Risk Factors for Cardiorespiratory and All Cause Mortality in Men and Women in Urban Scotland: 15 Year Follow Up

Abstract

Study objective: To describe the relationship between risk factors, risk behaviours, symptoms and mortality from cardiorespiratory diseases in an urban area with high levels of socioeconomic deprivation. A cohort study of 15,411 men and women aged 45–64, comprising 80% of the general population of Paisley and Renfrew, Scotland. Outcomes: Mortality after 15 years from coronary heart disease(ICD 410–4), stroke(ICD 430–8), respiratory disease(ICD 460–519) and all causes. Main results: Mortality rates from all causes were 19% in men aged 45–49, 31% in men aged 50–54, 42% in men aged 55–59 and 57% in men aged 60–64. The rates are considerably higher than those reported in previous UK prospective studies. For women the rates were 12%, 18%, 25% and 38% respectively. In general men and women showed similar relationships between risk factor levels and mortality rates. People in manual occupations had higher mortality rates. Raised levels of systolic and diastolic blood pressure were associated with increased coronary, stroke and all cause mortality rates. Plasma cholesterol had no such association with all cause mortality rates. High and low levels of body mass index were associated with higher mortality rates than intermediate levels. A relationship between short stature and increased mortality rates was observed in men and women. FEV1 expressed as a percentage of the expected value showed the strongest relationship with mortality rates, particularly for respiratory disease, but also for deaths from coronary heart disease, stroke and all causes. Conclusions A similar pattern of relationship between risk factor levels and mortality rates exists in men and women in Renfrew and Paisley. Respiratory impairment as measured by FEV 1% predicted appears to be the most likely explanation of the observed high all cause mortality rates in this population.