Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality.

Christina Magnussen; Francisco M. Ojeda; Darryl P. Leong; Jesus Alegre-Diaz; Philippe Amouyel; Larissa Aviles-Santa; Dirk De Bacquer; Christie M. Ballantyne; Antonio Bernabé-Ortiz; Martin Bobak; Hermann Brenner; Rodrigo M. Carrillo-Larco; James De Lemos; Annette Dobson; Marcus Dörr; Chiara Donfrancesco; Wojciech Drygas; Robin P. Dullaart; Gunnar Engström; Marco M. Ferrario; Jean Ferrières; Giovanni De Gaetano; Uri Goldbourt; Clicerio Gonzalez; Guido Grassi; Allison M. Hodge; Kristian Hveem; Licia Iacoviello; M. Kamran Ikram; Vilma Irazola; Modou Jobe; Pekka Jousilahti; Pontiano Kaleebu; Maryam Kavousi; Frank Kee; Davood Khalili; Wolfgang Koenig; Anna Kontsevaya; Kari Kuulasmaa; Karl J. Lackner; David M. Leistner; Lars Lind; Allan Linneberg; Thiess Lorenz; Magnus Nakrem Lyngbakken; Reza Malekzadeh; Sofia Malyutina; Ellisiv B. Mathiesen; Olle Melander; Andres Metspalu; J. Jaime Miranda; Marie Moitry; Joseph Mugisha; Mahdi Nalini; Vijay Nambi; Toshiharu Ninomiya; Karen Oppermann; Eleonora D'Orsi; Andrzej Pająk; Luigi Palmieri; Demosthenes Panagiotakos; Arokiasamy Perianayagam; Annette Peters; Hossein Poustchi; Andrew M. Prentice; Eva Prescott; Ulf Risérus; Veikko Salomaa; Susana Sans; Satoko Sakata; Ben Schöttker; Aletta E. Schutte; Sadaf G. Sepanlou; Sanjib Kumar Sharma; Jonathan E. Shaw; Leon A. Simons; Stefan Söderberg; Abdonas Tamosiunas; Barbara Thorand; Hugh Tunstall-Pedoe; Raphael Twerenbold; Diego Vanuzzo; Giovanni Veronesi; Julia Waibel; S. Goya Wannamethee; Masafumi Watanabe; Philipp S. Wild; Yao Yao; Yi Zeng; Andreas Ziegler; Stefan Blankenberg

doi:10.1056/NEJMoa2206916

Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality.

Christina Magnussen, Francisco M. Ojeda, Darryl P. Leong, Jesus Alegre-Diaz, Philippe Amouyel, Larissa Aviles-Santa, Dirk De Bacquer, Christie M. Ballantyne, Antonio Bernabé-Ortiz, Martin Bobak, Hermann Brenner, Rodrigo M. Carrillo-Larco, James De Lemos, Annette Dobson, Marcus Dörr, Chiara Donfrancesco, Wojciech Drygas, Robin P. Dullaart, Gunnar Engström, Marco M. FerrarioJean Ferrières, Giovanni De Gaetano, Uri Goldbourt, Clicerio Gonzalez, Guido Grassi, Allison M. Hodge, Kristian Hveem, Licia Iacoviello, M. Kamran Ikram, Vilma Irazola, Modou Jobe, Pekka Jousilahti, Pontiano Kaleebu, Maryam Kavousi, Frank Kee, Davood Khalili, Wolfgang Koenig, Anna Kontsevaya, Kari Kuulasmaa, Karl J. Lackner, David M. Leistner, Lars Lind, Allan Linneberg, Thiess Lorenz, Magnus Nakrem Lyngbakken, Reza Malekzadeh, Sofia Malyutina, Ellisiv B. Mathiesen, Olle Melander, Andres Metspalu, J. Jaime Miranda, Marie Moitry, Joseph Mugisha, Mahdi Nalini, Vijay Nambi, Toshiharu Ninomiya, Karen Oppermann, Eleonora D'Orsi, Andrzej Pająk, Luigi Palmieri, Demosthenes Panagiotakos, Arokiasamy Perianayagam, Annette Peters, Hossein Poustchi, Andrew M. Prentice, Eva Prescott, Ulf Risérus, Veikko Salomaa, Susana Sans, Satoko Sakata, Ben Schöttker, Aletta E. Schutte, Sadaf G. Sepanlou, Sanjib Kumar Sharma, Jonathan E. Shaw, Leon A. Simons, Stefan Söderberg, Abdonas Tamosiunas, Barbara Thorand, Hugh Tunstall-Pedoe, Raphael Twerenbold, Diego Vanuzzo, Giovanni Veronesi, Julia Waibel, S. Goya Wannamethee, Masafumi Watanabe, Philipp S. Wild, Yao Yao, Yi Zeng, Andreas Ziegler, Stefan Blankenberg

Research output: Contribution to journal › Article › peer-review

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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.)

Original language	English (US)
Pages (from-to)	1273-1285
Number of pages	13
Journal	New England Journal of Medicine
Volume	389
Issue number	14
DOIs	https://doi.org/10.1056/NEJMoa2206916
State	Published - 2023
Externally published	Yes

Keywords

Cardiology
Cardiology General
Coronary Disease/Myocardial Infarction
Diabetes
Endocrinology
Hypertension
Lipids
Obesity
Prevention
Public Health
Public Health General

ASJC Scopus subject areas

General Medicine

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10.1056/NEJMoa2206916

Cite this

Magnussen, C., Ojeda, F. M., Leong, D. P., Alegre-Diaz, J., Amouyel, P., Aviles-Santa, L., De Bacquer, D., Ballantyne, C. M., Bernabé-Ortiz, A., Bobak, M., Brenner, H., Carrillo-Larco, R. M., De Lemos, J., Dobson, A., Dörr, M., Donfrancesco, C., Drygas, W., Dullaart, R. P., Engström, G., ... Blankenberg, S. (2023). Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality. New England Journal of Medicine, 389(14), 1273-1285. https://doi.org/10.1056/NEJMoa2206916

Magnussen, C, Ojeda, FM, Leong, DP, Alegre-Diaz, J, Amouyel, P, Aviles-Santa, L, De Bacquer, D, Ballantyne, CM, Bernabé-Ortiz, A, Bobak, M, Brenner, H, Carrillo-Larco, RM, De Lemos, J, Dobson, A, Dörr, M, Donfrancesco, C, Drygas, W, Dullaart, RP, Engström, G, Ferrario, MM, Ferrières, J, De Gaetano, G, Goldbourt, U, Gonzalez, C, Grassi, G, Hodge, AM, Hveem, K, Iacoviello, L, Ikram, MK, Irazola, V, Jobe, M, Jousilahti, P, Kaleebu, P, Kavousi, M, Kee, F, Khalili, D, Koenig, W, Kontsevaya, A, Kuulasmaa, K, Lackner, KJ, Leistner, DM, Lind, L, Linneberg, A, Lorenz, T, Lyngbakken, MN, Malekzadeh, R, Malyutina, S, Mathiesen, EB, Melander, O, Metspalu, A, Miranda, JJ, Moitry, M, Mugisha, J, Nalini, M, Nambi, V, Ninomiya, T, Oppermann, K, D'Orsi, E, Pająk, A, Palmieri, L, Panagiotakos, D, Perianayagam, A, Peters, A, Poustchi, H, Prentice, AM, Prescott, E, Risérus, U, Salomaa, V, Sans, S, Sakata, S, Schöttker, B, Schutte, AE, Sepanlou, SG, Sharma, SK, Shaw, JE, Simons, LA, Söderberg, S, Tamosiunas, A, Thorand, B, Tunstall-Pedoe, H, Twerenbold, R, Vanuzzo, D, Veronesi, G, Waibel, J, Wannamethee, SG, Watanabe, M, Wild, PS, Yao, Y, Zeng, Y, Ziegler, A & Blankenberg, S 2023, 'Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality.', New England Journal of Medicine, vol. 389, no. 14, pp. 1273-1285. https://doi.org/10.1056/NEJMoa2206916

@article{321cc7a0e4ff41918d0ebb2f7a0aabc7,

title = "Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality.",

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.)",

keywords = "Cardiology, Cardiology General, Coronary Disease/Myocardial Infarction, Diabetes, Endocrinology, Hypertension, Lipids, Obesity, Prevention, Public Health, Public Health General",

author = "Christina Magnussen and Ojeda, {Francisco M.} and Leong, {Darryl P.} and Jesus Alegre-Diaz and Philippe Amouyel and Larissa Aviles-Santa and {De Bacquer}, Dirk and Ballantyne, {Christie M.} and Antonio Bernab{\'e}-Ortiz and Martin Bobak and Hermann Brenner and Carrillo-Larco, {Rodrigo M.} and {De Lemos}, James and Annette Dobson and Marcus D{\"o}rr and Chiara Donfrancesco and Wojciech Drygas and Dullaart, {Robin P.} and Gunnar Engstr{\"o}m and Ferrario, {Marco M.} and Jean Ferri{\`e}res and {De Gaetano}, Giovanni and Uri Goldbourt and Clicerio Gonzalez and Guido Grassi and Hodge, {Allison M.} and Kristian Hveem and Licia Iacoviello and Ikram, {M. Kamran} and Vilma Irazola and Modou Jobe and Pekka Jousilahti and Pontiano Kaleebu and Maryam Kavousi and Frank Kee and Davood Khalili and Wolfgang Koenig and Anna Kontsevaya and Kari Kuulasmaa and Lackner, {Karl J.} and Leistner, {David M.} and Lars Lind and Allan Linneberg and Thiess Lorenz and Lyngbakken, {Magnus Nakrem} and Reza Malekzadeh and Sofia Malyutina and Mathiesen, {Ellisiv B.} and Olle Melander and Andres Metspalu and Miranda, {J. Jaime} and Marie Moitry and Joseph Mugisha and Mahdi Nalini and Vijay Nambi and Toshiharu Ninomiya and Karen Oppermann and Eleonora D'Orsi and Andrzej Paj{\c a}k and Luigi Palmieri and Demosthenes Panagiotakos and Arokiasamy Perianayagam and Annette Peters and Hossein Poustchi and Prentice, {Andrew M.} and Eva Prescott and Ulf Ris{\'e}rus and Veikko Salomaa and Susana Sans and Satoko Sakata and Ben Sch{\"o}ttker and Schutte, {Aletta E.} and Sepanlou, {Sadaf G.} and Sharma, {Sanjib Kumar} and Shaw, {Jonathan E.} and Simons, {Leon A.} and Stefan S{\"o}derberg and Abdonas Tamosiunas and Barbara Thorand and Hugh Tunstall-Pedoe and Raphael Twerenbold and Diego Vanuzzo and Giovanni Veronesi and Julia Waibel and Wannamethee, {S. Goya} and Masafumi Watanabe and Wild, {Philipp S.} and Yao Yao and Yi Zeng and Andreas Ziegler and Stefan Blankenberg",

note = "Publisher Copyright: {\textcopyright} 2023 Massachusetts Medical Society.",

year = "2023",

doi = "10.1056/NEJMoa2206916",

language = "English (US)",

volume = "389",

pages = "1273--1285",

journal = "New England Journal of Medicine",

issn = "0028-4793",

publisher = "Massachussetts Medical Society",

number = "14",

}

TY - JOUR

T1 - Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality.

AU - Magnussen, Christina

AU - Ojeda, Francisco M.

AU - Leong, Darryl P.

AU - Alegre-Diaz, Jesus

AU - Amouyel, Philippe

AU - Aviles-Santa, Larissa

AU - De Bacquer, Dirk

AU - Ballantyne, Christie M.

AU - Bernabé-Ortiz, Antonio

AU - Bobak, Martin

AU - Brenner, Hermann

AU - Carrillo-Larco, Rodrigo M.

AU - De Lemos, James

AU - Dobson, Annette

AU - Dörr, Marcus

AU - Donfrancesco, Chiara

AU - Drygas, Wojciech

AU - Dullaart, Robin P.

AU - Engström, Gunnar

AU - Ferrario, Marco M.

AU - Ferrières, Jean

AU - De Gaetano, Giovanni

AU - Goldbourt, Uri

AU - Gonzalez, Clicerio

AU - Grassi, Guido

AU - Hodge, Allison M.

AU - Hveem, Kristian

AU - Iacoviello, Licia

AU - Ikram, M. Kamran

AU - Irazola, Vilma

AU - Jobe, Modou

AU - Jousilahti, Pekka

AU - Kaleebu, Pontiano

AU - Kavousi, Maryam

AU - Kee, Frank

AU - Khalili, Davood

AU - Koenig, Wolfgang

AU - Kontsevaya, Anna

AU - Kuulasmaa, Kari

AU - Lackner, Karl J.

AU - Leistner, David M.

AU - Lind, Lars

AU - Linneberg, Allan

AU - Lorenz, Thiess

AU - Lyngbakken, Magnus Nakrem

AU - Malekzadeh, Reza

AU - Malyutina, Sofia

AU - Mathiesen, Ellisiv B.

AU - Melander, Olle

AU - Metspalu, Andres

AU - Miranda, J. Jaime

AU - Moitry, Marie

AU - Mugisha, Joseph

AU - Nalini, Mahdi

AU - Nambi, Vijay

AU - Ninomiya, Toshiharu

AU - Oppermann, Karen

AU - D'Orsi, Eleonora

AU - Pająk, Andrzej

AU - Palmieri, Luigi

AU - Panagiotakos, Demosthenes

AU - Perianayagam, Arokiasamy

AU - Peters, Annette

AU - Poustchi, Hossein

AU - Prentice, Andrew M.

AU - Prescott, Eva

AU - Risérus, Ulf

AU - Salomaa, Veikko

AU - Sans, Susana

AU - Sakata, Satoko

AU - Schöttker, Ben

AU - Schutte, Aletta E.

AU - Sepanlou, Sadaf G.

AU - Sharma, Sanjib Kumar

AU - Shaw, Jonathan E.

AU - Simons, Leon A.

AU - Söderberg, Stefan

AU - Tamosiunas, Abdonas

AU - Thorand, Barbara

AU - Tunstall-Pedoe, Hugh

AU - Twerenbold, Raphael

AU - Vanuzzo, Diego

AU - Veronesi, Giovanni

AU - Waibel, Julia

AU - Wannamethee, S. Goya

AU - Watanabe, Masafumi

AU - Wild, Philipp S.

AU - Yao, Yao

AU - Zeng, Yi

AU - Ziegler, Andreas

AU - Blankenberg, Stefan

PY - 2023

Y1 - 2023

N2 - 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.)

AB - 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.)

KW - Cardiology

KW - Cardiology General

KW - Coronary Disease/Myocardial Infarction

KW - Diabetes

KW - Endocrinology

KW - Hypertension

KW - Lipids

KW - Obesity

KW - Prevention

KW - Public Health

KW - Public Health General

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UR - http://www.scopus.com/inward/citedby.url?scp=85175496095&partnerID=8YFLogxK

U2 - 10.1056/NEJMoa2206916

DO - 10.1056/NEJMoa2206916

M3 - Article

C2 - 37632466

AN - SCOPUS:85175496095

SN - 0028-4793

VL - 389

SP - 1273

EP - 1285

JO - New England Journal of Medicine

JF - New England Journal of Medicine

IS - 14

ER -

Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality.

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