Skip to main content
SpringerLink
Log in

Determinants of longevity and all-cause mortality among middle-aged men. Role of 48 personal characteristics in a 40-year follow-up of Italian Rural Areas in the Seven Countries Study

  • Original Articles
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background and aims: Forty-year all-cause mortality and its association with entry risk factor levels are reported for men enrolled in the Italian Rural Areas of the Seven Countries Study of Cardiovascular Diseases. Methods: Forty-eight potential risk factors were measured in 1712 men aged 40–59 at entry examination in 1960. Mortality data were collected during 40 years of follow-up. The relationship of entry risk factor levels with all-cause mortality was studied by univariate and multivariate approaches. Results: Overall death rate was 83.7%. The main causes of death were cardiovascular diseases, followed by cancer and others. The 48 risk factors were tested with univariate and multivariate approaches. In the final model, 15 risk factors were strongly and significantly related to all-cause mortality and survival. They were age, father and mother history of premature mortality, cigarette smoking, job-related physical activity (protective), body mass index (BMI) (in an inverse J-shaped fashion), mid-arm circumference (protective), mean blood pressure, forced respiratory volume in ¾ seconds (protective), serum cholesterol, corneal arcus, xanthelasma, presence of cardiovascular diseases, cancer and diabetes at entry examination. Conclusions: During a 40-year period 15 mainly cardiovascular risk factors were highly predictive of all-cause mortality and survival in middle-aged men.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Menotti A, Lanti M, Maiani G, Kromhout D. Forty-year mortality from cardiovascular diseases and their risk factors in men of the Italian Rural areas of the Seven Countries Study. Acta Cardiol 2005; 60: 521–31.

    Article  PubMed  Google Scholar 

  2. Keys A, Blackburn H, Menotti A, et al. Coronary heart disease in seven countries. Circulation 1970; 41(Suppl 1): 1–211.

    Google Scholar 

  3. Rose G, Blackburn H. Cardiovascular survey methods. Geneva. World Health Organization, 1968.

    Google Scholar 

  4. Anderson JT, Keys A. Cholesterol in serum and lipoprotein fractions: its measurement and stability. Clin Chem 1956; 2: 145–59.

    PubMed  CAS  Google Scholar 

  5. World Health Organization. International classification of diseases and causes of death. 8th Revision. Geneva, World Health Organization, 1965.

    Google Scholar 

  6. Menotti A, Kromhout D, Blackburn H, Jacobs D, Lanti M. Forty-year mortality from cardiovascular diseases and all causes of death in the US Railroad cohort of the Seven Countries Sudy. Eur J Epidemiol 2004; 19: 417–24.

    Article  PubMed  Google Scholar 

  7. Panagiotakos DB, Chrysoholou C, Pitsavos C, et al. Forty-years (1961–2001) of all-cause and coronary heart disease mortality and its determinants: the Corfu cohort from the Seven Countries Study. Int J Cardiol 2003; 90: 73–9.

    Article  PubMed  Google Scholar 

  8. Murray CJ, Lopez AD. Alternative projection of mortality and disability by cause 1990–2020: global burden of disease study. Lancet 1997; 349: 1498–504.

    Article  PubMed  CAS  Google Scholar 

  9. Stevens J, Cai J, Evenson KR, Thomas R. Fitness and fatness as predictors of mortality from all causes and from cardiovascular diseases in men and women in the Lipid Research Clinics Study. Am J Epidemiol 2002; 156: 832–41.

    Article  PubMed  Google Scholar 

  10. Su D. Body mass index and old-age survival: a comparative study between Union Army Records and the NHANES-I epidemiological follow-up sample. Am J Hum Biol 2005; 17: 341–54.

    Article  PubMed  Google Scholar 

  11. Kannel WB, Neaton JD, Wentworth D, et al, for the MRFIT Research Group. Overall and coronary heart disease mortality rates in relation to major risk factors in 325.348 men screened for the MRFIT. Am Heart J 1986; 112: 825–36.

    Article  PubMed  CAS  Google Scholar 

  12. Stamler J, Dyer AR, Shekelle RB, Neaton J, Stamler R. Relationship of baseline major risk factors to coronary and all-cause mortality, and to longevity: findings from long-term follow-up of Chicago cohorts. Cardiology 1993; 82: 191–222.

    Article  PubMed  CAS  Google Scholar 

  13. Lowe LP, Greenland Ph, Ruth KJ, Dyer AR, Stamler R, Stamler J. Impact of major cardiovascular disease risk factors, particularly in combination, on 22-year mortality in women and men. Arch Intern Med 1998; 158: 2007–14.

    Article  PubMed  CAS  Google Scholar 

  14. Hoes AW, Grobbee DE, Valkenburg HA, Lubsen J, Hofman A. Cardiovascular risk factors and all-cause mortality: a 12 year follow-up study in the Netherlands. Eur J Epidemiol 1993; 9: 285–92.

    Article  PubMed  CAS  Google Scholar 

  15. Kornitzer M, Dramaix M, Beriot I, Lannoy M, Gheyssens H, Kittel F. Twenty-five-year mortality follow-up in the Belgian Bank Study. Cardiology 1993; 82: 153–71.

    Article  PubMed  CAS  Google Scholar 

  16. Lindsted KD, Tonstad S, Kuzma JW. Self-report of physical activity and patterns of mortality in Seventh-Day Adventist men. J Clin Epidemiol 1991; 44: 355–64.

    Article  PubMed  CAS  Google Scholar 

  17. Goldberg RJ, Larson M, Levy D. Factors associated with survival to 75 years of age in middle-aged men and women. Arch Intern Med 1996; 156: 505–9.

    Article  PubMed  CAS  Google Scholar 

  18. Menotti A, Blackburn H, Kromhout D, Nissinen A, Adachi H, Lanti M. Cardiovascular risk factors as determinants of 25-year all-cause mortality in the seven countries study. Eur J Epidemiol 2001; 17: 337–46.

    Article  PubMed  CAS  Google Scholar 

  19. Reed T, Carmelli D, Robinson TS, Rinehart SA, Williams CJ. More favorable midlife cardiovascular risk factor levels in male twins and mortality after 25 years of follow-up is related to longevity of their parents. J Gerontol 2003; 58: 367–71.

    Article  Google Scholar 

  20. Goto A, Yasumura S, Nishise Y, Sakihara S. Association of health behavior and social role with total mortality among Japanese elders in Okinawa. Japan. Aging Clin Exp Res 2003; 15: 443–50.

    Google Scholar 

  21. Tsevat J, Weinstein MC, Williams LM, Tosteson AN, Goldman L. Expected gains in life expectancy from various coronary risk factor modifications. Circulation 1991; 84: 1194–201.

    Article  Google Scholar 

  22. Yarnell J, Yu S, Patterson C, et al. Family history, longevity, and risk of coronary heart disease: the PRIME study. Int J Epidemiol 2003; 32: 71–7.

    Article  PubMed  Google Scholar 

  23. West RR. Smoking: its influence on survival and causes of death. J R Coll Physicians Lond 1992; 26: 357–66.

    PubMed  CAS  Google Scholar 

  24. Quiao Q, Tervahauta M. Nissinen A, Tuomilehto J. Mortality from all causes and from coronary heart disease related to smoking and changes in smoking during a 35-year follow-up of middle-aged Finnish men. Eur Heart J 2000; 21: 1621–6.

    Google Scholar 

  25. Tafaro L, Cicconetti P, Tedeschi G, et al. Smoking and longevity: an incompatible binomial? Arch Gerontol Geriatr 2004; (Suppl): 425–30.

  26. Sandvik L, Erikssen J, Thaulow E, Erikssen G, Mundal R, Rodahl K. Physical fitness as a predictor of mortality among healthy middle-aged Norwegian men. N Engl J Med 1993; 328: 533–7.

    Article  PubMed  CAS  Google Scholar 

  27. Leon AS, Connett J. Physical activity and 10.5 year mortality in the Multiple Risk Factor Intervention Trial (MRFIT). Int J Epidemiol 1991; 20: 690–7.

    Article  PubMed  CAS  Google Scholar 

  28. Paffenbarger RS Jr, Jung DL, Leung RW, Hyde RT. Physical activity and hypertension: an epidemiological view. Ann Med 1991; 23: 319–27.

    Article  PubMed  Google Scholar 

  29. Ford ES, DeStefano F. Risk factors for mortality from all causes and from heart disease among persons with diabetes. Findings from the National Health and Nutrition Examination Survey I Epidemiologic follow-up Study. Am J Epidemiol 1991; 133: 1220–30.

    CAS  Google Scholar 

  30. US Department of Health and Human Services. Physical Activity and Health. A Report for the Surgeon General. US Dept of Health and Human Services, Centers for Disease Control and Prevention. Atlanta GA, National Center for Chronic Disease Prevention and Health Promotion, 1996.

  31. Keys A. Longevity of man: relative weight and fatness in middle age. Ann Med 1989; 21: 163–8.

    Article  PubMed  CAS  Google Scholar 

  32. Menotti A, Descovich GC, Lanti M, Spagnolo A, Dormi A, Seccareccia F. Indexes of obesity and all-causes mortality in Italian epidemiological data. Prev Med 1993; 22: 293–303.

    Article  PubMed  CAS  Google Scholar 

  33. Seccareccia F, Lanti M, Menotti, Scanga M. Role of body mass index in the prediction of all cause mortality in over 62,000 men and women. The Italian RIFLE Pooling Project. J Epidemiol Comm Health 1998; 52: 20–6.

    Article  CAS  Google Scholar 

  34. Selmer R. Blood pressure and twenty-year mortality in the city of Bergen, Norway. Am J Epidemiol 1992; 136: 428–40.

    PubMed  CAS  Google Scholar 

  35. Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–13.

    Article  Google Scholar 

  36. Kronmal RA, Cain KC, Ye Z, Omenn GS. Total serum cholesterol levels and mortality risk as a function of age. A report based on the Framingham data. Arch Intern Med 1993; 153: 1065–73.

    Article  CAS  Google Scholar 

  37. Neaton JD, Blackburn H, Jacobs D, et al. Serum cholesterol level and mortality findings for men screened in the Multiple Risk Factors Intervention trial. MRFIT Research Group. Arch Intern Med 1992; 152: 1490–500.

    Article  CAS  Google Scholar 

  38. Smith GD, Shipley MJ, Marmot MG, Rose G. Plasma cholesterol concentration and mortality. The Whitehall Study. JAMA 1992; 267: 70–6.

    CAS  Google Scholar 

  39. Clay CM, Dyer AR, Liu K, et al. Education, smoking and non-cardiovascular mortality: findings in three Chicago epidemiological studies. Int J Epidemiol 1988; 17: 341–7.

    Article  PubMed  CAS  Google Scholar 

  40. Davey-Smith G, Neaton JD, Wentworth D, Stamler R, Stamler J. Socioeconomic differential in mortality risk among men screened for the Multiple Risk Factor Intervention trial: I. white men. Am J Public Health 1996; 86: 486–96.

    Article  Google Scholar 

  41. Menotti A. Lanti M. Coronary risk factors predicting early and late coronary deaths. Heart 2003; 89: 19–24.

    CAS  Google Scholar 

  42. Lanti M, Menotti A, Nedeljkovic S, Nissinen A, Kafatos A, Kromhout D. Long term time trends in major cardiovascular risk factors in cohorts of aging men in the European cohorts of the Seven Countries Study. Aging Clin Exp Res 2005; 17: 306–15.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Associazione per le Ricerca Cardiologica — Association for Cardiac Research, Roma

    Alessandro Menotti MD, PhD & Mariapaola Lanti

  2. Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione, Roma, Italy

    Giuseppe Maiani

  3. Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands

    Daan Kromhout

Authors
  1. Alessandro Menotti MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mariapaola Lanti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giuseppe Maiani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daan Kromhout
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alessandro Menotti MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Menotti, A., Lanti, M., Maiani, G. et al. Determinants of longevity and all-cause mortality among middle-aged men. Role of 48 personal characteristics in a 40-year follow-up of Italian Rural Areas in the Seven Countries Study. Aging Clin Exp Res 18, 394–404 (2006). https://doi.org/10.1007/BF03324836

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03324836

Keywords

Search

Navigation