Risk factors for myocardial infarction and death due to ischemic heart disease and other causes

Abstract

As part of a study of the male population in an industrial city in Sweden, one third of all male inhabitants of Göteborg born in 1913 were invited to an examination in 1963. Of those invited, 855 (88 percent) accepted. This report examines the incidence of nonfatal myocardial infarction and death from ischemic heart disease and other causes in this group of men during the ensuing 10 years. There were 6l deaths; autopsy was performed in 56 cases. Nineteen men died of ischemic heart disease and 18 of cancer; 12 men died violently. Thirty-one men survived an acute myocardial infarction. Cigarette smoking and registration with the Temperance Board at the time of the initial examination were more common in men who later had a nonfatal myocardial infarction or died of ischemic heart disease or other causes than in surviving subjects and men who did not have an infarction. Dyspnea was more common in men who died of ischemic heart disease but was less common in those who died of other causes than in the remaining subjects. Values for systolic blood presure were higher and those for peak expiratory flow lower in men who died of ischemic heart disease. Serum cholesterol values were higher and those for serum triglycerides tended to be higher in men who died of ischemic heart disease than in other subjects. Heart size tended to be greater in those who had nonfatal or fatal ischemic heart disease. Obesity, the level of physical activity, fasting blood glucose levels, doffee consumption, hematocrit and erythrocyte sedimentation rate as determined at age 50 years had no predictive value for assissing the risk of nonfatal myocardial infarction, fatal ischemic heart disease or death from other causes before age 60. The results indicate that many so-called risk factors have a different relation to fatal than to nonfatal ischemic heart disease.