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Total and coronary heart disease mortality in relation to major risk factors--Quebec cardiovascular study
G R Dagenais1, Z Ahmed, N M Robitaille
1Department of Medicine, Faculty of Medicine, Laval University, Quebec.
Insights
High blood pressure and smoking significantly increase the risk of death from all causes and coronary artery disease (CAD). Quitting smoking reduces this risk to levels similar to never-smokers.
Area of Science:
- Cardiovascular epidemiology
- Public health research
- Risk factor analysis
Background:
- Cardiovascular diseases remain a leading cause of mortality worldwide.
- Identifying modifiable risk factors is crucial for public health interventions.
- Longitudinal studies are essential for understanding disease progression and mortality.
Purpose of the Study:
- To investigate the association between lifestyle factors and mortality.
- To quantify the risk of total and coronary artery disease (CAD) mortality.
- To evaluate the impact of blood pressure, smoking, cholesterol, and education on mortality.
Main Methods:
- A cohort study of 4576 Quebec men aged 35-64 years.
- Follow-up period of 12 years (January 1974 - January 1986).
- Analysis of mortality data (417 total deaths, 131 CAD deaths) in relation to baseline risk factors.
Main Results:
- Elevated systolic and diastolic blood pressure showed a progressive increase in total and CAD mortality risk.
- Smoking significantly increased overall and CAD mortality; risk reduced in former smokers.
- Serum cholesterol and education levels were not significantly associated with mortality.
Conclusions:
- Hypertension and smoking are significant risk factors for cardiovascular mortality.
- Smoking cessation appears to mitigate mortality risk.
- Further research may explore other contributing factors beyond those studied.
Abstract:
The relationships of blood pressure, smoking, serum cholesterol and education levels on total and coronary artery disease (CAD) mortality were evaluated in 4576 Quebec men aged 35 to 64 years, free from overt CAD at entry and followed for 12 years. From January 1974 to January 1986, there were 417 deaths, 131 due to CAD. A progressive increase in total and CAD mortality was observed from quintile 3 to 5 for both systolic and diastolic blood pressure. In comparison to quintile 1, the adjusted relative risks of quintiles 4 and 5 for systolic blood pressure were significantly elevated (2 P less than 0.01), being 1.5 and 2.0 for total mortality, and 2.6 and 3.5 for CAD mortality, respectively. The relative risks of quintiles 4 and 5 for diastolic blood pressure were also significantly elevated (2 P less than 0.04), being 1.5 and 1.6 for total mortality and 1.9 and 2.7 for CAD mortality, respectively. In comparison to those who never smoked, the relative risks of smoking one to 20, and 21 and more cigarettes per day, were 2.1 (2 P less than 0.003) and 3.1 (2 P less than 0.0001) for overall mortality, and 2.2 (2 P less than 0.08) and 3.5 (2 P less than 0.002) for CAD mortality. Men who had discontinued smoking at least one year before the study, had a relative risk not different from those who had never smoked. Serum cholesterol and education levels were not significantly associated with total or CAD mortality.(ABSTRACT TRUNCATED AT 250 WORDS)