Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality.
; Christina Magnussen; Francisco M Ojeda; Darryl P Leong; Jesus Alegre-Diaz; Philippe Amouyel; Larissa Aviles-Santa; Dirk De Bacquer; Christie M Ballantyne; Antonio Bernabé-Ortiz; Martin Bobak; Hermann Brenner; Rodrigo M Carrillo-Larco; James de Lemos; Annette Dobson; Marcus Dörr; Chiara Donfrancesco; Wojciech Drygas; Robin P Dullaart; Gunnar Engström; Marco M Ferrario; Jean Ferrières; Giovanni de Gaetano; Uri Goldbourt; Clicerio Gonzalez; Guido Grassi; Allison M Hodge; Kristian Hveem; Licia Iacoviello; M Kamran Ikram; Vilma Irazola; Modou Jobe; Pekka Jousilahti; Pontiano Kaleebu; Maryam Kavousi; Frank Kee; Davood Khalili; Wolfgang Koenig; Anna Kontsevaya; Kari Kuulasmaa; Karl J Lackner; David M Leistner; Lars Lind; Allan Linneberg; Thiess Lorenz; Magnus Nakrem Lyngbakken; Reza Malekzadeh; Sofia Malyutina; Ellisiv B Mathiesen; Olle Melander; Andres Metspalu; J Jaime Miranda; Marie Moitry; Joseph Mugisha; Mahdi Nalini; Vijay Nambi; Toshiharu Ninomiya; Karen Oppermann; Eleonora d'Orsi; Andrzej Pająk; Luigi Palmieri; Demosthenes Panagiotakos; Arokiasamy Perianayagam; Annette Peters; Hossein Poustchi; Andrew M Prentice; Eva Prescott; Ulf Risérus; Veikko Salomaa; Susana Sans; Satoko Sakata; Ben Schöttker; Aletta E Schutte; Sadaf G Sepanlou; Sanjib Kumar Sharma; Jonathan E Shaw; Leon A Simons; Stefan Söderberg; Abdonas Tamosiunas; Barbara Thorand; Hugh Tunstall-Pedoe; Raphael Twerenbold; Diego Vanuzzo; Giovanni Veronesi; Julia Waibel; S Goya Wannamethee; Masafumi Watanabe; Philipp S Wild; Yao Yao; Yi Zeng; Andreas Ziegler; Stefan Blankenberg
Abstract
Five modifiable risk factors are associated with cardiovascular disease and death from any cause. Studies using individual-level data to evaluate the regional and sex-specific prevalence of the risk factors and their effect on these outcomes are lacking.We pooled and harmonized individual-level data from 112 cohort studies conducted in 34 countries and 8 geographic regions participating in the Global Cardiovascular Risk Consortium. We examined associations between the risk factors (body-mass index, systolic blood pressure, non-high-density lipoprotein cholesterol, current smoking, and diabetes) and incident cardiovascular disease and death from any cause using Cox regression analyses, stratified according to geographic region, age, and sex. Population-attributable fractions were estimated for the 10-year incidence of cardiovascular disease and 10-year all-cause mortality.Among 1,518,028 participants (54.1% of whom were women) with a median age of 54.4 years, regional variations in the prevalence of the five modifiable risk factors were noted. Incident cardiovascular disease occurred in 80,596 participants during a median follow-up of 7.3 years (maximum, 47.3), and 177,369 participants died during a median follow-up of 8.7 years (maximum, 47.6). For all five risk factors combined, the aggregate global population-attributable fraction of the 10-year incidence of cardiovascular disease was 57.2% (95% confidence interval [CI], 52.4 to 62.1) among women and 52.6% (95% CI, 49.0 to 56.1) among men, and the corresponding values for 10-year all-cause mortality were 22.2% (95% CI, 16.8 to 27.5) and 19.1% (95% CI, 14.6 to 23.6).Harmonized individual-level data from a global cohort showed that 57.2% and 52.6% of cases of incident cardiovascular disease among women and men, respectively, and 22.2% and 19.1% of deaths from any cause among women and men, respectively, may be attributable to five modifiable risk factors. (Funded by the German Center for Cardiovascular Research (DZHK); ClinicalTrials.gov number, NCT05466825.).
Journal | THE NEW ENGLAND JOURNAL OF MEDICINE |
ISSN | 1533-4406 |
Published | 05 Oct 2023 |
Volume | 389 |
Issue | 14 |
Pages | 1273 1285 1273-1285 |
DOI | 10.1056/NEJMoa2206916 |
Type | Journal Article |
Sponsorship |