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Recent research analyzed the association of modifiable risk factors with cardiovascular disease and death in a global cohort.

Modifiable risk factors such as body mass index (BMI), systolic blood pressure (SBP), non-high-density lipoprotein (non-HDL) cholesterol level, smoking, and diabetes are associated with cardiovascular disease (CVD); however, data regarding their impact varies according to the study populations and methods. 

The Global Cardiovascular Risk Consortium analyzed harmonized individual-level data from various global cohort studies and examined the associations between five modifiable risk factors and incident CVD and death from any cause in a study published in The New England Journal of Medicine.

Participants and Risk Factors

A total of 1,518,028 participants were included, 54.1% of whom were female. The median age was 54.4 years. In the age- and sex-standardized analysis of the five risk factors, the median BMI was 26.4, the median systolic blood pressure (SBP) was 130 mmHg, and the median non-HDL cholesterol was 156.9 mg/dL. Among the participants, 21.6% were current smokers, and 8.3% had diabetes.

CVD and All-Cause Mortality

Incident CVD occurred in 80,596 participants during a median follow-up of 7.3 years, and 177,369 participants died during a median follow-up of 8.7 years. The global 10-year CVD incidence was 7.8% among men and 4% among women.

Effects of Modifiable Risk Factors

  •         All Five Factors

In the global population, 57.2% and 52.6% of cases of the 10-year CVD incidence among women and men, respectively, and 22.2% and 19.1% of deaths from any cause among women and men, respectively, were attributable to the five modifiable risk factors combined.

  •         Individual Factors
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The population-attributable fraction of CVD incidence among women and men, respectively, associated with SBP was 29.3% and 21.6%; that associated with non-HDL cholesterol was 15.4% and 16.6%, respectively; that associated with diabetes was 15.2% and 10.2%, respectively; that associated with current smok­ing was 6.7% and 10.7%, respectively; and that associated with BMI was 7.6% and 7.6%, respectively. The population-attributable fraction of all-cause mortality associated with diabetes was 12.2% among women, and that associated with current smoking was 14.4% among men.

  •         Age

For both CVD and all-cause mortality, the association with BMI was consistent across all ages, while the strength of associations with SBP, current smoking, and diabetes decreased with age. The strength of the association between non-HDL cholesterol levels and CVD declined with age but was stable for all-cause mortality.

  •         Countries and Regions

For all modifiable risk factors combined, the population-attributable fraction of the 10-year CVD incidence among women and men, respectively, was 64.2% and 60.5% in North Africa/ Middle East and 55.5% and 50.3% in North America. The population-attributable fraction of 10-year all-cause mortality among women and men, respectively, was 34.3% and 43.2% in Asia, 13.7% and 2.9% in Australia, and 15.7% and 2.1% in Western Europe.

Source:

Kim, J., Kim, B., Kim, D. H., Kim, Y., & Rajaguru, V. (2023). Association between Socioeconomic Status and Healthcare Utilization for Children with Allergic Diseases: Korean National Health and Nutritional Examination Survey (2015–2019). Healthcare, 11(4), 492. https://doi.org/10.3390/healthcare11040492