheumatic valvular heart diseases as a whole showed no difference in incidence according to sex and nearly 70 per cent of them were seen before the age of forty. The most common type of disease was mitral stenosis followed by mitral stenoinsufficiency and combined mitral and aortic valve disease, but isolated aortic valve disease and pure or predominant
mitral insufficiency were rather uncommon. In the observed cases, combined mitral and aortic valve disease, isolated aortic valve, disease and pure. or predominant mitral insufficiency were more frequent in males, but in the estimated cases isolated aortic
valve disease only was more frequent in males. In the estimated, cases the male to female ratio of
rheumatic valvular heart disease was 1 1.7. Approximately 95 per cent of arteriosclerotic heart disease was seen in the over fifty group. Myocardial infarction was the most common followed by chronic myocardial damage and angina pectoris, and all three conditions were more frequent in males. In the estimated cases, however, chronic myocardial damage was more common in females while the sex difference in the other two conditions became much less pronounced. The overall male to female ratio of arteriosclerotic heart disease was 2. 0 : 1 in the observed cases and 1 : 1. 1 in the estimated. Among the uncommon heart diseases, pericarditis, chronic cor pulmonale and syphilitic aortic insufficiency were more common in males, whereas myocarditis and thyrotoxic heart disease were more frequent in females, both in the observed and in the estimated cases. However, the sex difference was less pronounced in the estimated cases, in contrast to the latter two conditions, in which it became much more pronounced. In pericarditis, two major causes were tuberculosis and pyogenic infection: the peak age incidence of the former was in the forties and that of the latter in the twenties. Major causes of chronic cor pulmonale were chronic obstructive lung diseases, pulmonary tuberculosis and bronchiectasis, accounting for approximately 55, 33 and 10 per cent of all cases, respectively. All of these three causative diseases were more frequent in males,- in both the observed and the estimated cases. The peak age incidence of the disease due to chronic obstructive lung disease and pulmonary tuberculosis was in the fifties and forties,. respectively. Syphilitic aortic insufficiency was predominantly a disease of the old age group, about 80 per cent of the condition being noted in the forties and above age group. The most common cause of myocarditis was rheumatic, accounting for about two/thirds of all the cases, ´and approximately two/ -thirds of all cases were seen in the under thirties age group. Thyrotoxic heart disease was -seen predo ininantly in females. Postpartum cardiomyopath was noted in the 20 to 40 age range and more than Half of the cases were in the twenties. .
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