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Blood Pressure and Cardiovascular Diseases in the Seven Countries Study

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Prevention of Coronary Heart Disease: Diet, Lifestyle and Risk Factors in the Seven Countries Study

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 243))

Abstract

The role of blood pressure, and of high blood pressure, as risk factors for cardiovascular diseases was among the first to be identified in population studies by the Pickering monograph on the distribution of blood pressure in populations (1). Sir George Pickering showed the distribution of blood pressure in the general population to be continuous, roughly normal, and unimodal; therefore, the definition of hypertension was arbitrary. His “enemy and friend,” Robert Platt, insisted, however, on the existence of a bimodal distribution of blood pressure, apparently erroneously based on his selection of true hypertensive patients and their relatives on one side and of true non-hypertensives on the other. Later it became clear that Pickering’s intuition was correct. Hypertension was simply a quantitative deviation from blood pressure levels associated with lower risk.

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References

  1. Pickering G. The nature of essential hypertension. London, J & A Churchill ltd, 1961: 1–149.

    Google Scholar 

  2. Rose G, Blackburn H. Cardiovascular Survey Methods. Geneva, World Health Organization. 1968:1–188.

    Google Scholar 

  3. Keys A, Blackburn HW, Van Buchem FSP, Buzina R, Djordjevic BS, Dontas AS, Fidanza F, Karvonen MJ, Kimura N, Lekos D, Monti M, Puddu V, Taylor HL. Epidemiological studies related to coronary heart disease: characterstics of men aged 40–59 in seven countries. Acta Med Scand 1967; Suppl 460: 1–392.

    Google Scholar 

  4. Rayner M.Petersen S. Compilers European cardiovascular disease statistics. London: British Heart Foundation, 2000:1–132.

    Google Scholar 

  5. Kuulasma K, Tunstall-Pedoe H, Dobson A, Fortmann S, Sans S, Tolonen H. Evans A, Ferrario M, Tuomilehto J. Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the WHO MONICA Project populations. Lancet 2000;355:675–687.

    Article  Google Scholar 

  6. Menotti A, Lanti M, Puddu PE. Epidemiologia delle malattie cardiovascolari. Insegnamenti dalle aree Italiane del Seven Countries Study. Roma, Cardioricerca Ed. 1999.

    Google Scholar 

  7. Karvonen MJ, Punsar S. Sodium excretion and blood pressure of West and East Finns. ActaMed Scand 1977; 202: 501–507

    Article  CAS  Google Scholar 

  8. Kromhout D, Bosschieter EB, de Lezenne Coulander C. Potassium, calcium, alcohol intake and blood pressure: the Zutphen Study. Am J Clin Nutr 1985; 41: 1299–1304.

    PubMed  CAS  Google Scholar 

  9. Huijbregts PPCW, Feskens EJM, Kromhout D. Dietary patterns and cardivoascuilar risk factors in elderly men. The Zutphen Elderly Study. Int J Epidemiol 1995; 24: 313–320.

    Article  PubMed  CAS  Google Scholar 

  10. Keys A (Ed). Coronary heart disease in seven countries. Circulation 1970;41 Suppl 1:1–211.

    Article  Google Scholar 

  11. Keys A, Aravanis C, Blackburn H, Buzina R, Djordjevic BS, Dontas AS, Fidanza F, Karvonen MJ, Kimura N, Menotti A, Mohacek I, Nedeljkovic S, Puddu V, Punsar S, Taylor HL, Van Buchem FSP. Seven countries. A multivariate analysis of death and coronary heart disease. Cambridge, MA; Harvard University Press, ISBN: 0–674–80237–3, 1980:1–381.

    Google Scholar 

  12. Menotti A, Keys A, Kromhout D, Blackburn H, Aravanis C, Bloemberg B, Buzina R, Dontas A, Fidanza F, Giampaoli S, Karvonen M, Lanti M, Pekkanen J, Punsar S, Seccareccia F, Toshima H. Inter-cohort differences in coronary heart disease mortality in the 25-year follow-up of the Seven Countries Study. Eur J Epidemiol 1993; 9: 527–536

    Article  PubMed  CAS  Google Scholar 

  13. Menotti A, Keys A, Blackburn H, Aravanis C, Dontas A, Fidanza F, Giampaoli S, Karvonen M, Kromhout D, Nedeljkovic S, Nissinen A, Pekkanen J, Punsar S, Seccareccia F, Toshima H. Twenty-year mortality and prediction of stroke in twelve cohorts of the Seven Countries Study. Int J Epidemiol 1990; 19: 309–315.

    Article  PubMed  CAS  Google Scholar 

  14. Menotti A, Blackburn H, Kromhout D, Nissinen A, Karvonen M, Aravanis C, Dontas A, Fidanza F, Giampaoli S. The inverse relation of average population blood pressure and stroke mortality rates in the Seven Countries Study: a paradox. Eur J Epidemiol 1997; 13: 379–386.

    Article  PubMed  CAS  Google Scholar 

  15. Port S, Demer L, Jennerich R, Walter D, Garfinkel A. Systolic blood pressure and mortality. Lancet 2000; 355: 175–180.

    Article  PubMed  CAS  Google Scholar 

  16. Port S, Garfinkel A, Boyle N. There is non-linear relationship between mortality and blood pressure. Eur Heart J 2000; 21: 1635–1638.

    Article  PubMed  CAS  Google Scholar 

  17. Van den Hoogen P, Seidell J, Nagelkerke N, Menotti A, Kromhout D. Relation between blood pressure and mortality: is there a threshold? Eur Heart J 2001;22:2132–2133

    Article  PubMed  Google Scholar 

  18. Keys A, Aravanis C, Blackburn H, Van Buchem FSP, Buzina R, Djordjevic BS, Fidanza F, Karvonen M, Menotti A, Puddu V, Taylor HL. Probability of middle-aged men developing coronary heart disease in five years. Circulation 1972; 45: 815–828.

    Article  PubMed  CAS  Google Scholar 

  19. Menotti A, Lanti M, Puddu PE, Kromhout D. Coronary heart disease incidence in northern and southern European populations: a reanalysis of the Seven Countries Study for a European coronary risk chart. Heart 2000; 84: 238–244.

    Article  PubMed  CAS  Google Scholar 

  20. Menotti A, Keys A, Blackburn H, Kromhout D, Karvonen M, Nissinen A, Pekkanen J, Punsar S, Fidanza F, Giampaoli S, Seccareccia F, Buzina R, Mohacek I, Nedeljkovic S, Aravanis C, Dontas A, Toshima H, Lanti M. Comparison of multivariate predictive power of major risk factors for coronary heart disease in different countries: results from eight nations of the Seven Countries Study, 25-year follow-up. J Cardiov Risk 1996; 3: 69–75.

    Article  CAS  Google Scholar 

  21. Van den Hoogen PCW, Feskens EJM, Nagelkerke NJD, Menotti A, Nissinen A, Kromhout D. The relation between blood pressure and mortality due to coronary heart disease among men in different parts of the world. N Engl J Med 2000: 342: 1–8.

    Article  PubMed  Google Scholar 

  22. Menotti A, Jacobs DR, Blackburn H, Kromhout D, Nissinen A, Nedeljkovic S, Buzina R, Mohacek I, Seccareccia F, Giampaoli S, Dontas S, Aravanis C, Toshima H. Twenty-five-year prediction of stroke deaths in the Seven Countries Study. The role of blood pressure and its changes. Stroke 1996; 27: 381–387.

    Article  PubMed  CAS  Google Scholar 

  23. Menotti A, Keys A, Kromhout D, Nissinen A, Blackburn H, Fidanza F, Giampaoli S, Karvonen M, Pekkanen J, Punsar S, Seccareccia F. All cause mortality and its determinants in middle-aged men in Finland, the Netherlands and Italy in a 25-year follow-up. J Epidemiol Comm Hlth 1991; 45: 125–130.

    Article  CAS  Google Scholar 

  24. Dontas AS, Menotti A, Aravanis C. Ioannidis P, Seccareccia F. Comparative total mortality in 25 years in Italian and Greek middle aged rural men. J Epidemiol Comm Hlth 1998; 52: 638–644.

    Article  CAS  Google Scholar 

  25. Menotti A, Blackburn H, Kromhout D, Nissinen A, Adachi H, Lanti M, for the Seven Countries Study Research Group. Cardiovascular risk factors as determinants of 25-year all-cause mortality in the Seven Countries Study. Eur J Epidemiol, 2001 (in press).

    Google Scholar 

  26. Van den Hoogen PCW, Seidell JC, Feskens EJM, Nissinen A, Menotti A, Kromhout D. Systolic, diastolic and pulse pressure and 10-year cardiovascular mortality among elderly men in Finland, Italy and the Netherlands. Submitted, 2001.

    Google Scholar 

  27. Menotti A, Keys A, Blackburn H, Karvonen M, Punsar S, Nissinen A, Pekkanen J, Kromhout D, Giampaoli S, Seccareccia F, Fidanza F, Nedeljkovic S, Aravanis C, Dontas A, Toshima H. Blood pressure changes as predictors of future mortality in the Seven Countries Study. J Hum Hypertension 1991; 5: 137–144.

    CAS  Google Scholar 

  28. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH, Karanja N. A clinical trial of the effect of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997; 336: 1117–1124.

    Article  PubMed  CAS  Google Scholar 

  29. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER 3rdSimons-Morton DG, Karanja N, Lin PH, DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med 2001; 344: 3–10.

    Article  PubMed  CAS  Google Scholar 

  30. World Health Organization MONICA Project. Ecological analysis of the association between mortality and major risk factors of cardiovascular disease. Int J Epidemiol 1994; 23:505–516.

    Article  Google Scholar 

  31. Martin MJ, Hulley SB, Browner WS, Kuller LH, Wentworth D. Serum cholesterol, blood pressure and mortality: implications from a cohort of 361,662 men. Lancet 1986;2:933–936.

    Article  PubMed  CAS  Google Scholar 

  32. MacMahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J, Abbott R, Goodwin J, Dyer A, Stamler J. Blood pressure, stroke and coronary heart disease. Part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 1990; 334: 765–774.

    Article  Google Scholar 

  33. Prospective Studies Collaboration. Cholesterol, diastolic blood pressure and stroke: 13,000 strokes in 450,000 people in 45 prospective cohorts. Lancet 1995; 346: 1647–1452.

    Article  Google Scholar 

  34. Glynn RJ, Chae CUC, Guralnik JM, Taylor JO, Hennekens CH. Pulse pressure and mortality in older people. Arch Intern Med 2000; 160: 2765–2772.

    Article  PubMed  CAS  Google Scholar 

  35. Franklin SS, Khan SA, Wong ND, Larson MD, Levy D. Is pulse pressure useful in predicting risk of coronary heart disease ? Circulation 1999; 100: 354–360.

    Article  PubMed  CAS  Google Scholar 

  36. Blacher J, Staessen JA, Girerd X, Gasowski J, Thijs L, Liu L, Wang JG, Tagard RH, Safar ME. Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients. Arch Intern Med 2000; 160: 1085–1089.

    Article  PubMed  CAS  Google Scholar 

  37. Collins R, Peto R, MacMahon S, Hebert P, Fiebach NH, Eberlein KA, Goodwin J, Qizilbash N, Taylor JO, Hennekens CH. Blood pressure, stroke and coronary heart disease. Part 2, Short-term reductions in blood pressure: overview of randomized drug trials in their epidemiological context. Lancet 1990; 335: 827–838.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Alessandro Menotti
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Editor information

Editors and Affiliations

  1. Director Nutrition and Consumer Safety Division, National Institute of Public Health and the Environment, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands

    Daan Kromhout (Professor) (Professor)

  2. Association for Cardiac Research Cardioricerca, Via Adda 87, Rome, 00198, Italy

    Alessandro Menotti (Professor) (Professor)

  3. Division of Epidemiology, School of Public Health University of Minnesota, 1300 South Second Street, Minneapolis, MN, 55454-1015, USA

    Henry Blackburn (Mayo Professor Emeritus) (Mayo Professor Emeritus)

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Menotti, A. (2002). Blood Pressure and Cardiovascular Diseases in the Seven Countries Study. In: Kromhout, D., Menotti, A., Blackburn, H. (eds) Prevention of Coronary Heart Disease: Diet, Lifestyle and Risk Factors in the Seven Countries Study. Developments in Cardiovascular Medicine, vol 243. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1117-5_11

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  • DOI: https://doi.org/10.1007/978-1-4615-1117-5_11

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  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-5402-4

  • Online ISBN: 978-1-4615-1117-5

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