Cardiovascular risk and all-cause mortality; a 12 year follow-up study in The Netherlands

To assess the contribution of cardiovascular risk indicators to all-cause mortality, we used data from a follow-up study conducted in the Netherlands since 1975. Of 6,057 participants aged 20 years or over at the start of the study, 9.5% died during the 9 to 12 year follow-up period. Risk indicators independently related to all-cause mortality were age and diabetes mellitus in both sexes; pulse rate, smoking habits, antihypertensive drug use and a history of myocardial infarction most clearly in men; and body mass index and systolic blood pressure in women. A larger body mass index was associated with a gradual decrease in mortality probability. The risk of death for women in the highest quartile of body mass index (> 26.4 kg/m2) relative to those in the lowest quartile (< 21.9 kg/m2) was 0.56 (95% confidence limits 0.36 and 0.87). Serum cholesterol level showed no association with overall mortality. Risk functions were calculated to predict an individual's probability of dying within 11.5 years as a function of the level of cardiovascular risk indicators. Our findings suggest that the major cardiovascular risk indicators, apart from affecting cardiovascular morbidity and mortality, also influence all-cause mortality. Consequently, favourable changes in these characteristics might lead to an increase in life expectancy. The maximum individual benefit to be expected from these changes may be estimated using the risk functions derived from our data.