Open Access Open Badges Research article

Risk factors for ischaemic heart disease in a Cretan rural population: a twelve year follow-up study

Ioannis K Karalis12*, Athanasios K Alegakis1, Antonios G Kafatos3, Antonios D Koutis1, Panos E Vardas2 and Christos D Lionis1

Author Affiliations

1 Clinic of Social and Family Medicine, School of Medicine, University of Crete, Greece

2 Department of Cardiology, University Hospital of Crete, Greece

3 Clinic of Nutrition and Disease Prevention, School of Medicine, University of Crete, Greece

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BMC Public Health 2007, 7:351  doi:10.1186/1471-2458-7-351

Published: 18 December 2007



Crete has been of great epidemiological interest ever since the publication of the Seven Countries Study. In 1988 a well-defined area of rural Crete was studied, with only scarce signs of coronary heart disease (CHD) despite the unfavorable risk profile. The same population was re-examined twelve years later aiming to describe the trends of CHD risk factors over time and discuss some key points on the natural course of coronary heart disease in a rural population of Crete.

Methods and Results

We re-examined 200 subjects (80.7% of those still living in the area, 62.4 ± 17.0 years old). The prevalence of risk factors for CHD was high with 65.9% of men and 65.1% of women being hypertensive, 14.3% of men and 16.5% of women being diabetic, 44% of men being active smokers and more than 40% of both sexes having hyperlipidaemia. Accordingly, 77.5% of the population had a calculated Framingham Risk Score (FRS) ≥ 15%, significantly higher compared to baseline (p < 0.001). The overall occurrence rate for CHD events was calculated at 7.1 per 1000 person-years (95% confidence interval: 6.8–7.3).


The study confirms the unfavorable risk factor profile of a well defined rural population in Crete. Its actual effect on the observed incidence of coronary events in Cretans remains yet to be defined.