The present work evaluates several risk factors for stroke mortality based on a 40-year follow-up of the Corfu cohort from the Seven-Countries Study. The population studied in this analysis consisted of 529 rural men (49.7 +/- 5.7 years old) enrolled at 1961. The death rate at the end of follow-up was 87.1% (i.e. 461 deaths out of 529 participants). Of 529 cardiovascular-disease-free men at entry, 74 (14%) died because of hemorrhagic or thrombotic stroke. Age (HR = 1.11/year, p < 0.001), pulse pressure (HR = 1.16/5 mm Hg, p < 0.001), total serum cholesterol levels (HR = 0.81/10 mg/dl, p < 0.01) and presence of physical activity (HR = 0.59, p < 0.05), showed a statistically significant association with fatal stroke events. In conclusion, age, pulse pressure levels, physical activity (protective) and total serum cholesterol levels (protective) were significantly related with 40-year stroke mortality. Copyright (C) 2003 S. Karger AG, Basel.