Chronic disease in former college students. II. Methods of study and observations on mortality from coronary heart disease.

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Abstract
Over 45,000 former students of the University of Pennsylvania and of Harvard University are being studied for the kinds and amounts of chronic diseases that developed in their later life. Physical, social, and psychological data recorded during college years are correlated with later health status as measured through self-administered questionnaires, physical examinations, and death certificates. College records from the years of 1921 through 1950 contain precursive and causative factors of subsequent chronic disease. Observations on coronary heart disease were limited to the first 590 male former students known to have died from this cause. They were contrasted with 1,180 randomly chosen living classmates of equivalent age. Nine precursors of fatal coronary heart disease were identified: heavy cigarette smoking; higher levels of blood pressure; increased body weight; shortness of body height; early parental death; absence of siblings; non-participation in varsity athletics; higher emotional index; and scarlet fever in childhood. In paired combinations these precursors gave evidence of making independent contributions to risk of coronary mortality. Some precursors correlated only with early death from coronary disease and some with death throughout the range of ages afforded for study.

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