Global effect of modifiable risk factors on cardiovascular disease and mortality
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 sexspecific prevalence of the risk factors and their effect on these outcomes are lacking. Methods: We pooled and harmonized...
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| Main Authors: | , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
October 5, 2023
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| In: |
The New England journal of medicine
Year: 2023, Volume: 389, Issue: 14, Pages: 1273-1285 |
| ISSN: | 1533-4406 |
| DOI: | 10.1056/NEJMoa2206916 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1056/NEJMoa2206916
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| Author Notes: | the Global Cardiovascular Risk Consortium* |
| Summary: | 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 sexspecific 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.) |
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| Item Description: | Online veröffentlicht: 26. August 2023 *The Global Cardiovascular Risk Consortium: Christina Magnussen, M.D., Hermann Brenner, M.D., Ben Schöttker, Ph.D. [und viele weitere Personen] Gesehen am 06.02.2024 |
| Physical Description: | Online Resource |
| ISSN: | 1533-4406 |
| DOI: | 10.1056/NEJMoa2206916 |