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Lifetime risks of cardiovascular disease.
Pubmed ID: 22276822
Pubmed Central ID: PMC3336876
Journal: The New England journal of medicine
Publication Date: Jan. 26, 2012
MeSH Terms: Humans, Male, Adult, Female, Aged, Cardiovascular Diseases, Risk Factors, United States, Middle Aged, Risk Assessment, Risk, Cohort Effect, White People, Black or African American
Grants: N01-HC-35129, N01-HC-45133, N01-HC-75150, N01-HC-85079, N01-HC-85080, N01-HC-85081, N01-HC-85082, N01-HC-85083, N01-HC-85084, N01-HC-85085, N01-HC-85086, N01HC85079, N01HC85086, U01 HL080295, R21 HL085375, R21 HL085375-02, N01WH22110, K23 HL092229, K23 HL092229-04, N01-HC-15103, N01-HC-55222, N01-WH-22110, N01-WH-24152, N01-WH-32100, N01-WH-32101, N01-WH-32102, N01-WH-32105, N01-WH-32106, N01-WH-32108, N01-WH-32109, N01-WH-32111, N01-WH-32112, N01-WH-32113, N01-WH-32115, N01-WH-32118, N01-WH-32119, N01-WH-32122, N01-WH-42107, N01-WH-42108, N01-WH-42109, N01-WH-42110, N01-WH-42111, N01-WH-42112, N01-WH-42113, N01-WH-42114, N01-WH-42115, N01-WH-42116, N01-WH-42117, N01-WH-42118, N01-WH-42119, N01-WH-42120, N01-WH-42121, N01-WH-42122, N01-WH-42123, N01-WH-42124, N01-WH-42125, N01-WH-42126, N01-WH-42129, N01-WH-42130, N01-WH-42131, N01-WH-42132, N01-WH-44221, R01 HL068140, R01 HL068140-05, R01-HL68140, UL1 RR025741, R01 HL043232
Authors: Lloyd-Jones DM, Ning H, Berry JD, Van Horn L, Dyer A, Cai X, Garside DB, Thomas A, Greenland P, Tracy RP
Cite As: Berry JD, Dyer A, Cai X, Garside DB, Ning H, Thomas A, Greenland P, Van Horn L, Tracy RP, Lloyd-Jones DM. Lifetime risks of cardiovascular disease. N Engl J Med 2012 Jan 26;366(4):321-9.
Studies:
Abstract
BACKGROUND: The lifetime risks of cardiovascular disease have not been reported across the age spectrum in black adults and white adults. METHODS: We conducted a meta-analysis at the individual level using data from 18 cohort studies involving a total of 257,384 black men and women and white men and women whose risk factors for cardiovascular disease were measured at the ages of 45, 55, 65, and 75 years. Blood pressure, cholesterol level, smoking status, and diabetes status were used to stratify participants according to risk factors into five mutually exclusive categories. The remaining lifetime risks of cardiovascular events were estimated for participants in each category at each age, with death free of cardiovascular disease treated as a competing event. RESULTS: We observed marked differences in the lifetime risks of cardiovascular disease across risk-factor strata. Among participants who were 55 years of age, those with an optimal risk-factor profile (total cholesterol level, <180 mg per deciliter [4.7 mmol per liter]; blood pressure, <120 mm Hg systolic and 80 mm Hg diastolic; nonsmoking status; and nondiabetic status) had substantially lower risks of death from cardiovascular disease through the age of 80 years than participants with two or more major risk factors (4.7% vs. 29.6% among men, 6.4% vs. 20.5% among women). Those with an optimal risk-factor profile also had lower lifetime risks of fatal coronary heart disease or nonfatal myocardial infarction (3.6% vs. 37.5% among men, <1% vs. 18.3% among women) and fatal or nonfatal stroke (2.3% vs. 8.3% among men, 5.3% vs. 10.7% among women). Similar trends within risk-factor strata were observed among blacks and whites and across diverse birth cohorts. CONCLUSIONS: Differences in risk-factor burden translate into marked differences in the lifetime risk of cardiovascular disease, and these differences are consistent across race and birth cohorts. (Funded by the National Heart, Lung, and Blood Institute.).