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Joaquim Cardoso MSc.
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Chief Editor and Senior Advisor
October 17, 2023
National Institute on Minority Health and Health Disparities sent this bulletin at 10/17/2023 03:10 PM EDT
Five well-known risk factors-overweight, high blood pressure, high cholesterol, smoking, and diabetes-contribute to more than half of all cardiovascular diseases worldwide.
This is according to a study published by scientists of the Global Cardiovascular Risk Consortium.
The study showed differences in the frequency of the risk factors across the eight global regions.
- Scientists saw the highest rates for overweight in Latin America, and
- the highest values for high blood pressure and high cholesterol in Europe.
High blood pressure is the most significant factor for the occurrence of heart attacks and strokes.
However, the five risk factors merely accounted for about 20% overall mortality risk.
The study’s results were published in the New England Journal of Medicine and are based on the data of 1.5 million persons from 34 countries.
Originally published at https://content.govdelivery.com on October 17, 2023.
Dr. Larissa Avilés-Santa, Director, Division of Clinical and Health Services Research at NIMHD and the Hispanic Community Health Study/Study of Latinos representative of the consortium, co-authored the paper.
Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality
NEJM
The Global Cardiovascular Risk Consortium
October 5, 2023
N Engl J Med 2023; 389:1273–1285
DOI: 10.1056/NEJMoa2206916
Chinese Translation 中文翻译
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. opens in new tab.)
About the authors
Global Cardiovascular Risk Consortium;
Christina Magnussen 1, Francisco M Ojeda 1, Darryl P Leong 1, Jesus Alegre-Diaz 1, Philippe Amouyel 1, Larissa Aviles-Santa 1, Dirk De Bacquer 1, Christie M Ballantyne 1, Antonio Bernabé-Ortiz 1, Martin Bobak 1, Hermann Brenner 1, Rodrigo M Carrillo-Larco 1, James de Lemos 1, Annette Dobson 1, Marcus Dörr 1, Chiara Donfrancesco 1, Wojciech Drygas 1, Robin P Dullaart 1, Gunnar Engström 1, Marco M Ferrario 1, Jean Ferrières 1, Giovanni de Gaetano 1, Uri Goldbourt 1, Clicerio Gonzalez 1, Guido Grassi 1, Allison M Hodge 1, Kristian Hveem 1, Licia Iacoviello 1, M Kamran Ikram 1, Vilma Irazola 1, Modou Jobe 1, Pekka Jousilahti 1, Pontiano Kaleebu 1, Maryam Kavousi 1, Frank Kee 1, Davood Khalili 1, Wolfgang Koenig 1, Anna Kontsevaya 1, Kari Kuulasmaa 1, Karl J Lackner 1, David M Leistner 1, Lars Lind 1, Allan Linneberg 1, Thiess Lorenz 1, Magnus Nakrem Lyngbakken 1, Reza Malekzadeh 1, Sofia Malyutina 1, Ellisiv B Mathiesen 1, Olle Melander 1, Andres Metspalu 1, J Jaime Miranda 1, Marie Moitry 1, Joseph Mugisha 1, Mahdi Nalini 1, Vijay Nambi 1, Toshiharu Ninomiya 1, Karen Oppermann 1, Eleonora d’Orsi 1, Andrzej Pająk 1, Luigi Palmieri 1, Demosthenes Panagiotakos 1, Arokiasamy Perianayagam 1, Annette Peters 1, Hossein Poustchi 1, Andrew M Prentice 1, Eva Prescott 1, Ulf Risérus 1, Veikko Salomaa 1, Susana Sans 1, Satoko Sakata 1, Ben Schöttker 1, Aletta E Schutte 1, Sadaf G Sepanlou 1, Sanjib Kumar Sharma 1, Jonathan E Shaw 1, Leon A Simons 1, Stefan Söderberg 1, Abdonas Tamosiunas 1, Barbara Thorand 1, Hugh Tunstall-Pedoe 1, Raphael Twerenbold 1, Diego Vanuzzo 1, Giovanni Veronesi 1, Julia Waibel 1, S Goya Wannamethee 1, Masafumi Watanabe 1, Philipp S Wild 1, Yao Yao 1, Yi Zeng 1, Andreas Ziegler 1, Stefan Blankenberg 1
