Determinants of All-Cause Mortality and Incidence of Cardiovascular Disease (2009 to 2013) in Older Adults: The Ikaria Study of the Blue Zones

Angiology. 2016 Jul;67(6):541-8. doi: 10.1177/0003319715603185. Epub 2015 Aug 30.


Aim: Ikaria Island (North-East Aegean, Greece) has been recognized as one of the places with the highest life expectancy around the world (the Blues Zones). Risk factors in relation to 4-year all-cause mortality and cardiovascular disease (CVD) incidence in elders were studied.

Methods: From June to October 2009, 330 men and 343 women, aged 65 to 100 years, were enrolled, and in June to July 2013, they were reevaluated.

Results: Age-standardized, gender-specific, all-cause mortality rate was 790 deaths per 10 000 inhabitants, and causes of death were CVD (36%), cancer (21%), infection (10%), respiratory disease (2%), and other (31%). Incidence of CVDwas 520 cases per 10 000 men inhabitants and 320 cases per 10 000 women (P = .03). Age, male gender, heart rate, urea levels, left atrial maximum volume, left ventricular hypertrophy, thyroid-stimulating hormone, and moderate to severe depression were positively associated with mortality, whereas left ventricular ejection fraction as well as coffee and tea drinking, fruit intake, and exclusive olive oil use were inversely associated with CVD.

Conclusion: Heart function markers in addition to antioxidant dietary factors were placed in this puzzle of CVD morbidity.

Keywords: biomarkers; cardiovascular function; coronary heart disease; diet; elderly; lifestyle.

Publication types

  • Observational Study

MeSH terms

  • Age Distribution
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / mortality
  • Cause of Death
  • Diet, Healthy
  • Female
  • Greece / epidemiology
  • Humans
  • Incidence
  • Life Style*
  • Male
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Sex Distribution
  • Sex Factors
  • Socioeconomic Factors*
  • Time Factors