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.)Harmonized individual-level data from a global cohort showed that more than half the cases of incident cardiovascular disease and one fifth of deaths may be attributable to five modifiable risk factors.

Global effect of modifiable risk factors on cardiovascular disease and mortality

Ferrario, Marco M
Writing – Review & Editing
;
Iacoviello, Licia
Writing – Review & Editing
;
Veronesi, Giovanni
Membro del Collaboration Group
;
2023-01-01

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.)Harmonized individual-level data from a global cohort showed that more than half the cases of incident cardiovascular disease and one fifth of deaths may be attributable to five modifiable risk factors.
2023
2023
Magnussen, Christina; Ojeda, Francisco M; Leong, Darryl P; Alegre-Diaz, Jesus; Amouyel, Philippe; Aviles-Santa, Larissa; De Bacquer, Dirk; Ballantyne, Christie M; Bernabé-Ortiz, Antonio; Bobak, Martin; Brenner, Hermann; Carrillo-Larco, Rodrigo M; de Lemos, James; Dobson, Annette; Dörr, Marcus; Donfrancesco, Chiara; Drygas, Wojciech; Dullaart, Robin P; Engström, Gunnar; Ferrario, Marco M; Ferrières, Jean; de Gaetano, Giovanni; Goldbourt, Uri; Gonzalez, Clicerio; Grassi, Guido; Hodge, Allison M; Hveem, Kristian; Iacoviello, Licia; Ikram, M Kamran; Irazola, Vilma; Jobe, Modou; Jousilahti, Pekka; Kaleebu, Pontiano; Kavousi, Maryam; Kee, Frank; Khalili, Davood; Koenig, Wolfgang; Kontsevaya, Anna; Kuulasmaa, Kari; Lackner, Karl J; Leistner, David M; Lind, Lars; Linneberg, Allan; Lorenz, Thiess; Lyngbakken, Magnus Nakrem; Malekzadeh, Reza; Malyutina, Sofia; Mathiesen, Ellisiv B; Melander, Olle; Metspalu, Andres; Miranda, J Jaime; Moitry, Marie; Mugisha, Joseph; Nalini, Mahdi; Nambi, Vijay; Ninomiya, Toshiharu; Oppermann, Karen; D'Orsi, Eleonora; Pająk, Andrzej; Palmieri, Luigi; Panagiotakos, Demosthenes; Perianayagam, Arokiasamy; Peters, Annette; Poustchi, Hossein; Prentice, Andrew M; Prescott, Eva; Risérus, Ulf; Salomaa, Veikko; Sans, Susana; Sakata, Satoko; Schöttker, Ben; Schutte, Aletta E; Sepanlou, Sadaf G; Sharma, Sanjib Kumar; Shaw, Jonathan E; Simons, Leon A; Söderberg, Stefan; Tamosiunas, Abdonas; Thorand, Barbara; Tunstall-Pedoe, Hugh; Twerenbold, Raphael; Vanuzzo, Diego; Veronesi, Giovanni; Waibel, Julia; Wannamethee, S Goya; Watanabe, Masafumi; Wild, Philipp S; Yao, Yao; Zeng, Yi; Ziegler, Andreas; Blankenberg, Stefan
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