Seven Countries

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Coronary heart disease has long been characterized as a disease of affluence. Risk factors have been identified and tested in specific populations, but the cultural element in many of these is simply too strong for universal conclusions to be drawn from any one cohort.

Seven Countries reports the findings of a unique cross-cultural test of the predictive value of age, blood pressure, weight, smoking habit, exercise, and serum cholesterol in sixteen cohorts drawn in a wide variety of settings around the world. International teams followed the participants for a decade using standardized criteria and methods. The overriding importance of diet and blood pressure, and the negligible effect of relative weight or exercise when diet remains a constant, were critical findings that are of immediate concern to physicians and health care planners. Epidemiologists, though, will be fascinated equally by the methodology of this landmark study by one of the pioneers of cardiovascular epidemiology, carried out on three continents and involving more than twelve thousand individuals.