Forty-year coronary mortality trends and changes in major risk factors in the first 10 years of follow-up in the seven countries study
Open accessAbstract
Time trends in coronary heart disease (CHD) mortality during a 40-year follow-up were studied in the Seven Countries Study. Thirteen cohorts of men aged 40-59 at entry were enrolled in seven countries (USA, Finland, the Netherlands, Italy, Serbia, Greece and Japan) for a total of 10,628 subjects. Cardiovascular risk factors were measured at entry and at the 10-year follow-up examination and coronary heart disease mortality data collected during 40 years. During the 40-year follow-up, the hazard rate of the Weibull parametric distribution (annual conditional risk of death) for CHD mortality tended to slightly decline in the US, Finnish, Dutch and Japanese cohorts, moderately increased in Italy and exponentially increased in cohorts of Serbia and Greece. A strong positive association was found between the shape of the hazard curve, describing the acceleration of the hazard, and a score of population mean risk factor changes (serum cholesterol, systolic blood pressure and smoking prevalence) observed during the first 10 years of follow-up, with a correlation coefficient of 0.91 between the two indicators. The countries with a relative decline in the annual hazard function were the same where, during the same historical period, large decreases in official death rate from CHD were recorded, and viceversa. The acceleration in mortality risk for CHD mortality in different countries, described by the shape of the Weibull distribution, is related to changes in mean levels of major coronary risk factors.
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- Authors
- Menotti, A., Lanti, M., Kromhout, D., Blackburn, H., Nissinen, A., Dontas, A., Kafatos, A., Nedeljkovic, S., & Adachi, H.
- Affiliations
- Wageningen University & Research (NL)
- University of Minnesota (US)
- University of Crete (GR)
- Kurume University (JP)
- Corresponding author
- Menotti, Alessandro
- Venue
- European Journal of Epidemiology
- Published
- 2007-09-07
- Volume
- 22
- Issue
- 11
- Pages
- 747-754
- ISSN
- 0393-2990 (ISSN-L)
- 1573-7284
- OpenAlex
- W2048186816
- Cited by
- 61
- References
- 28
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 1 · 2019: 5 · 2018: 3 · 2017: 3 · 2016: 4 · 2015: 3 · 2014: 2 · 2013: 5 · 2012: 5
- FWCI
- 5.15
- Type
- journal article
- Language
- en
- Open access
- green
- research.wur.nl
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Socio-Environmental Systems Modeling (acceptedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Istituto Superiore di Sanità
- Science and Engineering Research Board
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- coronary heart disease mortality, mortality trends, cardiovascular risk factors, serum cholesterol, systolic blood pressure, smoking prevalence, Seven Countries Study, cross-national comparison
- MeSH terms
- Adult, Coronary Artery Disease, Europe, Follow-Up Studies, Humans, Japan, Male, Middle Aged, Mortality, Risk Factors, United States, Cohort Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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