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

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.; Ferrario M.M.; Ferrières J.; De Gaetano G.; Goldbourt U.; Gonzalez C.; Grassi G.; Hodge A.M.; Hveem K.; Iacoviello L.; Ikram M.K.; Irazola V.; Jobe M.; Jousilahti P.; Kaleebu P.; Kavousi M.; Kee F.; Khalili D.; Koenig W.; Kontsevaya A.; Kuulasmaa K.; Lackner K.J.; Leistner D.M.; Lind L.; Linneberg A.; Lorenz T.; Lyngbakken M.N.; Malekzadeh R.; Malyutina S.; Mathiesen E.B.; Melander O.; Metspalu A.; Miranda J.J.; 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 A.M.; Prescott E.; Risérus U.; Salomaa V.; Sans S.; Sakata S.; Schöttker B.; Schutte A.E.; Sepanlou S.G.; Sharma S.K.; Shaw J.E.; Simons L.A.; Söderberg S.; Tamosiunas A.; Thorand B.; Tunstall-Pedoe H.; Twerenbold R.; Vanuzzo D.; Veronesi G.; Waibel J.; Wannamethee S.G.; Watanabe M.; Wild P.S.; Yao Y.; Zeng Y.; Ziegler A.; Blankenberg S. · New England Journal of Medicine (2023) · DOI: 10.1056/nejmoa2206916

Resumen

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.)

Instituciones: Universidad Peruana Cayetano Heredia