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BMJ 2004;328 (3 January), doi:10.1136/bmj.328.7430.0
Prolonged starvation results, three to six decades later, in raised blood pressure and higher mortality from heart disease and stroke. Sparén and colleagues (p 11) followed up nearly 4000 men from St Petersburg (formerly Leningrad) from 1975 to 1999; a third had lived through the siege of the city during the second world war. They found that a higher proportion of those who had starved for a long time had cardiovascular diseases and increased mortality, particularly if they were aged 9 to15 at the time of the siege. Wars and starvation continue, and severe starvation, accompanied by stress and trauma, may increase cardiovascular disease, especially if it occurs during puberty.
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