Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality

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Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality. / Global Cardiovascular Risk Consortium.

In: NEW ENGL J MED, Vol. 389, No. 14, 05.10.2023, p. 1273-1285.

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@article{a2364c6b807f4d92b30b7b3ee87c631d,
title = "Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality",
abstract = "BACKGROUND: 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.METHODS: 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.RESULTS: 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).CONCLUSIONS: 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.).",
keywords = "Female, Humans, Male, Middle Aged, Cardiovascular Diseases/epidemiology, Diabetes Mellitus, Risk Factors, Smoking/adverse effects, Heart Disease Risk Factors, Internationality",
author = "{Global Cardiovascular Risk Consortium} and Christina Magnussen and Ojeda, {Francisco M} and Leong, {Darryl P} and Jesus Alegre-Diaz and Philippe Amouyel and Larissa Aviles-Santa and {De Bacquer}, Dirk and Ballantyne, {Christie M} and Antonio Bernab{\'e}-Ortiz and Martin Bobak and Hermann Brenner and Carrillo-Larco, {Rodrigo M} and {de Lemos}, James and Annette Dobson and Marcus D{\"o}rr and Chiara Donfrancesco and Wojciech Drygas and Dullaart, {Robin P} and Gunnar Engstr{\"o}m and Ferrario, {Marco M} and Jean Ferri{\`e}res and {de Gaetano}, Giovanni and Uri Goldbourt and Clicerio Gonzalez and Guido Grassi and Hodge, {Allison M} and Kristian Hveem and Licia Iacoviello and Ikram, {M Kamran} and Vilma Irazola and Modou Jobe and Pekka Jousilahti and Pontiano Kaleebu and Maryam Kavousi and Frank Kee and Davood Khalili and Wolfgang Koenig and Anna Kontsevaya and Kari Kuulasmaa and Lackner, {Karl J} and Leistner, {David M} and Lars Lind and Allan Linneberg and Thiess Lorenz and Lyngbakken, {Magnus Nakrem} and Reza Malekzadeh and Sofia Malyutina and Mathiesen, {Ellisiv B} and Olle Melander and Andres Metspalu and Miranda, {J Jaime} and Marie Moitry and Joseph Mugisha and Mahdi Nalini and Vijay Nambi and Toshiharu Ninomiya and Karen Oppermann and Eleonora d'Orsi and Andrzej Paj{\c a}k and Luigi Palmieri and Demosthenes Panagiotakos and Arokiasamy Perianayagam and Annette Peters and Hossein Poustchi and Prentice, {Andrew M} and Eva Prescott and Ulf Ris{\'e}rus and Veikko Salomaa and Susana Sans and Satoko Sakata and Ben Sch{\"o}ttker and Schutte, {Aletta E} and Sepanlou, {Sadaf G} and Sharma, {Sanjib Kumar} and Shaw, {Jonathan E} and Simons, {Leon A} and Stefan S{\"o}derberg and Abdonas Tamosiunas and Barbara Thorand and Hugh Tunstall-Pedoe and Raphael Twerenbold and Diego Vanuzzo and Giovanni Veronesi and Julia Waibel and Wannamethee, {S Goya} and Masafumi Watanabe and Wild, {Philipp S} and Yao Yao and Yi Zeng and Andreas Ziegler and Stefan Blankenberg",
note = "Copyright {\textcopyright} 2023 Massachusetts Medical Society.",
year = "2023",
month = oct,
day = "5",
doi = "10.1056/NEJMoa2206916",
language = "English",
volume = "389",
pages = "1273--1285",
journal = "NEW ENGL J MED",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "14",

}

RIS

TY - JOUR

T1 - Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality

AU - Global Cardiovascular Risk Consortium

AU - Magnussen, Christina

AU - Ojeda, Francisco M

AU - Leong, Darryl P

AU - Alegre-Diaz, Jesus

AU - Amouyel, Philippe

AU - Aviles-Santa, Larissa

AU - De Bacquer, Dirk

AU - Ballantyne, Christie M

AU - Bernabé-Ortiz, Antonio

AU - Bobak, Martin

AU - Brenner, Hermann

AU - Carrillo-Larco, Rodrigo M

AU - de Lemos, James

AU - Dobson, Annette

AU - Dörr, Marcus

AU - Donfrancesco, Chiara

AU - Drygas, Wojciech

AU - Dullaart, Robin P

AU - Engström, Gunnar

AU - Ferrario, Marco M

AU - Ferrières, Jean

AU - de Gaetano, Giovanni

AU - Goldbourt, Uri

AU - Gonzalez, Clicerio

AU - Grassi, Guido

AU - Hodge, Allison M

AU - Hveem, Kristian

AU - Iacoviello, Licia

AU - Ikram, M Kamran

AU - Irazola, Vilma

AU - Jobe, Modou

AU - Jousilahti, Pekka

AU - Kaleebu, Pontiano

AU - Kavousi, Maryam

AU - Kee, Frank

AU - Khalili, Davood

AU - Koenig, Wolfgang

AU - Kontsevaya, Anna

AU - Kuulasmaa, Kari

AU - Lackner, Karl J

AU - Leistner, David M

AU - Lind, Lars

AU - Linneberg, Allan

AU - Lorenz, Thiess

AU - Lyngbakken, Magnus Nakrem

AU - Malekzadeh, Reza

AU - Malyutina, Sofia

AU - Mathiesen, Ellisiv B

AU - Melander, Olle

AU - Metspalu, Andres

AU - Miranda, J Jaime

AU - Moitry, Marie

AU - Mugisha, Joseph

AU - Nalini, Mahdi

AU - Nambi, Vijay

AU - Ninomiya, Toshiharu

AU - Oppermann, Karen

AU - d'Orsi, Eleonora

AU - Pająk, Andrzej

AU - Palmieri, Luigi

AU - Panagiotakos, Demosthenes

AU - Perianayagam, Arokiasamy

AU - Peters, Annette

AU - Poustchi, Hossein

AU - Prentice, Andrew M

AU - Prescott, Eva

AU - Risérus, Ulf

AU - Salomaa, Veikko

AU - Sans, Susana

AU - Sakata, Satoko

AU - Schöttker, Ben

AU - Schutte, Aletta E

AU - Sepanlou, Sadaf G

AU - Sharma, Sanjib Kumar

AU - Shaw, Jonathan E

AU - Simons, Leon A

AU - Söderberg, Stefan

AU - Tamosiunas, Abdonas

AU - Thorand, Barbara

AU - Tunstall-Pedoe, Hugh

AU - Twerenbold, Raphael

AU - Vanuzzo, Diego

AU - Veronesi, Giovanni

AU - Waibel, Julia

AU - Wannamethee, S Goya

AU - Watanabe, Masafumi

AU - Wild, Philipp S

AU - Yao, Yao

AU - Zeng, Yi

AU - Ziegler, Andreas

AU - Blankenberg, Stefan

N1 - Copyright © 2023 Massachusetts Medical Society.

PY - 2023/10/5

Y1 - 2023/10/5

N2 - BACKGROUND: 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.METHODS: 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.RESULTS: 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).CONCLUSIONS: 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.).

AB - BACKGROUND: 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.METHODS: 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.RESULTS: 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).CONCLUSIONS: 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.).

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Cardiovascular Diseases/epidemiology

KW - Diabetes Mellitus

KW - Risk Factors

KW - Smoking/adverse effects

KW - Heart Disease Risk Factors

KW - Internationality

U2 - 10.1056/NEJMoa2206916

DO - 10.1056/NEJMoa2206916

M3 - SCORING: Journal article

C2 - 37632466

VL - 389

SP - 1273

EP - 1285

JO - NEW ENGL J MED

JF - NEW ENGL J MED

SN - 0028-4793

IS - 14

ER -