Cardiovascular risk factors predict age at death in 60-year follow-up of the Seven Countries Study

Paolo Emilio Puddu, Alessandro Menotti, David R. Jacobs, Hisashi Adachi, Antony Kafatos, Hanna Tolonen

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objectives: To study age at death (AD) and its determinants in cohorts of middle-aged men followed-up until extinction. Material and methods: A total of 9063 middle-aged men enrolled in 10 cohorts of 6 countries (USA, Finland, the Netherlands, Italy, Greece and Japan) within the Seven Countries Study were examined and then followed up for 60 years until extinction. AD was computed and a small number of risk factors were tested through multiple linear regression as possibly related to attained AD. Results: AD ranged across cohorts from 71.8 years in East Finland and 80.5 years in Crete with levels roughly lower in the USA and Northern Europe and higher elsewhere. Across cohorts, the correlation coefficients of systolic blood pressure (R = −0.58) and of CVD prevalence (R = −0.65) versus average AD were the only significant ones. At the individual level in the pool of all cohorts, a multiple linear regression model showed that age, vigorous physical activity, never and ex-smokers were favorably related to AD, while the reverse was true for systolic blood pressure, heart rate, serum cholesterol, CVD prevalence and silent ECG abnormalities. BMI had a parabolic relationship with AD. The predicting power of single risk factors, expressed in years gained or lost, was relatively small, but arbitrary combinations of several of them produced large differences in AD. Conclusions: A small number of CVD risk factors were strongly associated with AD in a life-long follow-up.

Original languageEnglish (US)
Pages (from-to)193-202
Number of pages10
JournalAging Clinical and Experimental Research
Issue number1
StatePublished - Jan 2023

Bibliographical note

Funding Information:
The authors acknowledge the following collaborators for their professional and enthusiastic action in collecting the most recent follow-up data: Ms Cleo Dontas in Corfu; Dr Manolis Linardakis in Crete; Ms Giovina Catasta in the Italian Areas; Ms Rose Hilk and Ms Karen Virnig in the USA. Moreover, appreciation is expressed to Prof Daan Kromhout, University of Groningen, the Netherlands, for allowing the use of the Zutphen data, the Dutch cohort of the Seven Countries Study.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Switzerland AG.


  • Age at death
  • Cardiovascular risk factors
  • Men
  • Prediction
  • Residential populations

PubMed: MeSH publication types

  • Journal Article


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