Publication Date
10-5-2023
Journal
The New England Journal of Medicine
DOI
10.1056/NEJMoa2206916
PMID
37632466
PMCID
PMC10589462
PubMedCentral® Posted Date
10-21-2023
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Female, Humans, Male, Middle Aged, Cardiovascular Diseases, Diabetes Mellitus, Risk Factors, Smoking, Heart Disease Risk Factors, Internationality
Abstract
BACKGROUND: Five modifiable risk factors are associated with cardiovascular disease (CVD) and all-cause mortality. The regional and sex-specific prevalence of these modifiable risk factors and their impact on CVD and all-cause mortality have not been evaluated using individual-level data.
METHODS: The Global Cardiovascular Risk Consortium harmonized individual-level data from 112 cohort studies conducted in 34 countries and 8 geographic regions. Associations between body-mass index, systolic blood pressure, non-high-density lipoprotein cholesterol, smoking, and diabetes with incident CVD and all-cause mortality were examined using Cox regression analyses and stratified by geographic region, age and sex. Population-attributable fractions were estimated for 10-year incident CVD and all-cause mortality.
RESULTS: Among 1,518,028 individuals (54.1% women, median age 54.4 years), there were regional variations in the prevalence of the five modifiable risk factors. Incident CVD occurred in 80,596 individuals (median and maximum follow-up, 7.3 and 47.3 years, respectively) and 177,369 individuals died (median and maximum follow-up, 8.7 and 47.6 years, respectively). Aggregate global CVD population-attributable fractions were 57.2% (95% confidence interval [CI], 52.4 to 62.1) in women and 52.6% (95% CI, 49.0 to 56.1) in men for all risk factors combined. Aggregate global all-cause mortality population-attributable fractions were 22.2% in women and 19.1% in men.
CONCLUSIONS: Harmonized individual-level data from a global cohort found that 57.2% of incident CVD in women and 52.6% in men, and 22.2% of deaths in women and 19.1% in men may be attributable to five modifiable risk factors. The prevalence and impact of these risk factors on incident CVD and all-cause mortality varies by sex and across geographic regions.
- Citations
- Citation Indexes: 281
- Policy Citations: 2
- Usage
- Downloads: 12
- Abstract Views: 5
- Captures
- Readers: 545
- Mentions
- News Mentions: 23
Included in
Biochemistry, Biophysics, and Structural Biology Commons, Biomedical Informatics Commons, Cardiology Commons, Cardiovascular Diseases Commons, Community Health and Preventive Medicine Commons, International Public Health Commons, Medical Sciences Commons
