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February 6, 1981

Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease

Author Affiliations

National Heart, Lung, and Blood Institute National Institutes of Health Bethesda, Md


by Ancel Keys, with Christ Aravanis et al (Commonwealth Fund Book), 381 pp, with illus, $25, Cambridge, Mass, Harvard University Press, 1980.

JAMA. 1981;245(5):511-512. doi:10.1001/jama.1981.03310300063026

During the last 30 years, epidemiologists have made remarkable progress in identifying important factors that are associated with the incidence of chronic diseases. Nowhere has this been more successful than in the area of coronary heart disease.

Beginning with Professor Keys' study of Minnesota businessmen and the Framingham (Mass) Heart Study, innumerable reports have appeared that have documented a wide variety of personal characteristics strongly associated with heart attacks. These characteristics include high blood pressure, elevated blood cholesterol levels, cigarette smoking, and glucose intolerance. The available data for other characteristics are more controversial; these include overweight and obesity, physical activity, and specific components of diet. Most studies have been concerned with single population groups, and most of the reports have covered only one or two endpoints, usually coronary heart disease or myocardial infarction. However, a few studies have wisely examined several diverse population groups and have included the observation of