Coronary risk factors and a 20-year incidence of coronary heart disease and mortality in a Mediterranean industrial population. The Manresa Study, Spain.

The association between coronary risk factors measured at entry and 20-year coronary heart disease (CHD) incidence and mortality was studied in an industrial cohort of 1059 men aged 30 to 59 years and free of CHD in 1968, in Spain. Myocardial infarction and fatal CHD cases were diagnosed according to recognized criteria. Mean serum cholesterol was 223.3 mg.dl-1 and 67% of men were current smokers. Rates of CHD incidence, CHD mortality and all-causes mortality, per 10(5) persons-year of observation, were 476, 194 and 617, respectively. Age, serum cholesterol, plasma glucose, cigarettes smoked and systolic blood pressure (SBP) contributed to the risk of CHD incidence. The first four variables predicted CHD death risk. All-causes death risk was positively associated with age, plasma glucose and SBP levels. Results are consistent with prior reported low CHD mortality and morbidity rates in the Mediterranean area, and confirm the importance of coronary risk factors in this low-risk population.