This study examined trends in ischemic heart disease (IHD) mortality rates in Canada from 1986 to 2000, including analyses at the county level. The study population comprised Canadians aged 35 and over. Age-standardized mortality rates (ASMRs) were computed. Linear regression and Poisson regression were used to calculate average annual percentage change (AAPC) by age, sex, county and province. A substantial decrease in mortality rates was observed in those aged 35 and over for both sexes; the AAPC indicated a decline of 3.44 percent for males and 3.42 percent for females. The ASMRs were plotted for three time periods; the rates increased with each successive age group and decreased with each consecutive time period for both sexes. A significant decline in the IHD mortality rate was found in 47.2 percent and 46.9 percent of the counties among males and females, respectively; those counties had a statistically significant lower prevalence of daily smoking in both genders, and obese in females only. Only two counties showed a significant increase in the ASMRs of IHD in males and females, respectively. Enhanced prevention and control strategies should be considered to address IHD in countries where more modest decreases (or no decrease at all) in IHD mortality have been observed.
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