Cardiovascular risk factors as determinants of 25-year all-cause mortalityin the seven countries study

This analysis aims at describing all-cause mortality and their determinants in 16 cohorts of middle-aged men of eight nations. A total of 12,763 men a ged 40-59 years were enrolled in the late 1950s and early 1960s in 16 cohor ts located in the USA, Finland, The Netherlands, Italy, Croatia, Serbia, Gr eece and Japan. The highest death rates were found in Slavonia-Croatia, due to high rates of infectious diseases and violence (death rate of 610 per 1 000), and in East Finland due to high rates from coronary heart disease (de ath rate of 597 per 1000). The lowest death rates were found in a highly ed ucated group in Belgrade, Serbia (death rate 295 per 1000) and in Crete, Gr eece (death rate 314 per 1000). The ecological analysis showed no significa nt relationship between mean risk factor levels and all-cause death rates e xcept for the direct association with systolic blood pressure during the fi rst 15 years follow-up. Individual multivariate analysis on eight national pools showed that age, systolic blood pressure, and smoking habits are dire ct, significant, and universal long-term predictors of all-cause mortality. Serum cholesterol, physical activity and body mass index were so only in s ome areas. Multivariate coefficients were similar across nations. Pooled ha zards ratios were 1.55 for a difference of 5 years of age (CI: 1.51-1.59); 1.23 for 10 cigarettes smoked per day (CI: 1.20-1.26); 0.91 for one unit (b ased on three grades) of physical activity score (CI: 0.87-0.95); 1.04 for 1 mmol/l of serum cholesterol (CI: 1.02-1.07); and 0.93 for three units of body mass index (CI: 0.91-0.96). In conclusion some cardiovascular risk fac tors predict long-term risk of all-cause mortality in different cultures.