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

Authors :
Magnussen C
Ojeda FM
Leong DP
Alegre-Diaz J
Amouyel P
Aviles-Santa L
De Bacquer D
Ballantyne CM
Bernabé-Ortiz A
Bobak M
Brenner H
Carrillo-Larco RM
de Lemos J
Dobson A
Dörr M
Donfrancesco C
Drygas W
Dullaart RP
Engström G
Ferrario MM
Ferrières J
de Gaetano G
Goldbourt U
Gonzalez C
Grassi G
Hodge AM
Hveem K
Iacoviello L
Ikram MK
Irazola V
Jobe M
Jousilahti P
Kaleebu P
Kavousi M
Kee F
Khalili D
Koenig W
Kontsevaya A
Kuulasmaa K
Lackner KJ
Leistner DM
Lind L
Linneberg A
Lorenz T
Lyngbakken MN
Malekzadeh R
Malyutina S
Mathiesen EB
Melander O
Metspalu A
Miranda JJ
Moitry M
Mugisha J
Nalini M
Nambi V
Ninomiya T
Oppermann K
d'Orsi E
Pająk A
Palmieri L
Panagiotakos D
Perianayagam A
Peters A
Poustchi H
Prentice AM
Prescott E
Risérus U
Salomaa V
Sans S
Sakata S
Schöttker B
Schutte AE
Sepanlou SG
Sharma SK
Shaw JE
Simons LA
Söderberg S
Tamosiunas A
Thorand B
Tunstall-Pedoe H
Twerenbold R
Vanuzzo D
Veronesi G
Waibel J
Wannamethee SG
Watanabe M
Wild PS
Yao Y
Zeng Y
Ziegler A
Blankenberg S
Source :
The New England journal of medicine [N Engl J Med] 2023 Oct 05; Vol. 389 (14), pp. 1273-1285. Date of Electronic Publication: 2023 Aug 26.
Publication Year :
2023

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.<br />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.<br />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).<br />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.).<br /> (Copyright © 2023 Massachusetts Medical Society.)

Details

Language :
English
ISSN :
1533-4406
Volume :
389
Issue :
14
Database :
MEDLINE
Journal :
The New England journal of medicine
Publication Type :
Academic Journal
Accession number :
37632466
Full Text :
https://doi.org/10.1056/NEJMoa2206916