Relationship of Baseline Major Risk Factors to Coronary and All-Cause Mortality, and to Longevity: Findings from Long-Term Follow-Up of Chicago Cohorts

Abstract

The focus here is on relationships between major risk factors and long-term mortality from coronary heart disease (CHD) and all causes, and on longevity, in Chicago cohorts: 25-year follow-up for Peoples Gas (PG) men aged 25-39 (n = 1,119), 30-year follow-up for PG men aged 40-59 (n = 1,235), 24-year follow-up for Western Electric (WE) men aged 40-55 (n = 1,882); also 15-year follow-up for five cohorts of the Chicago Heart Association (CHA) Study: men aged 25-39 (n = 7,873), 40-59 (n = 8,515), 60-74 (n = 1,490), and women aged 40-59 (n = 7,082) and 60-74 (n = 1,243); also 12-year findings for very low risk men (n = 11,098) and other men (n = 350,564) screened for the Multiple Risk Factor Intervention Trial (MRFIT). With a high degree of consistency, multivariate analyses showed independent positive relationships of baseline serum cholesterol, blood pressure and cigarette use to risk of death from CHD and all causes. For the WE cohort, with baseline nutrient data, dietary cholesterol was also independently related to these mortality risks. Combined risk factor impact was strong for both men and women of all baseline ages. Thus, for WE men, favorable compared to observed levels of serum cholesterol, blood pressure, cigarette use and dietary cholesterol were estimated to result in 24-year risk of CHD death 69% lower, all-cause death 42% lower and longevity 9 years greater. For CHA middle-aged and older women, favorable baseline levels of serum cholesterol, blood pressure and cigarette use were estimated to yield 15-year-CHD risk lower by about 60% and longevity greater by about 5 years. For MRFIT, very low risk men (serum cholesterol < 182 mg/dl, systolic/diastolic blood pressure < 120/ < 80), nonsmokers, nondiabetic, no previous heart attack), compared to all others, observed 12-year death rates were lower by 89% for CHD, 79% for stroke, 86% for all cardiovascular diseases, 30% for cancers, 21 % for other causes, 53% for all causes, and longevity was estimated to be more than 9 years longer. These findings indicate great potentials for prevention of the CHD epidemic and for increased longevity with health for men and women, through improved life-styles and consequent lower risk factor levels.

Work-related risk factors of myocardial infarction

“…Authors of numerous epidemiological studies conclude that tobacco smoking is associated with ca. 1.5 to 2.5 increase in the risk of developing CVD [16][17][18][19]. In Europe, 18% of deaths from CVD are attributable to tobacco smoking.…”

Blood pressure control status and effects of pravastatin on cardiovascular events occurrence in patients with dyslipidaemia

“…4 It is well known that the accumulation of risk factors for cardiovascular events increases the incidence of such events. In previously reported subanalyses of the MEGA Study involving patients with hypertension and diabetes, the incidence of cardiovascular events was higher than in patients without hypertension and diabetes.…”

“…[1][2][3][4][5][6] In addition, dyslipidaemia is a conventional risk factor for cardiovascular disease (CVD), and the presence of hypertension increases the incidence of CVD. [7][8][9] We previously reported that hypertension is a strong risk factor for coronary heart disease (CHD) 10 and stroke, 11 and that pravastatin is effective to prevent cardiovascular events in patients with hypertension in the MEGA Study.…”

Effect of a mineral salt diet on 24-h blood pressure monitoring in elderly hypertensive patients

“…42 It was pointed out that a cut in sodium consumption by both manufacturers and individuals of 100 mmol/24h could reduce the incidence of stroke by 39% and that of ischaemic heart disease by 30%, 43 and effect a marked reduction in mortality 44 and/or morbidity. 45 Such figures put the onus on the food industry to reduce the amount of salt added in food processing and help implement the recommendations made to the public for salt reduction. [46][47][48][49] It should be noted that the standard diet in the residents of our old peoples home did not include processed food in the first place; thus, lowered BP was achieved in them only by removing ordinary salt from the kitchen and the table and substituting it with Pansalt ® .…”