Twenty-five-year coronary mortality trends in the seven countries study using the accelerated failure time model
A Menotti1, P E Puddu, M Lanti
1Division of Epidemiology, University of Minnesota, Minneapolis, Minnesota, USA.
European Journal of Epidemiology
|May 8, 2003
Summary
The accelerated failure time model revealed varying coronary heart disease mortality hazard shapes across countries. Risk factor changes, like cholesterol and blood pressure, correlated with these hazard curve patterns over 25 years.
Area of Science:
- Epidemiology
- Biostatistics
- Cardiovascular Disease Research
Background:
- The Seven Countries Study provides a unique 25-year dataset on cardiovascular health across diverse populations.
- Understanding long-term mortality patterns for coronary heart disease (CHD) is crucial for public health interventions.
Purpose of the Study:
- To apply the accelerated failure time (AFT) model to describe CHD mortality hazard shapes over 25 years in the Seven Countries Study.
- To investigate the relationship between population-level risk factor changes and observed CHD mortality hazard patterns.
Main Methods:
- Utilized the accelerated failure time (AFT) model with Weibull survival distribution on pooled cohorts from eight countries (n=12,763 men aged 40-59).
- Analyzed 25 years of coronary heart disease (CHD) mortality data, estimating cumulative and annual hazards.
- Correlated hazard curve shapes with changes in population mean risk factors (serum cholesterol, systolic blood pressure) during the initial 10 years.
Main Results:
- Annual CHD hazard patterns varied significantly: decreasing/flattening in Northern Europe/America, moderate increase in Southern Europe, and exponential increase in Serbia and Japan.
- Positive correlations were observed between hazard curve shape and changes in mean serum cholesterol and systolic blood pressure over the first decade.
- Countries with the greatest decline in annual hazard function mirrored those with the largest recorded decreases in official CHD death rates.
Conclusions:
- The shape of the annual hazard for CHD mortality appears linked to changes in population mean levels of serum cholesterol and systolic blood pressure.
- The AFT model effectively describes diverse CHD mortality hazard trajectories and their association with modifiable risk factors across different countries.
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