American Journal of Epidemiology Vol. 141, No. 1: 50-60
Copyright © 1995 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
Effect of Risk Factors and Changes in Risk Factors on Coronary Mortality in Three Cohorts of Middle-aged People in Eastern Finland
1National Public Health Institute, Department of Epidemiology and Health Promotion Helsinki, Finland
2National Public Health Institute, Department of Environmental Epidemiology Kuopio, Finland
Reprint requests to Dr. Pekka Jousilahti, National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheimintie 166, FIN-00300 Helsinki, Finland
The association of smoking, serum cholesterol, and blood pressure with coronary mortality and the contribution of changes in these risk factors to the decline in coronary mortality was assessed in three cohorts of middle-aged population examined in 1972, 1977, and 1982 in Eastern Finland. A total of 10,758 men and 11,112 women were included in this study. The follow-up time of each subject was 8 years. Age-adjusted coronary mortality decreased from 54 per 10,000 person-years in the 1972 cohort to 30 per 10,000 person-years in the 1982 cohort among men and from eight per 10,000 person-years to four per 10,000 person-years among women in the 1972 and 1982 cohorts, respectively. Concomitantly with the decrease in coronary mortality, there was a marked decrease in cardiovascular risk factors. Among men, the age- and geographic area-adjusted hazard rate ratio of coronary mortality between 1972 and 1982 cohorts was 0.52 (95% confidence interval (Cl) 0.38–0.72). After further adjustment for smoking, serum cholesterol, and blood pressure, the hazard rate ratio was 0.74 (95% Cl 0.54–1.02). Among women, the corresponding hazard rate ratios were 0.49 (95% Cl 0.21–1.12) and 0.73 (95% Cl 0.30–1.71), respectively. Therefore, it can be estimated that in both sexes nearly half of the decrease in coronary mortality hazard was associated with the changes in risk factors. The fall in serum cholesterol level among men and the decrease in blood pressure among women contributed most of the decrease in coronary mortality hazard.
coronary disease; mortality; risk factors
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A Rosengren, A Dotevall, H Eriksson, and L Wilhelmsen Optimal risk factors in the population: prognosis, prevalence, and secular trends. Data from Goteborg population studies Eur. Heart J., January 2, 2001; 22(2): 136 - 144. [Abstract] [PDF]
|
|
|
|
 |
|
 S. Ebrahim, S G. Wannamethee, P. Whincup, M. Walker, and A G. Shaper Locomotor disability in a cohort of British men: the impact of lifestyle and disease Int. J. Epidemiol., June 1, 2000; 29(3): 478 - 486. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Emmons, K. J. Kalkbrenner, N. Klar, T. Light, K. A. Schneider, and J. E. Garber Behavioral Risk Factors among Women Presenting for Genetic Testing Cancer Epidemiol. Biomarkers Prev., January 1, 2000; 9(1): 89 - 94. [Abstract] [Full Text]
|
|
|
|
 |
|
 P. Jousilahti, E. Vartiainen, J. Pekkanen, J. Tuomilehto, J. Sundvall, and P. Puska Serum Cholesterol Distribution and Coronary Heart Disease Risk : Observations and Predictions Among Middle-aged Population in Eastern Finland Circulation, March 24, 1998; 97(11): 1087 - 1094. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Council on Scientific Affairs Management of Disorders of Cholesterol, Triglyceride, and Lipoprotein Metabolism: Report 6 of the Council on Scientific Affairs Arch Fam Med, October 1, 1995; 4(10): 869 - 878. [Abstract] [PDF]
|
|