Cardiovascular disease mortality rates, especially for myocardial infarction and stroke, have fallen markedly over the past several decades in all race, sex, and age groups in the United States. Between 1966 and 1986, the combined death rate for all cardiovascular diseases declined by 42 percent. In 1986, the death rate for coronary heart disease was 55 percent of what it had been in 1966, and cerebrovascular disease was 42 percent of what it had been in 1966. The decline is assumed to be related to several factors including improved medical care and risk factor modification for elevated blood lipids, cigarette smoking, and hypertension. The Minnesota Heart Survey provide trends (1970-2002) in coronary heart disease deaths out-of-hospital, in hospitalization rates, case fatality and survivorship for myocardial infarction and stroke in the metropolitan area.