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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 Sep; 84(3):238-44.H

Abstract

OBJECTIVE

A systematic reanalysis of 10 year coronary heart disease incidence data from the northern and the southern European cohorts of the seven countries study, to contribute indirectly to the production of a European coronary risk chart.

DESIGN AND SETTING

Men aged 40-59 years at entry were studied in three northern European cohorts based in Finland and Netherlands (n = 2213); and in 10 southern European cohorts based in Italy, former Yugoslavia, and Greece (n = 5897). Multiple logistic models for the prediction of coronary deaths, coronary incidence (hard criteria), and coronary incidence (any criterion) were solved for the two geographical groups and their pool. Risk factors fed into the models were age, systolic blood pressure, serum total cholesterol, and cigarette smoking.

RESULTS

10 year coronary heart disease mortality and incidence were higher in northern than in southern Europe, with ratios around 2.65. Ratios among the three coronary heart disease manifestations were identical in the two cultural groupings. Coefficients of the multiple logistic models were similar and not significantly different between the two groupings. When applying the coefficients back to the same or the opposite population, the relative risk was large and similar in the different cultures. Relative risk was larger for more severe coronary heart disease manifestations. The absolute risk was overestimated when applying the northern European model to southern European populations and vice versa, with ratios of about 1.5 and 0.5, respectively. Coronary risk charts created to reproduce the shape of those incorporated in recent European guidelines confirmed the excess of absolute risk in the northern compared with the southern European cohorts, all else being equal.

CONCLUSIONS

In theory, a more appropriate European coronary risk chart could be produced by adopting coefficients to correct for different background incidence rates in different cultures. Other coefficients could appropriately be used to transform mortality risk into incidence risk.

Authors+Show Affiliations

Division of Epidemiology, University of Minnesota, Minneapolis, Minnesota, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10956281

Citation

Menotti, A, et al. "Coronary Heart Disease Incidence in Northern and Southern European Populations: a Reanalysis of the Seven Countries Study for a European Coronary Risk Chart." Heart (British Cardiac Society), vol. 84, no. 3, 2000, pp. 238-44.
Menotti A, Lanti M, Puddu PE, et al. 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(3):238-44.
Menotti, A., Lanti, M., Puddu, P. E., & Kromhout, D. (2000). Coronary heart disease incidence in northern and southern European populations: a reanalysis of the seven countries study for a European coronary risk chart. Heart (British Cardiac Society), 84(3), 238-44.
Menotti A, et al. 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(3):238-44. PubMed PMID: 10956281.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coronary heart disease incidence in northern and southern European populations: a reanalysis of the seven countries study for a European coronary risk chart. AU - Menotti,A, AU - Lanti,M, AU - Puddu,P E, AU - Kromhout,D, PY - 2000/8/24/pubmed PY - 2000/9/23/medline PY - 2000/8/24/entrez SP - 238 EP - 44 JF - Heart (British Cardiac Society) JO - Heart VL - 84 IS - 3 N2 - OBJECTIVE: A systematic reanalysis of 10 year coronary heart disease incidence data from the northern and the southern European cohorts of the seven countries study, to contribute indirectly to the production of a European coronary risk chart. DESIGN AND SETTING: Men aged 40-59 years at entry were studied in three northern European cohorts based in Finland and Netherlands (n = 2213); and in 10 southern European cohorts based in Italy, former Yugoslavia, and Greece (n = 5897). Multiple logistic models for the prediction of coronary deaths, coronary incidence (hard criteria), and coronary incidence (any criterion) were solved for the two geographical groups and their pool. Risk factors fed into the models were age, systolic blood pressure, serum total cholesterol, and cigarette smoking. RESULTS: 10 year coronary heart disease mortality and incidence were higher in northern than in southern Europe, with ratios around 2.65. Ratios among the three coronary heart disease manifestations were identical in the two cultural groupings. Coefficients of the multiple logistic models were similar and not significantly different between the two groupings. When applying the coefficients back to the same or the opposite population, the relative risk was large and similar in the different cultures. Relative risk was larger for more severe coronary heart disease manifestations. The absolute risk was overestimated when applying the northern European model to southern European populations and vice versa, with ratios of about 1.5 and 0.5, respectively. Coronary risk charts created to reproduce the shape of those incorporated in recent European guidelines confirmed the excess of absolute risk in the northern compared with the southern European cohorts, all else being equal. CONCLUSIONS: In theory, a more appropriate European coronary risk chart could be produced by adopting coefficients to correct for different background incidence rates in different cultures. Other coefficients could appropriately be used to transform mortality risk into incidence risk. SN - 1468-201X UR - https://www.unboundmedicine.com/medline/citation/10956281/Coronary_heart_disease_incidence_in_northern_and_southern_European_populations:_a_reanalysis_of_the_seven_countries_study_for_a_European_coronary_risk_chart_ L2 - http://heart.bmj.com/cgi/pmidlookup?view=long&pmid=10956281 DB - PRIME DP - Unbound Medicine ER -