Do Cardiovascular Disease Risk Factors Predict All-Cause Mortality?

BACKGROUND: The purpose of this study is to describe associations between a number of standard cardiovascular risk factors and all-cause mortality. METHOD: Mortality data were collected for a randomly selected cohort of 1029 New Zealand men aged 35-64 years, followed up over a 9-year period. A proportional hazards regression model was used to estimate the relative risks (RR) for all-cause mortality associated with a number of cardiovascular risk factors. RESULTS: In all, 96 deaths occurred over the 9-year period, of which 50% were due to cardiovascular causes. All-cause mortality was positively associated with cigarette smoking (age-adjusted RR = 2.01, 95% CI:1.15-3.53, current versus never), systolic blood pressure (age-adjusted RR = 2.18, 95% CI:1.23-4.44, upper versus lower tertile), and body mass index (age-adjusted RR = 1.59, 95% CI:0.94-2.66, upper versus lower tertile) and inversely associated with high density lipoprotein (HDL)-cholesterol (age-adjusted RR = 0.45, 95% CI:0.25-0.80, upper versus lower tertile). All-cause mortality was only weakly associated with serum total cholesterol (age-adjusted RR = 1.19, 95% CI:0.70-1.99, upper versus lower tertile), and there was no evidence of a U-shaped relationship for this risk factor. There was an inverse association between all-cause mortality and socioeconomic status (age-adjusted RR = 1.70, 95% CI:1.03-2.80, lower versus upper). Light alcohol consumption was associated with reduced all-cause mortality (age-adjusted RR = 0.63, 95% CI:0.37-1.05, light versus teetotal), but this benefit did not persist for alcohol consumption above about three standard drinks per day. CONCLUSIONS: The findings of this study indicate that the standard cardiovascular risk factors are likely to have a beneficial impact on all-cause mortality as well as cardiovascular disease in middle-aged and older men.