Study objective: To investigate the association of residence in
mountainous or lowland areas with total and coronary mortality, in a
cohort with 15 years of follow up.
Design and setting: Prospective study, based on the adult population of
two lowland and one mountainous village in rural Greece. Baseline
measurements on sociodemographic, lifestyle, somatometric, clinical, and
biochemical variables were recorded in 1981 during a health survey and
total and coronary deaths were ascertained on the basis of death
certificates up to 1996.
Participants: 1198 men and women, who had participated in the 1981
survey. Analyses are based on 504 men and 646 women with complete data.
Main results: There were 150 deaths among men and 140 among women (
coronary deaths: 34 and 33 respectively). In multivariate analysis with
Cox regression, after adjustment for age, education, body weight,
smoking, alcohol consumption, systolic blood pressure, serum total
cholesterol, blood glucose, serum triglycerides, and serum uric acid,
total and coronary mortality were lower for residents of the mountainous
village in comparison with residents of the lowland villages ( hazard
ratios (95% confidence intervals) for men and women, respectively:
total mortality, 0.57 (0.38 to 0.84) and 0.69 ( 0.47 to 1.02); coronary
mortality, 0.39 (0.16 to 0.98) and 0.46 (0.20 to 1.05)).
Conclusions: Residence in mountainous areas seems to have a “protective
effect” from total and coronary mortality. Increased physical activity
from walking on rugged terrains under conditions of moderate hypoxia
among the mountain residents could explain these findings
