Factors Predictive of Long-Term Coronary Heart Disease Mortality among 10,059 Male Israeli Civil Servants and Municipal Employees

Abstract

Over 10,000 male civil servants and municipal employees in Israel, aged 40 years and above, underwent an extensive clinical, biochemical, anthropometric, sociodemographic and psychosocial evaluation in 1963, 1965 and 1968. Follow-up for mortality was continued through 1986. Over 23 years, a number of previously established risk factors for coronary heart disease (CHD) incidence were found to predict mortality. The long-term follow-up assisted in illustrating temporal patterns. A single casual assessment of blood pressure retained high prediction for long-term mortality. Blood lipids, while significantly associated with both coronary and all-cause mortality, exhibited a small contribution to the latter, when compared to hypertension, cigarette smoking habits and diabetes. Weak associations of long-term coronary mortality with the dietary intake patterns of fatty acids, as reported at baseline, were probably fully mediated by the effect of the diet on serum cholesterol. Religious orthodoxy appeared to provide a degree of immunity, part of which was independent of life-style correlates. A number of now well-established associations in cardiovascular epidemiology were first demonstrated, or amplified, in the study. Patterns of ethnic diversity in the risk factor and prevalence rates of CHD persisted, as viewed from the angle of mortality rates, over nearly a quarter of a decade, highlighting the enigma of a migrant country as a cardiovascular melting pot.

Religion and healthy lifestyle behaviors among postmenopausal women: the women’s health initiative

“…Another large study of a representative sample of over 3,600 U.S. adults age 25 and older, with an average of 7.5 years of follow up, also found more frequent worship attendance was associated with decreased all-cause mortality (Musick, House, & Williams, 2004). Some evidence for a similar association also has been reported from samples in countries other than the US (Goldbourt, Yaari, & Medalie, 1993;Kark et al, 1996). A recent meta-analysis (Chida, Steptoe, & Powell, 2009) described a positive association of religious involvement with survival in healthy populations (HR=0.82, CI 0.76, 0.87), with even stronger associations among women (HR=0.70, CI 0.55, 0.89) and older adults (HR=0.79, CI 0.69, 0.90).…”

C-Reactive Protein, Diabetes, and Attendance at Religious Services

“…By linking religious attendance and CRP, the current study's findings provide evidence for one possible physiological mechanism for lower cardiovascular mortality among attenders of religious services (4,5,15). Although the results of the current study are based on an analysis of adult people aged Ն40 years with diabetes, people in this population account for a substantial portion of people with cardiovascular disease.…”

“…In addition, there is growing evidence of an association between acute inflammatory markers, such as C-reactive protein (CRP), and the risk of acute coronary syndromes and other forms of cardiovascular disease (2,3). Furthermore, attendance at religious services has been linked epidemiologically to improved morbidity and mortality from cardiovascular causes (4,5). Whether the association between spiritual practices, such as religious attendance, and improved cardiovascular outcome is mediated by biological proteins involved in the inflammatory and immune system is unknown.…”

“…In a population at high risk of cardiovascular disease, such as people with diabetes, psychosocial and religious practice influences on inflammatory mediators may be more pronounced. Combined with recent findings that higher religious commitment and religious service attendance has been linked to a lower risk of death from coronary heart disease (4,15,16), the hypothesis that attendance at religious services may play a role in modulating CRP level bears investigation. We sought to further investigate the relationship between attendance at religious services and CRP in people with diabetes.…”

Calidad de grasa, arterioesclerosis y enfermedad coronaria: efectos de los ácidos grasos saturados y ácidos grasos trans

“…De esta manera estos estudios dieron a conocer que más que el porcentaje de grasa ingerida es el tipo de grasa el que se asocia a un mayor riesgo de ECV. Sin embargo, con posterioridad sólo algunos estudios han comunicado la asociación entre AGS y riesgo de ECV [13][14][15] . Siri-Tarino et al 16 en un metaanálisis de 21 estudios prospectivos que reúnen aproximadamente 350.000 personas seguidas por 5 a 23 años, de las cuales 11.000 desarrollaron ECV, la ingesta de AGS no se asoció a un aumento de las ECV.…”