Global Effect of Cardiovascular Risk Factors on Lifetime Estimates.

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Cardiovascular disease (CVD) poses a significant global health burden, with five key risk factors contributing to approximately 50% of its impact.
• The long-term effects of these classic risk factors on lifetime CVD incidence and all-cause mortality remain incompletely understood.

Purpose of the Study:

• To investigate the impact of the presence or absence of five major cardiovascular risk factors on lifetime CVD risk and overall mortality.
• To estimate the differences in life expectancy, specifically life-years free from CVD and death, based on the status of these risk factors at age 50.

Main Methods:

• Harmonized individual-level data from over 2 million participants across 133 cohorts globally were analyzed.
• Lifetime risk of CVD and all-cause mortality were estimated up to age 90, stratified by the presence or absence of arterial hypertension, hyperlipidemia, abnormal BMI, diabetes, and smoking at age 50.
• Risk factor trajectories were examined to predict lifetime differences based on risk factor modification over time.

Main Results:

• Individuals with all five risk factors faced a lifetime CVD risk of 24% (women) to 38% (men).
• Compared to those with all risk factors, individuals with none gained an estimated 13.3 (women) to 10.6 (men) additional life-years free of CVD, and 14.5 (women) to 11.8 (men) life-years free of death.
• Modifying hypertension between ages 55-60 yielded the most additional CVD-free life-years; modifying smoking in the same age range yielded the most death-free life-years.

Conclusions:

• The absence of five major cardiovascular risk factors at age 50 is linked to over a decade increase in life expectancy for both sexes.
• Midlife modification of hypertension and smoking offers substantial benefits, maximizing life-years free from cardiovascular disease and all-cause mortality, respectively.