Skip to main content
SpringerLink
Log in

Will Measures to Prevent Coronary Heart Disease Protect Against Other Chronic Disorders?

  • Conference paper
Lessons for Science from the Seven Countries Study

Summary

The possibility that coronary heart disease could be prevented was hardly considered until around 1950. The history of the developments which led to creating the scientific foundations for prevention, including the role played by the Seven Countries Study, is reviewed. There is now a need to move from cardiovascular disease prevention to the prevention of other major chronic disorders in order to reduce the total burden of chronic illness and mortality in individuals and the population at large. Evidence for links between cardiovascular and noncardiovascular diseases is summarized, suggesting that they share some common causes and may thus be amenable to the same preventive measures. These links include correlations between these groups of diseases within and between countries, similarities in the lifestyles predisposing to a number of chronic disorders, and demonstrations that the predictiveness of coronary disease risk-factors extends to other diseases. Furthermore, there is a correlation between the secular mortality trends for heart disease, cancer, stroke, and total mortality. The problems of devising all-encompassing chronic disease prevention strategies, as opposed to strategies directed to single diseases, are discussed. The Seven Countries Study, combining as it does the advantages of ecological comparisons and observations on cohorts, provides one model for new investigations into the potential of chronic disease prevention on a broad front.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. MacKenzie J (1926) The basis of vital activity: being a review of five years’ work at the St. Andrews Institute for Clinical Research. Faber and Gwyer, London

    Google Scholar 

  2. Keys A (1953) Prediction and possible prevention of coronary disease. Am J Publ Health 43: 1399–1407

    Article  CAS  Google Scholar 

  3. Keys A, White PD (eds) (1956) Cardiovascular epidemiology. Paul B Hoeber, New York

    Google Scholar 

  4. Keys A (1949) The physiology of the individual as an approach to a more quantitative biology of man. Fed Proc 8: 523–529

    PubMed  CAS  Google Scholar 

  5. Measuring the risk of coronary heart disease in adult populations—a symposium. Am J Publ Health 47[Suppl I]: 1–63

    Google Scholar 

  6. Stamler J (1967) Lectures on preventive cardiology. Grune and Stratton, New York

    Google Scholar 

  7. Keys A, Aravanis C, Blackburn, H, Buzina R, Djordjevic B, Dontas A, Fidanza F, Karvonen M, Kimura N, Menotti A, Mohacek I, Nedeljkovic S, Puddu V, Punsar S, Taylor H, van Buchem FSP (1980) Seven Countries Study: a multivariate analysis of death and coronary heart disease. Harvard University Press, Cambridge, Mass.

    Google Scholar 

  8. Keys A, Menotti A, Aravanis C, Blackburn H, Djordjevic BS, Buzina R, Dontas AS, Fidanza F, Karvonen MJ, Kimura N, Mohacek I, Nedeljkovic S, Puddu V, Punsar S, Taylor HL, Conti S, Kromhout D, Toshima H (1984) The seven countries study: 2289 deaths in 15 years. Prev Med 13: 2141–154

    Article  Google Scholar 

  9. Keys A, Aravanis C, van Buchem FSP, Blackburn H, Buzina R, Djordjevic BS, Dontas AS, Fidanza F, Karvonen MJ, Kimura N, Menotti A, Nedeljkovic S, Puddu V, Punsar S, Taylor HL (1981) The diet and all-cause death rate in the Seven Countries Study. Lancet 2: 58–61

    Google Scholar 

  10. Keys A, Menotti A, Karvonen MJ, Aravanis C, Blackburn H, Buzina R, Djordjevic BS, Dontas AS, Fidanza F, Keys MH, Kromhout D, Nedeljkovic S, Punsar S, Seccareccia F, Toshima H (1986) The diet and 15-year death rate in the Seven Countries study. Am J Epidemiol 124: 903–915

    PubMed  CAS  Google Scholar 

  11. Keys A (1992) Longevity and body fatness in middle age. Nutr Metab Cardiovasc Dis 2: 11–18

    Google Scholar 

  12. Feinleib M (1982) Summary of a workshop on cholesterol and non-cardiovascular disease mortality. Prev Med 11: 360–367

    Article  PubMed  CAS  Google Scholar 

  13. Jacobs D, Blackburn H, Higgins M, Reed D, Iso H, McMillan GC, Neaton J, Nelson J, Potter J, Rifkind B, Rossouw J, Shekelle R, Yusuf S (1992) Report of a conference on low blood cholesterol: mortality associations. Circulation 86: 1046–1060

    PubMed  CAS  Google Scholar 

  14. Sauer HI, Enterline PE (1959) Are geographic variations in death rates from cardiovascular disease real? J Chronic Dis 10: 513–524

    Article  PubMed  CAS  Google Scholar 

  15. Sidney S, Farquhar JW (1983) Cholesterol, cancer and public health policy. Am J Med 75: 494–508

    Article  PubMed  CAS  Google Scholar 

  16. Thom TJ, Kannel WB, Feinleib M (1958) Factors in the decline of coronary heart disease mortality. In: Connor WE, Bristow JD (eds) Coronary heart disease— prevention, complications, treatment. Lippincott, Philadelphia, pp 5–20

    Google Scholar 

  17. Epstein FH, Francis T Jr, Hayner NS, Johnson BC, Kjelsberg MO, Napier JA, Ostrander LD Jr, Payne MW, Dodg HJ (1965) Prevalence of chronic diseases and distribution of selected physiologic variables in a total community, Tecumseh, Michigan. Am J Epidemiol 81: 307–322

    PubMed  CAS  Google Scholar 

  18. Abramson JH, Gofin J, Peritz E, Hopp C, Epstein LM (1981) Clustering of chronic disorders—a community study of coprevalence in Jerusalem. J Chronic Dis 35: 221–230

    Article  Google Scholar 

  19. Menotti A, Conti S, Dima F, Giampaoli S, Giuli B, Rumi A, Seccareccia F, Signoretti P (1983) Prediction of all causes of death as a function of some factors commonly measured in cardiovascular disease surveys. Prev Med 12: 318–325

    Article  PubMed  CAS  Google Scholar 

  20. Menotti A (1992) Coronary risk factors and non-cardiovascular disease. In: Marmot M, Elliott P (eds) Coronary heart disease epidemiology. From aetiology to public health. Oxford University Press, Oxford, pp 298–310

    Google Scholar 

  21. Epstein FH (1992) Low cholesterol cancer and other non-cardiovascular disorders. Atherosclerosis 94: 1–12

    Article  PubMed  CAS  Google Scholar 

  22. Stamler J, Dyer AR, Shekelle RB, Neaton J, Stamler R (1993) 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 82: 191–222

    Article  PubMed  CAS  Google Scholar 

  23. Wingard DL, Berkman LF, Brand RJ (1982) A multivariate analysis of health- related practices: a nine year mortality follow-up of the Alameda County Study. Am J Epidemiol 116: 765–775

    PubMed  CAS  Google Scholar 

  24. Marmot MG, Shipley MJ, Rose G (1984) Inequalities in death-specific explanations of a general pattern. Lancet 1: 1003–1006

    Article  PubMed  CAS  Google Scholar 

  25. Committee on Diet and Health, Food and Nutrition Board, Commission on Life Sciences, National Research Council (1989) Diet and health—implications for reducing chronic disease risk. National Academy Press, Washington, D.C.

    Google Scholar 

  26. Report of a WHO Study Group (1990) Diet, nutrition, and the prevention of chronic diseases. World Health Organization Technical Report Series 797, World Health Organization, Geneva

    Google Scholar 

  27. Waldron KW, Johnson IT, Fenwick GR (eds) (1993) Food and cancer prevention: chemical and biological aspects. Royal Society of Chemistry, Cambridge

    Google Scholar 

  28. Kesteloot H (1992) Nutrition and health. Eur Heart J 13: 120–128

    PubMed  CAS  Google Scholar 

  29. Paffenbarger RS, Hyde RT, Wing AL, Lee I-M, Jung DL, Kampert JB (1993) The association of changes in physical activity level and other lifestyle characteristics with mortality among men. N Engl J Med 328: 538–545

    Article  PubMed  Google Scholar 

  30. Thorn TJ, Epstein FH, Feldman JJ, Leaverton PE, Wolz M (1992) Total mortality and mortality from heart disease, cancer and stroke from 1950 to 1987 in 27 countries—highlights of trends and their interrelationships among causes of death. National Institutes of Health, National Heart, Lung and Blood Institute, NIH publication no 92 - 3088, Bethesda, Md.

    Google Scholar 

  31. Fortmann SP, Taylor CB, Flora J A, Winkleby MA (1993) Effect of community health education on plasma cholesterol levels and diet: the Stanford Five-City Project. Am J Epidemiol 137: 1039–1055

    PubMed  CAS  Google Scholar 

  32. Epstein FH, Holland WW (1983) Prevention of chronic diseases in the community—one disease versus multiple disease strategies. Int J Epidemiol 12: 135–137

    Article  PubMed  CAS  Google Scholar 

  33. Interhealth Steering Committee (1991) Demonstration projects for the integrated prevention and control of non-communicable diseases (Interhealth Programme): epidemiological background and rationale. World Health Statist Q 44: 48–54

    Google Scholar 

  34. Glasunov IS, Grabauskas V, Holland WW, Epstein FH (1983) An integrated programme for the prevention and control of non-communicable diseases. J Chronic Dis 36: 419–426

    Article  PubMed  CAS  Google Scholar 

  35. Blackburn H, Jacobs D (1984) Sources of the diet—heart controversy: confusion over population versus individual correlations. Circulation 70: 775–780

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Frederick H. Epstein
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Division of Epidemiology, School of Public Health, University of Minnesota, 55454, MN, USA

    Ancel Keys M.D. (Emeritus Professor) & Henry Blackburn M.D. (Mayo Professor of Public Health and Professor of Medicine) (Emeritus Professor) &  (Mayo Professor of Public Health and Professor of Medicine)

  2. The Third Department of Medicine, The Institute of Cardiovascular Diseases, Kurume University School of Medicine, 830, Kurume, Japan

    Hironori Toshima M.D. (Emeritus Professor) (Emeritus Professor)

  3. The Third Department of Medicine, Kurume University School of Medicine, 830, Kurume, Japan

    Yoshinori Koga M.D. (Associate Professor) (Associate Professor)

Rights and permissions

Reprints and permissions

Copyright information

© 1994 Springer-Verlag Tokyo

About this paper

Cite this paper

Epstein, F.H. (1994). Will Measures to Prevent Coronary Heart Disease Protect Against Other Chronic Disorders?. In: Keys, A., Toshima, H., Koga, Y., Blackburn, H. (eds) Lessons for Science from the Seven Countries Study. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68269-1_14

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-68269-1_14

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68271-4

  • Online ISBN: 978-4-431-68269-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation