[Erfurt male cohort study (ERFORT study). Study design and selected results]

The main objective of the Erfurt male cohort study (ERFORT study) is to investigate cardiovascular risk factors, life-style related factors and psychosocial factors with regard to total and cause-specific mortality and morbidity during a follow-up of 30 years. This paper describes the study design, descriptive data on cardiovascular and psychosocial factors at baseline survey and findings of three 5-year follow-up medical examinations.

The ERFORT study is a population-based prospective cohort study. The baseline survey from 1973 to 1975 examined a random population-based sample of 1,160 males aged 35 to 61 years (response rate 74.6%) from the city of Erfurt, East Germany followed by3 medical follow-up examinations after 5 years each. Life status was followed for 30 years.

During the follow-up examinations over 15 years the prevalence for cardiovascular diseases, such as myocardial infarction, angina pectoris and intermittent claudication doubled. The prevalence of diabetes increased from 2.8% to 12%. Elevated blood pressure (≥ 160/95 mmHg) increased slightly, whereas antihypertensive treatment increased strongly from 8.7 to 33.6%. Smoking and diabetes were revealed to be strong predictors for the onset of claudication. Elevated 1 h post-load glucose levels (≥ 200 mg/dl) as well as diabetes resulted in a statistically significant increase in all-cause mortality. Finally, weight cycling during a 15-year follow-up showed a statistically increased risk for all-cause mortality in the subsequent 15 years, which was higher than for stable obesity.

This German male cohort, which was followed for several decades, is an outstanding database to answer questions about long-term associations between biological and psychosocial factors and mortality in men. It shows the feasibility of a long-term follow-up.