학술논문
Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality
Document Type
Author
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; Risérus, Ulf, 1967; Blankenberg, Stefan
Source
New England Journal of Medicine. 389(14):1273-1285
Subject
Language
English
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.