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Blood pressure in the seven countries cohorts of Crete and Netherlands

In May and August 2000 the survivors (aged 80-96) of the Cretan 7 Countries cohort and younger male rural Cretans (aged 43-64), who lived in the same villages as the survivors, were re-examined.
Blood pressure was measured in accordance with the Cross-Cultural study protocol, just as in the initial sample of 1960.

The results of the measurements of the Cretan men are compared to Zutphen men and are presented in the following table:

Blood pressure in 2000 for the Cretan and Zutphen cohort survivors
and younger male rural Cretans
43-64 yr olds
P Value Crete
80-96 yr olds
P Value Zutphen
80-98 yr olds

n 80 133 146

Mean (SD)

Systolic blood pressure (mmHg) 134 (18.3) <0.0001 151 (21.5) <0.5 146 (21.3)
Diastolic blood pressure (mmHg) 83 (9.5) <0.001 77 (10.7) 0.01 74 (10.2)

NOTE: The percentages of subjects taking blood pressure-lowering medication in each group has not been assessed.

Blood pressure is an important determinant of various cardiovascular diseases e.g. CHD, stroke and kidney failure. It is postulated that the greatest lowering of blood pressure is obtained when, in addition to a reduction in sodium intake, a diet rich in low-fat dairy products, fruits and vegetables is consumed. Studies suggest that a dietary pattern rich in fruits, vegetables, whole grains and nuts substantially decreases the risk of CHD. Recent guidelines for a healthy diet include an intake of at least 400g/d of fruit and vegetables. The average fruit and vegetable intakes do not surpass 400g in either of the elderly cohorts, although they are in the region of 300 g/d. In both the Cretan cohorts, the percentage of subjetcs consuming nuts appears to be low (8% in the elderly cohort and only 3% in the younger males), in contrast to the Dutch cohort (63% consumers).
In Western societies, blood pressure is known to increase as age increases (Jacobs et al, 1999). Average diastolic blood pressure in the Cretan 7 countries survivors was significantly lower, however, than in the younger Cretan men. Medication effects could be acting as a confounder. Certain medications may also affect other blood measurements e.g. homocysteine.

A. Kafatos, Ch. Hatzis, M.Linardakis, J. Moschandreas
Univerity of Crete, Greece
D. Kromhout, National Institute of Public Health and the Environment RIVM, The Netherlands

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