Background and aim: In India, Kerala has the best health indicators, having experienced dramatic shifts in mortality and fertility. However, the mortality pattern in Kerala has not been studied. In this article, the authors analyze and report the pattern of mortality in the PROLIFE cohort (n = 161,942).

Methods: Data on death were collected through regular home visits using a pretested, structured questionnaire. The data were validated by a physician. The deaths were grouped under disease categories using ICD 10.

Results: Out of 4271 deaths recorded during 5 years, diseases of the circulatory system contributed 40%. Coronary heart disease was the leading cause of death in men (31.1%) and women (17.6%). Age-standardized cardiovascular disease (CVD) death rates were 490 for men and 231 for women per 100,000 person years.

Conclusion: The burden of CVD deaths in this community now exceeds that of industrialized countries.