Journal Mobile Options
Table of Contents
Vol. 22, No. 6, 2003
Issue release date: November–December 2003
Neuroepidemiology 2003;22:332–338

Risk Factors of Stroke Mortality: A 40-Year Follow-Up of the Corfu Cohort from the Seven-Countries Study

Panagiotakos D.P. · Chrysohoou C. · Pitsavos C. · Menotti A. · Dontas A. · Skoumas J. · Stefanadis C. · Toutouzas P.
aCardiology Department, School of Medicine, University of Athens and bCentre of Studies of Age-Related Changes in Man, Athens, Greece; cAssociation for Cardiac Research, Rome, Italy

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


The present work evaluates several risk factors for stroke mortality based on a 40-year follow-up of the Corfu cohort from the Seven-Countries Study. The population studied in this analysis consisted of 529 rural men (49.7 ± 5.7 years old) enrolled at 1961. The death rate at the end of follow-up was 87.1% (i.e. 461 deaths out of 529 participants). Of 529 cardiovascular-disease-free men at entry, 74 (14%) died because of hemorrhagic or thrombotic stroke. Age (HR = 1.11/year, p < 0.001), pulse pressure (HR = 1.16/5 mm Hg, p < 0.001), total serum cholesterol levels (HR = 0.81/10 mg/dl, p < 0.01) and presence of physical activity (HR = 0.59, p < 0.05), showed a statistically significant association with fatal stroke events. In conclusion, age, pulse pressure levels, physical activity (protective) and total serum cholesterol levels (protective) were significantly related with 40-year stroke mortality.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Warlow CP: Epidemiology of stroke. Lancet 1998;352:1–4.
  2. Kjekshus J, Pedersen TR: Reducing the risk of coronary events; evidence from the Scandinavian Simvastatin Survival Study (4S). Am J Cardiol 1995;76:64C–68C.

    External Resources

  3. Hebert PR, Gaziano JM, Chan KS, Hennekens CH: Cholesterol lowering with statin drugs, risk of stroke, and total mortality: An overview of randomised trials. JAMA 1997;278:313–321.
  4. Keys A: Coronary heart disease in seven countries. Circulation 1970;41(suppl 4):1–210.
  5. Menotti A, Seccareccia F: Risk factors and mortality patterns in the Seven-Countries Study; in Toshima H, Koga Y, Blackburn H (eds): Lessons for Science From the Seven-Countries Study. Tokyo, Springer, 1994 pp 17–34.
  6. 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;17:337–346.
  7. Anderson JT, Keys A: Serum cholesterol in serum and lipoprotein fractions: Its measurement and stability. Clin Chem 1956;2:145–159.
  8. 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.
  9. 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.
  10. Labarthe DR: Epidemiology and Prevention of Cardiovascular Diseases. A Global Challenge. Maryland, An Aspen, 1998.
  11. Prospective Studies Collaboration: Cholesterol, diastolic blood pressure, and stroke. 13,000 strokes in 450,000 people in 45 prospective cohorts. Lancet 1995;346:1647–1653.
  12. Blair SN, Kohl HW, Gordon NF, Paffenbarger RS Jr: How much physical activity is good for health? Annu Rev Public Health 1992;13:99–126.
  13. Kokkinos PF, Narayan P, Colleran JA, Pittaras A, Notargiacomo L, Reda D, Papademetriou V: Effects of regular exercise on blood pressure and left ventricular hypertrophy in African-American men with severe hypertension. N Engl J Med 1995;333:1462–1467.
  14. Kokkinos PF, Papademetriou V: Exercise and hypertension. Coron Artery Dis 2000;11:99–102.
  15. Reaven PD, Barrett-Connor E, Edelstein S: Relation between leisure-time physical activity and blood pressure in older women. Circulation 1991;83:559–565.
  16. Sandvik L, Erikssen J, Thaulow E, Erikssen G, Mundal R, Rodahl K: Physical fitness as a predictor of mortality among healthy, middle-aged Norwegian men. N Eng J Med 1993;328:533–537.
  17. Evenson KR, Rosamond WD, Cai J, Toole JF, Hutchinson RG, Shahar E, Folsom AR: Physical activity and ischemic stroke risk. The atherosclerosis risk in communities study. Stroke 1999;30:1333–1339.
  18. Lee IM, Paffenbarger RS Jr: Physical activity and stroke incidence: The Harvard Alumni Health Study. Stroke 1998;29:2049–2054.
  19. Abbot RD, Rodriguez BL, Burchfiel CM, Curb JD: Physical activity in older middle-aged men and reduced risk of stroke. The Honolulu Heart Program. Am J Epidemiol 1994;139:881–893.
  20. Gillum RF, Mussolino ME, Ingram DD: Physical activity and stroke incidence in women and men. The NHANES I Epidemiologic Follow-up Study. Am J Epidemiol 1996;143:860–869.
  21. Haheim LL, Holme I, Hjermann I, Leren P: Risk factors of stroke incidence and mortality. A 12-year follow-up of the Oslo Study. Stroke 1993;24:1484–1489.
  22. Stallones RA: Epidemiology of cerebrovascular disease: A review. J Chronic Dis 1965;18:859–872.
  23. Benfante R, Yano K, Hwang LJ, Curb JD, Kagan A, Ross W: Elevated serum cholesterol is a risk factor for both coronary heart disease and thrombotic stroke in Hawaiian Japanese men. Implications of shared risk. Stroke 1994;25:814–820.
  24. Kromhout D: Serum cholesterol in cross-cultural perspective. The Seven-Countries Study. Acta Cardiol 1999;54:155–158.
  25. Burt VL, Whelton P, Roccella EJ: Prevalence of hypertension in the US adults’ population. Results from the Third National Health and Nutrition Examination Survey. 1988–1991. Hypertension 1995;25:305–313.
  26. O’Rourke M: Mechanical principles in arterial disease. Hypertension 1995;26:2–9.
  27. Wannamethee SG, Shaper AG, Whincup PH, Walker M: Smoking cessation and the risk of stroke in middle-aged men. JAMA 1995;274:155–160.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50