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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; Miranda, J Jaime; Moitry, Marie; Mugisha, Joseph; Nalini, Mahdi; Nambi, Vijay; Ninomiya, Toshiharu; Oppermann, Karen; d'Orsi, Eleonora; Pająk, Andrzej; Palmieri, Luigi; Panagiotakos, Demosthenes; Perianayagam, Arokiasamy; Peters, Annette; Poustchi, Hossein; Prentice, Andrew M; Prescott, Eva; Risérus, Ulf; Salomaa, Veikko; Sans, Susana; Sakata, Satoko; Schöttker, Ben; Schutte, Aletta E; Sepanlou, Sadaf G; Sharma, Sanjib Kumar; Shaw, Jonathan E; Simons, Leon A; Söderberg, Stefan; Tamosiunas, Abdonas; Thorand, Barbara; Tunstall-Pedoe, Hugh; Twerenbold, Raphael; Vanuzzo, Diego; Veronesi, Giovanni; Waibel, Julia; Wannamethee, S Goya; Watanabe, Masafumi; Wild, Philipp S; Yao, Yao; Zeng, Yi; Ziegler, Andreas; Blankenberg, Stefan
The New England journal of medicine, 10/2023, Volume: 389, Issue: 14Journal Article
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. 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. 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). 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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