Lifetime prediction of coronary heart disease and heart disease of uncertain etiology in a 50-year follow-up population study

Lifestyle behaviour and lifetime incidence of heart diseases

“…An intriguing finding was the absence of a significant association between living habits and HDUE incidence in contrast with the strong significant association found for CHD events. In another analysis conducted on the same end-points versus classical risk factors [22] the major difference between these two categories of heart diseases was the strong and significant association of serum cholesterol with CHD but not with HDUE. The conclusion was reached that HDUE could not be the expression of gross coronary atheroma and, due to the very well-known relation with dietary habits [32], that it could also be less influenced by dietary habits.…”

“…Note that only 9% of the enrolled men reached the age of 90 years chosen as the follow-up period's end. The analysis has used as predictor of heart disease incidence only three lifestyle behaviours and has purposely excluded other recognized risk factors also because their role has been documented elsewhere [22]. This analysis increases previous know-how since incidence of heart diseases during life-time exposure up to 90 years of age, instead of mortality, has been systematically related to baseline behavioural characteristics, still being considered for two large groups of heart disease.…”

“…Incidence of common heart diseases was measured exploiting all possible information collected at baseline, at periodical re-examinations, at special search at hospitals, clinics and general practitioners, interviews with relatives and data from causes of death as described elsewhere [21,22]. Diagnoses were based on history, physical examination, ECG tracings, causes of death and occasionally reported diagnoses.…”

“…Heart diseases were classified into two large groups following analyses presented elsewhere [21], as follows: a) CHD were manifested as sudden death (when other causes could be reasonably excluded), fatal and non-fatal myocardial infarction, and other fatal and non-fatal acute ischemic syndromes; b) HDUE were manifested only as heart failure, severe chronic arrhythmia (such as atrial fibrillation), heart blocks, documented diagnoses of hypertensive heart disease or "chronic CHD". Subjects with these latter manifestations who in addition had angina pectoris were classified as CHD due to reasons documented and explained elsewhere [21,22]. The two groups defined in this way were mutually exclusive.…”

“…Observations of this type are sometimes defined as lifetime estimates although studies with complete extinction of the original cohorts are rare [19]. The Italian Rural Areas (IRA) of the Seven Countries of Cardiovascular Diseases have reached 50 years of follow-up and some reports on that duration have been already published [18,[20][21][22].…”