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Cardiorespiratory risk factors as predictors of 40-year mortality in women and men
  1. J E Ferrie1,
  2. A Singh-Manoux1,2,
  3. M Kivimäki1,
  4. J Mindell1,
  5. E Breeze1,
  6. G Davey Smith3,
  7. M J Shipley1
  1. 1
    Department of Epidemiology and Public Health, University College London, London, UK
  2. 2
    INSERM, U687-IFR69, France
  3. 3
    Department of Social Medicine, University of Bristol, Bristol, UK
  1. Dr Jane Ferrie, Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, London WC1E 6BT, UK; j.ferrie{at}


Objective: Most historical studies of cardiorespiratory risk factors as predictors of mortality have been based on men. This study examines whether they predict mortality over long periods in women and men.

Design: Prospective cohort study.

Setting: Participants were employees of the General Post Office.

Methods: Risk factor data were collected via clinical examination and questionnaire, 1966–7. Associations between cardiorespiratory risk factors and 40-year mortality were determined for 644 women and 1272 men aged 35–70 at examination.

Main outcome measures: All-cause, cardiovascular (CVD), cancer and respiratory mortality.

Results: Associations between systolic blood pressure and all-cause and stroke mortality were equally strong for women and men, hazard ratio (95% confidence interval) 1.25 (1.1 to 1.4) and 1.18 (1.1 to 1.3); and 2.17 (1.7 to 2.8) and 1.69 (1.4 to 2.1), respectively. Cholesterol was higher in women and was associated with all-cause 1.22 (1.1 to 1.4) and CVD 1.39 (1.2 to 1.7) mortality, while associations between 2-hour glucose and all-cause 1.15 (1.1 to 1.2), coronary heart disease (CHD) 1.25 (1.1 to 1.4) and respiratory mortality 1.21 (1.0 to 1.5) were observed in men. Obesity was associated with stroke in women (2.42 (1.12 to 5.24)) and CHD in men (1.59 (1.02 to 2.49)), while ECG ischaemia was associated with CVD in both sexes. The strongest, most consistent predictor of mortality was smoking in women and poor lung function in men. However, evidence of sex differences in associations between the cardiorespiratory risk factors measured and mortality was sparse.

Conclusions: Data from a 40-year follow-up period show remarkably persistent associations between risk factors and cardiorespiratory and all-cause mortality in women and men.

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  • Additional tables are published online only at

  • Funding: The GPO study was supported by a grant to Donald Reid. The diabetes component of the study was funded by a grant to Harry Keen from the Chief Scientist Fund, Department of Health. JEF is supported by the MRC (grant number G8802774), MJS by a grant from the British Heart Foundation and MK by the Academy of Finland (grant number 117604, 124332).

  • Competing interests: None.