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A Menotti

Publications and source records attributed to A Menotti.

At least 37 records · Page 2Linked to original sources
PubMed2001

The association of silent electrocardiographic findings with coronary deaths among elderly men in three European countries. The FINE study.

OBJECTIVES: Ten-year coronary heart disease (CHD) mortality in elderly male cohorts in three European countries was evaluated as a function of silent resting Minnesota Code electrocardiographic (ECG) findings found at baseline. METHODS AND RESULTS: Men aged 65-84 at entry were enrolled, examined and followed up for 10 years in 5 cohorts of three countries: Finland (N=716), the Netherlands (N= 887), and Italy (N = 682). Men with symptomatic angina pectoris, a documented history of myocardial infarction or heart failure were excluded from analysis, leaving 505 men in Finland, 713 in the Netherlands and 567 in Italy. ECG abnormalities were arranged in different groupings. Multivariate analyses adjusted ECG prediction of CHD mortality for cohort, and baseline age, systolic blood pressure, serum cholesterol, body mass index and cigarette smoking. RESULTS: Silent ECG abnormalities of presumed severity were found in more than half of these elderly men, with higher prevalence in Finland, compared to the other two countries. Adjusted hazards ratios for CHD deaths as a function of major single or combined ECG abnormalities, such as QQS and ST-T abnormalities, arrhythmia, definite and possible myocardial infarction and an operative definition of ischaemia, are generally similar across areas varying according to severity from around 1.5 to almost 4. Groupings of minor and major ECG abnormalities in the pooled countries gave significant relative risks of 1.79 and 3.12 respectively, compared to the group without or with marginal abnormalities. Sensitivity and positive predictive value were low, while specificity was high. CONCLUSIONS: Silent ECG abnormalities in elderly people are common and they carry a high risk of coronary death in the next 10 years, with relative risk ranging from around 1.5 to almost 4 or more depending upon severity and combination of findings.

Aged↗
PubMed2001

Serum uric acid for short-term prediction of cardiovascular disease incidence in the Gubbio population Study.

OBJECTIVE: The Gubbio Study is an Italian population study measuring risk factors for and incidence of major cardiovascular diseases. This analysis investigates the association of serum uric acid with the incidence of coronary and cardiovascular events. METHODS: A population sample of 2469 men and women aged 35-74 years, free from major cardiovascular diseases and in whom serum uric acid was measured in 1983 along with other standard risk factors, were followed up for 6 years and the incidence of coronary heart disease (CHD) and all cardiovascular atherosclerotic (CVD) events, both fatal and non-fatal, was computed. Proportional hazards models were used for the prediction of these events. RESULTS: In six years 61 CHD hard criteria, 109 CHD any criterion and 149 CVD events were recorded. Age-adjusted rates per 1000 of the 3 event categories were computed in sex-specific quintiles (Q) of serum uric acid with 428 +/- 76 (Q5) and 198 +/- 42 (Q1) micromol/l, respectively. Although higher rates were seen in Q5 as compared to Q1 for all three first event categories considered (relative risks 6.2, 3.6 and 3.7, respectively), a statistically significant trend was seen only for CVD all criteria (t = 3.63, p < 0.036). These trends were borderline significant for CHD any criterion (t = 2.92, p < 0.06) and not significant for CHD hard criteria (t = 2.23, p < 0.11). In multivariate models, adjusted for 8 other risk factors, serum uric acid showed a statistically significant contribution to predict CVD incidence [relative risk (RR) for 92 micromol/l difference of 1.24 with 95% confidence intervals (CI) 1.05-1.45], whereas the statistical contribution to predict CHD any criterion (RR = 1.19 with CI 0.98-1.45) and CHD hard criteria (RR = 1.20 with CI 0.93-1.55) was not significant. Diuretic treatment and blood urea, as further confounders, were positively and significantly related to event incidence (RR ranging from 1.21 to 2.00) but serum uric acid maintained its independent and statistically significant role in the prediction of CVD events (RR = 1.18 with CI 1.00-1.39). Presence of specific treatments to lower serum uric acid levels (in 1.13% of the population), tested as final confounders, was not statistically contributory. CONCLUSIONS: Increased serum uric acid levels are independently and significantly associated with risk of CVD events in the 6-year follow-up of the Gubbio Study. Longer follow-up is needed before the contributory role of serum uric acid can be properly assessed to explain CHD incidence.

Adult↗
PubMed2001

Markers of insulin resistance and colorectal cancer mortality.

A link between insulin metabolism and colorectal cancer has been hypothesized, supported by a series of potential physiological mechanisms, and confirmed by a number of reports in experimental animals. However, the evidence in humans is limited and mostly indirect. The aim of the present report is to analyze whether individuals with a cluster of metabolic abnormalities associated with abnormalities in insulin metabolism experience higher mortality for colorectal cancer than those without this cluster of metabolic abnormalities. A total of 21,311 men and 15,991 women 20-69 years of age were followed-up for an average of 7 years as part of the Risk Factors and Life Expectancy Project, a pooling of a number of epidemiological studies conducted in Italy. Our analyses indicate that participants with high levels of blood glucose and a cluster of metabolic abnormalities linked to insulin resistance experienced a significant increased risk of colorectal cancer mortality compared with participants without the cluster. For the presence of the cluster of metabolic abnormalities, the calculated hazard ratios and 95% CIs were 2.96 (1.05-8.31) for men, 2.71 (0.59-12.50) for women, and 2.99 (1.27-7.01) when both sexes were combined. These associations were independent from the potential confounding effect of age, drinking of alcoholic beverages, and smoking. Our findings are supportive of the hypotheses that glucose metabolism hyperinsulinemia, insulin resistance, and metabolic abnormalities associated with it may play a significant role in the etiology of colorectal cancer.

Adult↗
PubMed2000

Role of smoking and diet in the cross-cultural variation in lung-cancer mortality: the Seven Countries Study. Seven Countries Study Research Group.

We examined the role of smoking and diet in the cross-cultural variation in lung-cancer mortality, using aggregated data of the Seven Countries Study, a follow-up study comprising 12,763 middle-aged men in 16 cohorts in Europe, the United States and Japan, which started around 1960. Smoking habits were assessed with a standardised questionnaire. Dietary intake was collected in random sub-samples of each cohort by the dietary record method. Cohort-specific 25-year lung-cancer mortality among all men and among categories of smoking behaviour was related to smoking prevalence and population average dietary intake, respectively, using Poisson regression. Smoking prevalence was positively associated with lung-cancer mortality [risk ratio 1.47, 95% confidence interval (CI) 1.05-2.07, for an increase of 10 percentage points]. Lung-cancer mortality among smokers, which varied significantly among cultures, was positively associated with average fat intake, especially saturated fat intake (rate ratio 1.10, 95% CI 1.04-1.17, for an increase of 4.6 g) but not with unsaturated fat intake. Average fruit and vegetable intake were not related to lung-cancer mortality. Among never-smokers, the power to detect associations was low. In conclusion, both smoking prevalence and average fat intake, especially saturated fat, may play a role in the cross-cultural variation in lung-cancer mortality, either independently or by effect modification.

Adult↗
PubMed2000

Fish consumption and coronary heart disease mortality in Finland, Italy, and The Netherlands.

Fish consumption seems to protect against death from coronary heart disease (CHD). If this association is due to n-3 polyunsaturated fatty acids, especially fatty fish may be responsible for this protective effect. The association between total, lean, and fatty fish consumption and the risk of CHD mortality was examined in 1,088 Finnish, 1,097 Italian, and 553 Dutch men participants in the Seven Countries Study who were aged 50-69 years and free of CHD around 1970. After 20 years of follow-up, 242 (22.2%) men in Finland, 116 (10.6%) men in Italy, and 105 (19.0%) men in the Netherlands had died of CHD. Cox proportional hazards analysis showed no association between total fish consumption and CHD mortality. After adjustments were made for age, body mass index, smoking, energy intake, and relevant dietary variables, the pooled relative risk for the highest quartile of total fish compared with no fish consumption in the three countries was 1.08 (95% confidence interval: 0.76, 1.53). Lean fish consumption also was not associated with CHD mortality in any country. Fatty fish compared with non-fatty-fish consumption was associated with lower CHD mortality; the adjusted, pooled relative risk for fatty fish consumers was 0.66 (95% confidence interval: 0.49, 0.90). These data suggest that especially fatty fish is protective against CHD mortality.

Adult↗
PubMed2000

Underweight and overweight in relation to mortality among men aged 40-59 and 50-69 years: the Seven Countries Study.

This study investigated the relation between body mass index (BMI) and the all-cause mortality rate among 7,985 European men. Starting around 1960, when all men were aged 40-59 years, mortality was followed for 15 years (1960-1975); starting around 1970, the survivors were followed for an additional 15 years (1970-1985). For the first and second follow-up periods, a BMI of 18.5-25 kg/m2 around 1960 and 1970, respectively, was considered the reference category. The authors found that the hazard ratios of mortality for a BMI of <18.5 kg/m2 was 2.1 (95% confidence interval (CI): 1.5, 2.8) for the first follow-up period and 1.7 (95% CI: 1.3, 2.2) for the second. A BMI of 25-30 kg/m2 was not related to increased mortality. Among never smokers, the hazard ratios for a BMI of >30 kg/m2 were 1.8 (95% CI: 1.2, 2.8) for the 1960-1975 follow-up period and 1.4 (95% CI: 1.0, 1.9) for the 1970-1985 follow-up period. A BMI of >30 kg/m2 was not related to increased mortality among current smokers. When mortality was followed for more than 15 years, the hazard ratio for a BMI of <18.5 kg/m2 declined and the hazard ratios for a BMI of >30 kg/m2 did not change. Underweight among those in all smoking categories and severe overweight in never smokers remained predictors of increased mortality when middle-aged men became older.

Adult↗
PubMed2000

The relation between blood pressure and mortality due to coronary heart disease among men in different parts of the world. Seven Countries Study Research Group.

BACKGROUND: Elevated blood pressure is known to be a risk factor for death from coronary heart disease (CHD). However, it is unclear whether the risk of death from CHD in relation to blood pressure varies among populations. METHODS: In six populations in different parts of the world, we examined systolic and diastolic blood pressures and hypertension in relation to long-term mortality from CHD, both with and without adjustment for variability in blood pressure within individual subjects. Blood pressure was measured at base-line in 12,031 men (age range, 40 to 59 years) who were free of CHD. During 25 years of follow-up, 1291 men died from CHD. RESULTS: At systolic and diastolic blood pressures of about 140 and 85 mm Hg, respectively, 25-year rates of mortality from CHD (standardized for age) varied by a factor of more than three among the populations. Rates in the United States and northern Europe were high (approximately 70 deaths per 10,000 person-years), but rates in Japan and Mediterranean southern Europe were low (approximately 20 deaths per 10,000 person-years). However, the relative increase in 25-year mortality from CHD for a given increase in blood pressure was similar among the populations. The overall unadjusted relative risk of death due to CHD was 1.17 (95 percent confidence interval, 1.14 to 1.20) per 10 mm Hg increase in systolic pressure and 1.13 (95 percent confidence interval, 1.10 to 1.15) per 5 mm Hg increase in diastolic pressure, and it was 1.28 for each of these increments after adjustment for within-subject variability in blood pressure. CONCLUSIONS: Among the six populations we studied, the relative increase in long-term mortality due to CHD for a given increase in blood pressure is similar, whereas the absolute risk at the same level of blood pressure varies substantially. If the absolute risk of CHD is used as an indication for antihypertensive therapy, these findings will have major implications for treatment in different parts of the world.

Adult↗
PubMed2000

Genomic homology of the domestic ferret with cats and humans.

We used chromosome paints from both the domestic cat and humans to directly establish chromosomal homology between the genome of these species and the domestic ferret. The chromosome painting data indicate that the ferret has a highly conserved karyotype closer to the ancestral carnivore karyotype than that of the cat. The cat chromosome paints revealed 22 homologous autosomal regions in the ferret genome: 16 ferret chromosomes were hybridized by a single cat paint, while 3 ferret chromosomes were hybridized by two cat paints. In situ hybridization combined with banding showed that ferret Chromosome (Chr) 1 = cat A2p/C2, Chr 2 = F2/C1q, and Chr 3 = A2q/D2. Five ferret chromosomes are homologous to single arms of cat chromosomes: ferret 4 = A1q, 5 = B1q, 6 = C1p, 10 = A1p, and 12 = B1p. The human chromosome paints revealed 32 + XY homologous regions in the ferret genome: 9 ferret chromosomes were each hybridized by a single human paint, 7 by two paints, 3 by three paints. The 10 ferret chromosomes hybridized by multiple human paints produced the following associations: ferret 1 = human 19/3/21, 2 = 8q/2q, 3 = 10/7, 5 = 8/4, 8 = 15/14, 9 = 10/12/22, 11 = 20/2, 12 = 8/4, 14 = 12/22/18, 18 = 19/16. We present an index of genomic diversity, Z, based on the relative number of conserved whole chromosome and chromosome segments as a preliminary statistic for rapid comparison between species. The index of diversity between human-ferret (Z = 0. 812) is slightly less than human-cat (Z = 0.843). The homology data presented here allow us to transfer gene mapping data from both cats and humans to the ferret.

Animals↗
PubMed2000

Comparison of the Framingham risk function-based coronary chart with risk function from an Italian population study.

AIMS: The aim is to compare the coronary risk chart published by the European Task Force for Prevention of Coronary Heart Disease and produced using a Framingham risk function, with a risk function derived from an Italian population study. METHODS AND RESULTS: Coronary risk function in this study was the result of longitudinal experience in an Italian middle-aged population of 1656 male subjects followed-up for 25 years. To comply with the Framingham equation the same risk factors (age, systolic blood pressure, total serum cholesterol and smoking habits), end-points (any possible coronary event including angina pectoris), and length of follow-up (10 years) were used, and the model (log-linear accelerated time failure model, accommodating the Weibull distribution) was similar. Comparisons were made computing the coronary risk for each cell of the coronary risk chart for men aged 40, 50 and 60 years. The Italian risk function produced highly significant coefficients for all four risk factors. Forty-four out of a total of 120 cells had a coronary risk of 20% or more in 10 years following the coronary risk chart, whereas this was reduced to four while using the Italian risk function (P<0.001). The Italian risk function largely underestimated the corresponding levels produced by the coronary risk chart and vice versa. CONCLUSION: The Framingham risk function-based coronary risk chart overestimates absolute coronary risk in countries characterized by a lower incidence of coronary events and should be used with caution.

Adult↗
PubMed2000

Saturated fat, vitamin C and smoking predict long-term population all-cause mortality rates in the Seven Countries Study.

BACKGROUND: The Seven Countries Study has shown that population mortality rates for various chronic diseases are related to diet and smoking. This paper addresses the associations between diet, smoking and 25-year all-cause mortality. METHODS: Baseline surveys were carried out between 1958 and 1964 on 12,763 middle-aged men constituting 16 cohorts in seven countries. In 1987/88 equivalent food composites representing the average food intake of each cohort at baseline were collected and chemically analysed in one central laboratory. During 25 years of follow-up 5973 men died and age-adjusted population mortality rates were calculated for each cohort. RESULTS: Multivariate linear regression analyses showed that the population intake of saturated fat and the prevalence of smoking were positively associated with population all-cause mortality rates. Population vitamin C intake was inversely associated with all-cause mortality. It was calculated that a reduction in saturated fat intake of 5% of energy, a 20 mg/d increase in vitamin C and a 10% decrease in the prevalence of smokers may decrease the 25-year all-cause population mortality rate by 12.4% (95% CI: 5.6, 19.4%) at an average population all-cause mortality rate of 45%. CONCLUSION: At the population level saturated fat, vitamin C and cigarette smoking are important determinants of all-cause mortality.

Adult↗
PubMed2000

Alcohol and survival in the Italian rural cohorts of the Seven Countries Study.

BACKGROUND: Middle-aged men who regularly drink a moderate amount of alcohol have lower mortality rates from all causes in comparison with abstainers and heavy drinkers. This cohort study looks at the relationship between alcohol consumption and long-term survival, adjusting for smoking habit and physical activity. METHODS: In 1965, a total of 1536 Italian males aged 45-65 years underwent an examination which included: a general questionnaire, anthropometric measurements, an overall physical examination, ECG recording, blood pressure and serum cholesterol measurements and measurement of food consumption including alcohol. The cohort was followed for total mortality from 1965 to 1995. RESULTS: During a period of 30 years 1096 deaths occurred. Age-adjusted life expectancy for men assuming a mean daily quantity of 63 g of alcohol (range 4-7 drinks per day) was 21.6 +/- 0.4 years, roughly 2 years more than men taking a mean quantity of 3.7 g (</=1 drink) and men consuming >10 drinks per day. Taking smoking habit into account, the longest survival of 22.4 +/- 0.5 years was observed in non-smokers drinking 4-7 drinks daily; the lowest, 18.5 +/- 0.7 years, in smokers drinking >10 drinks. Stratifying for physical activity, the longest survival (23.4 +/- 0. 7 years) was experienced by men engaged in heavy physical activity at work drinking 1-4 drinks per day. CONCLUSIONS: The relationship between life expectancy and alcohol consumption (97% wine in this Italian cohort and mostly red wine) is confirmed to be non-linear. Men aged 45-64 at entry drinking about 5 drinks per day have a longer life expectancy than occasional and heavy drinkers.

Aged↗
PubMed2000

Total but not high-density lipoprotein cholesterol is consistently associated with coronary heart disease mortality in elderly men in Finland, Italy, and The Netherlands.

We studied the relation between serum total and high-density lipoprotein (HDL) cholesterol and 10-year coronary heart disease mortality in elderly men in different European countries. The Finland, Italy and the Netherlands Elderly (FINE) Study is a prospective follow-up study in 2,132 elderly men ages 65-84 years in Finland, the Netherlands, and Italy. We estimated relative risks using Cox proportional hazard analysis with time-dependent covariates. Total cholesterol was positively related to coronary heart disease mortality in all three countries. The combined relative risk for the total population of the FINE Study was 1.17 (95% confidence interval = 1.06-1.29) for each 1.00 mmol/liter increase in total cholesterol. HDL cholesterol was inversely related to coronary heart disease mortality in Finland, but not in the Netherlands and Italy. In Italy we noted an interaction among HDL cholesterol, body mass index, and alcohol intake, with an inverse association for HDL cholesterol in lean men who drank <40 gm of alcohol daily and a positive association for HDL cholesterol among overweight men who drank > or =40 gm of alcohol per day. Serum total cholesterol remains an important predictor of coronary heart disease mortality in elderly men in different European countries. The effect of HDL cholesterol differed among the three countries.

Aged↗
PubMed2000

Coronary heart disease incidence in northern and southern European populations: a reanalysis of the seven countries study for a European coronary risk chart.

OBJECTIVE: A systematic reanalysis of 10 year coronary heart disease incidence data from the northern and the southern European cohorts of the seven countries study, to contribute indirectly to the production of a European coronary risk chart. DESIGN AND SETTING: Men aged 40-59 years at entry were studied in three northern European cohorts based in Finland and Netherlands (n = 2213); and in 10 southern European cohorts based in Italy, former Yugoslavia, and Greece (n = 5897). Multiple logistic models for the prediction of coronary deaths, coronary incidence (hard criteria), and coronary incidence (any criterion) were solved for the two geographical groups and their pool. Risk factors fed into the models were age, systolic blood pressure, serum total cholesterol, and cigarette smoking. RESULTS: 10 year coronary heart disease mortality and incidence were higher in northern than in southern Europe, with ratios around 2.65. Ratios among the three coronary heart disease manifestations were identical in the two cultural groupings. Coefficients of the multiple logistic models were similar and not significantly different between the two groupings. When applying the coefficients back to the same or the opposite population, the relative risk was large and similar in the different cultures. Relative risk was larger for more severe coronary heart disease manifestations. The absolute risk was overestimated when applying the northern European model to southern European populations and vice versa, with ratios of about 1.5 and 0.5, respectively. Coronary risk charts created to reproduce the shape of those incorporated in recent European guidelines confirmed the excess of absolute risk in the northern compared with the southern European cohorts, all else being equal. CONCLUSIONS: In theory, a more appropriate European coronary risk chart could be produced by adopting coefficients to correct for different background incidence rates in different cultures. Other coefficients could appropriately be used to transform mortality risk into incidence risk.

Adult↗
PubMed2000

Long-term time-related predictivity of coronary events as a function of a single measurement of serum cholesterol and systolic blood pressure.

OBJECTIVE: To study the time-related association of a single measurement of serum cholesterol and systolic blood pressure with the occurrence of a first coronary event in a population sample of middle-aged men. METHODS AND RESULTS: A single measurement of serum total cholesterol and systolic blood pressure (along with age, cigarette consumption, physical activity at work and body mass index as possible confounders) was made in 1,605 coronary disease-free men aged 40-59 belonging to the Italian rural cohorts of the Seven Countries Study. During 25 years of follow-up 353 men developed a first event, that is a coronary death (sudden or not), and definite or possible myocardial infarction. Twenty-five partitioned proportional hazards models were solved, one for each independent year of follow-up, to predict the risk of incident events. Single-year hazard functions, separately for serum cholesterol and systolic blood pressure, were cumulated and smoothed. The resulting curves showed a regularly increasing risk for coronary events. They fit straight lines, with large correlation coefficients for both serum total cholesterol (r = 0.99) and systolic blood pressure (r = 0.99). These slopes were similar to the coefficients estimated by a single proportional hazards model solved for all events during 25 years. CONCLUSION: A single measurement of serum total cholesterol and systolic blood pressure in middle aged-men maintains a regular and monotonic relationship with occurrence of a first coronary event during 25 years of follow-up.

Adult↗
PubMed2000

First risk functions for prediction of coronary and cardiovascular disease incidence in the Gubbio Population Study.

BACKGROUND: The Gubbio study is an Italian population study which measures the risk factors and incidence of major cardiovascular diseases. This analysis produces multivariate models for the prediction of cardiovascular end-points. METHODS: A population sample of 2,963 men and women aged 35-74, free from major cardiovascular diseases, was examined in 1983 with risk factor measurement, and a 6-year incidence was computed for coronary heart disease and all cardiovascular (atherosclerotic) events. Proportional hazards models were solved for the prediction of these events. RESULTS: Over a 6-year period, 74 hard criteria, and 126 any criterion coronary heart disease and 174 cardiovascular events were recorded. Multivariate models showed the predictive power of sex (relative risk ranging 1.63 to 2.60), age (relative risk for 5-year difference ranging 1.38 to 1.48), systolic blood pressure (relative risk for 20 mmHg difference ranging 1.17 to 1.27), HDL cholesterol (relative risk for a difference of 10 mg/dl ranging 0.73 to 0.81), non-HDL cholesterol (relative risk for 40 mg/dl difference ranging 1.15 to 1.27), cigarette smoking (relative risk for 10 cigarette difference ranging 1.21 to 1.28), and body mass index (relative risk for 3 units ranging 0.99 to 1.02). All coefficients were statistically significant except that for body mass index, they were larger for hard criteria coronary heart disease, and their magnitude was similar to that found in previous Italian population studies. CONCLUSIONS: Traditional cardiovascular risk factors predict coronary and cardiovascular events in another Italian population study confirming previous findings and similar predictive models.

Adult↗
PubMed2000

Twenty-five-year cardiovascular disease incidence among middle-aged men. Disease burden, time shape, predictors, risk probabilities.

BACKGROUND: This analysis aims at describing the 25-year experience in cardiovascular incidence in a sample of middle-aged men in rural Italy. METHODS: A total of 1712 men aged 40-59 years were examined in 1960 in two rural Italian cohorts belonging to the Seven Countries Study. Major risk factors were measured and a monitoring system for incidence of cardiovascular events was in operation for the next 25 years centered on the first event occurring within each subgroup of cardiovascular diseases. Data were modeled by the Weibull distribution incorporated in the accelerated failure time model. RESULTS: Among 1695 cardiovascular disease-free men at entry, 51.3% experienced at least one cardiovascular event, the first being a coronary heart disease (35.6%), a cerebrovascular disease (17.8%) or a peripheral artery disease (13.0%). Among all first events the most common was intermittent claudication (17.6%), followed by angina pectoris (16.6%). A proportion of 13% of all initial episodes was rapidly fatal, whereas 38 % of subjects developing a cardiovascular event died within the 25-year deadline. Age, cigarette smoking, diabetes, corneal arcus, serum cholesterol, systolic blood pressure, and vital capacity fed into the accelerated failure time model showed a statistically significant association with cardiovascular disease incidence (inverse for vital capacity). The same model provided the shape of hazard during the 25 years with major events continuing to appear in an increasing exponential fashion, while soft criteria events were less likely to appear as a first event in the late phase of follow-up. CONCLUSIONS: In middle-aged men 25-year incidence of cardiovascular diseases is high and more relevant compared to that of traditional hard criteria coronary heart disease that in the past has attracted almost exclusive interest.

Adult↗
PubMed1999

Cigarette smoking and mortality risk: twenty-five-year follow-up of the Seven Countries Study.

BACKGROUND: Although most observations in the Seven Countries Study suggest that cigarette smoking is harmful for health, universality of this conclusion remains controversial. SUBJECTS AND METHODS: Cohort-specific and pooled smoking habits at baseline (1957-1964) in 12 763 men aged 40 through 59 years living in Europe, the United States, and Japan in relation to 25-year mortality follow-up. Pooled hazard ratios for smokers vs never smokers were calculated by the Cox proportional hazards model, adjusting for baseline country of residence, age, body mass index, serum cholesterol, systolic blood pressure, and clinical cardiovascular disease. RESULTS: Adjusted hazard ratios for all-causes death in smokers compared with never smokers were 1.3 (95% confidence interval, 1.2-1.4) for smokers of less than 10 cigarettes per day and 1.8 (95% confidence interval, 1.7-1.9) for smokers of 10 cigarettes per day or more. Hazard ratios were elevated for death due to coronary heart disease, all stroke, other arterial disease, lung cancer, other cancer, chronic obstructive pulmonary disease, and other disease in smokers compared with never smokers. Within country, a few instances in which never smokers had a higher cause-specific death rate than smokers of 10 cigarettes per day or more were attributable to random variation associated with low prevalence of never smokers and multiple comparisons. CONCLUSIONS: These findings confirm the association of cigarette smoking with elevated risk of mortality from all causes, several cardiovascular diseases, cancer, and chronic obstructive pulmonary disease. Risk associated with cigarette smoking is independent of culture.

Accidents↗