The classic risk factors for coronary heart disease: experience in Europe

This article is based on the follow-up of 9,182 men from 13 cohorts of five European countries (Finland, Greece, Italy, Holland, and Yugoslavia). Its purpose is to explore the associations of known risk factors for coronary heart disease (CHD). A significant positive association was found between age and 10-year mortality from CHD (10-MCHD), between systolic blood pressure (SBP) and 10-MCHD (steeper for the Finns than for men from Mediterranean countries), and between serum cholesterol and 10-MCHD (more pronounced in northern than southern European men). Age-standardized 10-MCHD was found to increase with degree of smoking; the regression slope of this correlation was steeper for men from northern than from southern Europe. Although death from all causes tended to be inversely related to relative body weight, no consistent evidence of a relation between relative body weight or body fatness and CHD was found. Incidence rate of CHD was not consistently related to physical activity characteristics of the groups. Resting pulse rate was an important risk factor for all causes of death in 10 years, but of less consequence for MCHD. Regression slopes were steeper for northern than for southern Europeans. Vital capacity was a significant risk factor for MCHD for Italian but not for Finnish, Greek, or Serbian men. The 10-year adjusted MCHD was correlated with total fat in the diet; the correlation with saturated fatty acids was much more significant.