This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by KEYS, A. Articles by SIMONSON, E. Search for Related Content PubMed Articles by KEYS, A. Articles by SIMONSON, E.

(Circulation. 1963;28:381.)
© 1963 American Heart Association, Inc.

---

Coronary Heart Disease among Minnesota Business and Professional Men Followed Fifteen Years

ANCEL KEYS PH.D.¹; HENRY LONGSTREET TAYLOR PH.D.¹; HENRY BLACKBURN M.D.¹; JOSEF BROZEK PH.D.¹; JOSEPH T. ANDERSON PH.D.¹; ERNST SIMONSON M.D.¹

¹ From the Laboratory of Physiological Hygiene, University of Minnesota, Minneapolis, Minnesota.

Relative weight, body fatness (skinfold thickness), blood pressure, and serum cholesterol are reported from 281 Minnesota business and professional men, initially clinically healthy and aged 45 to 55, who were followed by annual examinations since the winter of 1947-48. In 15 elapsed years, coronary heart disease developed definitely in 32 men and possibly in 16 other men.

The incidence of coronary heart disease tended to be higher among men above the median at first examination in relative weight, body fatness, systolic and diastolic blood pressure, and serum cholesterol concentration but these segregations were not statistically significant except with serum cholesterol, which was associated with p < 0.001. The data for the last pre-disease year on the men who developed coronary heart disease showed a significant relationship between incidence and systolic blood pressure as well as for cholesterol. Average data over all pre-disease years showed significantly reduced risk among the men in the bottom quartile for diastolic as well as for systolic blood pressure, while the cholesterol level was significantly prognostic over the entire range of that variable. The few men who developed coronary heart disease with low cholesterol values tended to be in the top 20 per cent of the distribution of blood pressure or relative weight or both.

Relative weight showed a high but still imperfect correlation with body fatness. Arterial blood pressure tended to be elevated in extremely obese or grossly overweight men. Serum cholesterol was not significantly related to any of the other variables.

Men who developed coronary heart disease tended to have low values for cholesterol in the alpha-lipoprotein fraction in the serum but the ratio of cholesterol in the alpha- to the beta-lipoprotein fraction of the serum was no more prognostic than total cholesterol alone.

Comparison with similar follow-up data from Framingham, Massachusetts, Albany, New York, and Chicago, show a high degree of concordance. In all series relative weight had least significance and the incidence of coronary heart disease rose continuously with the serum cholesterol level. With men classified according to pre-disease cholesterol level, about 80 per cent of the total variance in relative subsequent risk is accounted for by regression of risk on the cholesterol value raised to any power from 2 to 3 and the correlation between observed and predicted relative risk is of the order of r = 0.9.

This article has been cited by other articles:

				G. M Oppenheimer Profiling risk: the emergence of coronary heart disease epidemiology in the United States (1947-70) Int. J. Epidemiol., June 1, 2006; 35(3): 720 - 730. [Abstract] [Full Text] [PDF]

				G. M. Oppenheimer Becoming the Framingham Study 1947-1950 Am J Public Health, April 1, 2005; 95(4): 602 - 610. [Abstract] [Full Text] [PDF]

				F. H. Epstein Cardiovascular Disease Epidemiology : A Journey From the Past Into the Future Circulation, May 1, 1996; 93(9): 1755 - 1764. [Full Text]

				W. B. Kannel Clinical Misconceptions Dispelled by Epidemiological Research Circulation, December 1, 1995; 92(11): 3350 - 3360. [Abstract] [Full Text]

				C. H. Slater, B. Carlton, G. Ramirez, and C. Ashton Heart Disease: Strategies for Prevention Eval Health Prof, September 1, 1987; 10(3): 255 - 286. [Abstract] [PDF]

				R. W. Fenderson, S. Deutsch, E. Menachemi, B. Chin, and P. Samuel Effect of Gemfibrozil on Serum Lipids in Man Angiology, September 1, 1982; 33(9): 581 - 593. [Abstract] [PDF]

				L Breslow Risk factor intervention for health maintenance Science, May 26, 1978; 200(4344): 908 - 912. [Abstract] [PDF]

				I. J. Voudoukis Cold Pressor Test: a New Application as a Screening Test for Arteriosclerosis Angiology, January 1, 1973; 24(8): 472 - 479. [PDF]