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Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality.
Magnussen, Christina; Ojeda, Francisco M; Leong, Darryl P; Alegre-Diaz, Jesus; Amouyel, Philippe; Aviles-Santa, Larissa; De Bacquer, Dirk; Ballantyne, Christie M; Bernabé-Ortiz, Antonio; Bobak, Martin; Brenner, Hermann; Carrillo-Larco, Rodrigo M; de Lemos, James; Dobson, Annette; Dörr, Marcus; Donfrancesco, Chiara; Drygas, Wojciech; Dullaart, Robin P; Engström, Gunnar; Ferrario, Marco M; Ferrières, Jean; de Gaetano, Giovanni; Goldbourt, Uri; Gonzalez, Clicerio; Grassi, Guido; Hodge, Allison M; Hveem, Kristian; Iacoviello, Licia; Ikram, M Kamran; Irazola, Vilma; Jobe, Modou; Jousilahti, Pekka; Kaleebu, Pontiano; Kavousi, Maryam; Kee, Frank; Khalili, Davood; Koenig, Wolfgang; Kontsevaya, Anna; Kuulasmaa, Kari; Lackner, Karl J; Leistner, David M; Lind, Lars; Linneberg, Allan; Lorenz, Thiess; Lyngbakken, Magnus Nakrem; Malekzadeh, Reza; Malyutina, Sofia; Mathiesen, Ellisiv B; Melander, Olle; Metspalu, Andres.
Affiliation
  • Magnussen C; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Ojeda FM; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Leong DP; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Alegre-Diaz J; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Amouyel P; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Aviles-Santa L; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • De Bacquer D; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Ballantyne CM; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Bernabé-Ortiz A; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Bobak M; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Brenner H; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Carrillo-Larco RM; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • de Lemos J; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Dobson A; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Dörr M; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Donfrancesco C; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Drygas W; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Dullaart RP; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Engström G; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Ferrario MM; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Ferrières J; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • de Gaetano G; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Goldbourt U; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Gonzalez C; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Grassi G; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Hodge AM; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Hveem K; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Iacoviello L; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Ikram MK; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Irazola V; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Jobe M; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Jousilahti P; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Kaleebu P; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Kavousi M; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Kee F; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Khalili D; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Koenig W; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Kontsevaya A; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Kuulasmaa K; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Lackner KJ; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Leistner DM; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Lind L; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Linneberg A; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Lorenz T; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Lyngbakken MN; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Malekzadeh R; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Malyutina S; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Mathiesen EB; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Melander O; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
  • Metspalu A; The authors' affiliations are as follows: the Center for Population Health Innovation, University Heart and Vascular Center Hamburg (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), University Medical Center Hamburg-Eppendorf (C.M., F.M.O., T.L., R.T., J.W., A.Z., S.B.), the German Center for Cardiovasc
N Engl J Med ; 389(14): 1273-1285, 2023 10 05.
Article in En | MEDLINE | ID: mdl-37632466
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.).
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiovascular Diseases / Heart Disease Risk Factors Type of study: Etiology_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Limits: Female / Humans / Male / Middle aged Language: En Journal: N Engl J Med Year: 2023 Document type: Article
Fulltext
Add to My VHL
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PubMed Links
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiovascular Diseases / Heart Disease Risk Factors Type of study: Etiology_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Limits: Female / Humans / Male / Middle aged Language: En Journal: N Engl J Med Year: 2023 Document type: Article