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

Research output: Contribution to journalJournal articleResearchpeer-review

  • 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
  • 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
  • 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

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.)

Original languageEnglish
JournalNew England Journal of Medicine
Volume389
Issue number14
Pages (from-to)1273-1285
Number of pages13
ISSN0028-4793
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 Massachusetts Medical Society.

    Research areas

  • Cardiology, Cardiology General, Coronary Disease/Myocardial Infarction, Diabetes, Endocrinology, Hypertension, Lipids, Obesity, Prevention, Public Health, Public Health General

ID: 375969781