Global Effect of Cardiovascular Risk Factors on Lifetime Estimates.

Pubmed ID: 40162648

Journal: The New England journal of medicine

Publication Date: July 10, 2025

MeSH Terms: Humans, Male, Female, Aged, Aged, 80 and over, Cardiovascular Diseases, Age Factors, Middle Aged, Smoking, Life Expectancy, Hypertension, Cause of Death, Obesity, Overweight, Diabetes Mellitus, Smoking Cessation, Hyperlipidemias, Global Health, Heart Disease Risk Factors, Thinness

Grants: FP5, QLG2-CT-2002-01254, FP7, HEALTH-F3-2010-242244, Horizon 2020, No. 825903, Biomed, BMH4-CT98-3183, G0601463, No. 80983, FP7, HEALTH-F4-2007-201413, Horizon 2020, No. 847770, FP7, HEALTH-F2-2011-278913

Authors: Magnussen C, Alegre-Diaz J, Al-Nasser LA, Amouyel P, Aviles-Santa L, Bakker SJL, Ballantyne CM, Bernabé-Ortiz A, Bobak M, Boffetta P, Brenner H, Brunström M, Can G, Carrillo-Larco RM, Checkley W, Dallongeville J, De Bacquer D, de Gaetano G, de Lemos JA, di Carluccio E, Dobson A, Donfrancesco C, Dörr M, d'Orsi E, Drygas W, Dullaart RPF, Engström G, Ferrario MM, Ferrières J, Figtree GA, Gaye B, Ghayour-Mobarhan M, Goldbourt U, Gonzalez C, Gossling A, Grassi G, Gupta PC, He J, Hodge AM, Hozawa A, Hveem K, Iacoviello L, Ikram MK, Inoue M, Irazola V, Jobe M, Jousilahti P, Kaleebu P, Kavousi M, Kee F, Khalili D, Klotsche J, Koenig W, Kontsevaya A, Kowlessur S, Kuri-Morales P, Kuulasmaa K, Kweon SS, Lackner KJ, Landmesser U, Leistner DM, Leiva Sisnieguez CE, Leong D, Lind L, Linneberg A, Lorenz T, Lyngbakken MN, Malekzadeh R, Malyutina S, Mathiesen EB, McElduff P, Melander O, Metspalu A, Miranda JJ, Moitry M, Mugisha J, Munzinger J, Nalini M, Nambi V, Nilsson PM, Ninomiya T, Omland T, Ong SK, Oppermann K, Pajak A, Palmieri L, Panagiotakos D, Park SK, Pednekar MS, Perianayagam A, Peters A, Poustchi H, Prabhakaran D, Prentice AM, Prescott E, Quyyumi A, Risérus U, Sakata S, Salazar M, Salomaa V, Sans S, Sattler ELP, Schöttker B, Schutte AE, Sepanlou SG, Sharma SK, Shaw J, Simons LA, Söderberg S, Tamosiunas A, Tapia-Conyer R, Thorand B, Tunstall-Pedoe H, Tuomilehto J, Twerenbold R, Vanuzzo D, Veronesi G, Wannamethee SG, Watanabe M, Weimann J, Wild PS, Yao Y, Zeng Y, Ziegler A, Ojeda FM, Blankenberg S, Ahmadi A, Alqarni S, Ashraf N, Azizi F, Badreldine H, Cesana G, Chong CL, Costanzo S, Faal A, Farshidi H, Giampaoli S, Giles G, Großmann E, Heecharan J, Heier M, Hellström V, Hoshiyar A, Jääskeläinen T, Jørgensen T, Joseph B, Lund Kårhus L, Lackner M, Lee S, Leon DA, Lewington S, Linkohr B, Mirzai M, Mohebbi I, Morai Sheibani E, Moradpour F, Neumann JT, Safarpour AR, Saghi M, Sekitoleko I, Shin A, Soflaei SS, Spritzer PM, Vakilian A, Watanabe T, Whincup P, Alegre J, Al-Nasser LA, Aviles-Santa L, Ballantyne CM, Boffetta P, Blankenberg S, Gaye B, Irazola V, Jobe M, Kee F, Kuulasmaa K, de Lemos J, Leong DP, Lorenz T, Miranda JJ, Magnussen C, Munzinger J, Ninomiya T, Ojeda FM, Perianayagam A, Quyyumi A, Schutte A, Salomaa V, Sepanlou SG, Shaw JE, Tunstall-Pedoe H, Twerenbold R, Yao Y, Ziegler A, De Bacquer D, Bernabe-Ortiz A, di Carluccio E, Goßling A, Veronesi G, Weimann J

Cite As: Global Cardiovascular Risk Consortium, Magnussen C, Alegre-Diaz J, Al-Nasser LA, Amouyel P, Aviles-Santa L, Bakker SJL, Ballantyne CM, Bernabé-Ortiz A, Bobak M, Boffetta P, Brenner H, Brunström M, Can G, Carrillo-Larco RM, Checkley W, Dallongeville J, De Bacquer D, de Gaetano G, de Lemos JA, di Carluccio E, Dobson A, Donfrancesco C, Dörr M, d'Orsi E, Drygas W, Dullaart RPF, Engström G, Ferrario MM, Ferrières J, Figtree GA, Gaye B, Ghayour-Mobarhan M, Goldbourt U, Gonzalez C, Gossling A, Grassi G, Gupta PC, He J, Hodge AM, Hozawa A, Hveem K, Iacoviello L, Ikram MK, Inoue M, Irazola V, Jobe M, Jousilahti P, Kaleebu P, Kavousi M, Kee F, Khalili D, Klotsche J, Koenig W, Kontsevaya A, Kowlessur S, Kuri-Morales P, Kuulasmaa K, Kweon SS, Lackner KJ, Landmesser U, Leistner DM, Leiva Sisnieguez CE, Leong D, Lind L, Linneberg A, Lorenz T, Lyngbakken MN, Malekzadeh R, Malyutina S, Mathiesen EB, McElduff P, Melander O, Metspalu A, Miranda JJ, Moitry M, Mugisha J, Munzinger J, Nalini M, Nambi V, Nilsson PM, Ninomiya T, Omland T, Ong SK, Oppermann K, Pajak A, Palmieri L, Panagiotakos D, Park SK, Pednekar MS, Perianayagam A, Peters A, Poustchi H, Prabhakaran D, Prentice AM, Prescott E, Quyyumi A, Risérus U, Sakata S, Salazar M, Salomaa V, Sans S, Sattler ELP, Schöttker B, Schutte AE, Sepanlou SG, Sharma SK, Shaw J, Simons LA, Söderberg S, Tamosiunas A, Tapia-Conyer R, Thorand B, Tunstall-Pedoe H, Tuomilehto J, Twerenbold R, Vanuzzo D, Veronesi G, Wannamethee SG, Watanabe M, Weimann J, Wild PS, Yao Y, Zeng Y, Ziegler A, Ojeda FM, Blankenberg S, The Global Cardiovascular Risk Consortium. Global Effect of Cardiovascular Risk Factors on Lifetime Estimates. N Engl J Med 2025 Jul 10;393(2):125-138. Epub 2025 Mar 30.

Studies:

Abstract

BACKGROUND: Five risk factors account for approximately 50% of the global burden of cardiovascular disease. How the presence or absence of classic risk factors affects lifetime estimates of cardiovascular disease and death from any cause remains unclear. METHODS: We harmonized individual-level data from 2,078,948 participants across 133 cohorts, 39 countries, and 6 continents. Lifetime risk of cardiovascular disease and death from any cause was estimated up to 90 years of age according to the presence or absence of arterial hypertension, hyperlipidemia, underweight and overweight or obesity, diabetes, and smoking at 50 years of age. Differences in life span (in terms of additional life-years free of cardiovascular disease or death from any cause) according to the presence or absence of these risk factors were also estimated. Risk-factor trajectories were analyzed to predict lifetime differences according to risk-factor variation. RESULTS: The lifetime risk of cardiovascular disease was 24% (95% confidence interval [CI], 21 to 30) among women and 38% (95% CI, 30 to 45) among men for whom all five risk factors were present. In the comparison between participants with none of the risk factors and those with all the risk factors, the estimated number of additional life-years free of cardiovascular disease was 13.3 (95% CI, 11.2 to 15.7) for women and 10.6 (95% CI, 9.2 to 12.9) for men; the estimated number of additional life-years free of death was 14.5 (95% CI, 9.1 to 15.3) for women and 11.8 (95% CI, 10.1 to 13.6) for men. As compared with no changes in the presence of all risk factors, modification of hypertension at an age of 55 to less than 60 years was associated with the most additional life-years free of cardiovascular disease, and modification of smoking at an age of 55 to less than 60 years was associated with the most additional life-years free of death. CONCLUSIONS: The absence of five classic risk factors at 50 years of age was associated with more than a decade greater life expectancy than the presence of all five risk factors, in both sexes. Persons who modified hypertension and smoking in midlife had the most additional life-years free of cardiovascular disease and death from any cause, respectively. (Funded by the German Center for Cardiovascular Research [DZHK]; ClinicalTrials.gov number, NCT05466825.).