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.
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
Comments
ClinicalTrials.gov number NCT05466825
Associated Data