Lifestyle behaviour and lifetime incidence of heart diseases

Objectives: Investigate the relationship of some behavioural characteristics of a male population with lifetime incidence of heart diseases. Material and methods: In the Italian Rural Areas of the Seven Countries Study of Cardiovascular Diseases, 1677 heart disease-freemen aged 40–59 yearswere followed up during 50 years for lifetime incidence of heart disease up to the age of 90 years. They were classified as coronary heart disease (CHD) and heart diseases of uncertain etiology (HDUE). Baseline cigarette smoking habits (non-smokers and ex-smokers, moderate smokers, heavy smokers), physical activity (sedentary, moderate, vigorous) and eating habits (non-Mediterranean Diet, Prudent Diet and Mediterranean Diet) were related to incidence of heart disease. Results: Incidence of CHD and HDUE up to the age of 90 years was 28.8 and 17.7%, respectively. Univariate and multivariate analyses showed strong association of behavioural characteristics with CHD incidence, but not with HDUE incidence. Cox proportional hazard rates for CHD were 1.45 (95% confidence intervals, CI: 1.11– 1.90) for heavy smokers versus non-smokers; 0.67 (CI 0.50–0.89) for vigorous activity versus sedentary habits and 0.62 (CI 0.47–0.83) for Mediterranean Diet versus non-Mediterranean Diet. Combining CHD cases with HDUE cases made the predictive picture similar to that of CHD. When some basic risk factors were added to the model results remained substantially unaltered, despite the existence of some correlations of behaviours with risk factors. Conclusions: Behavioural factors including cigarette smoking, physical activity and diet are strong predictors of lifetime incidence of common heart diseases even adding other traditional risk factors.