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How much does eliminating one or two cardiovascular risk factors matter?: Evidence from the Global Cardiovascular
Roberto Spoladore1, Stefano Pedroli1,2, Andrea Tacchetto1,2
1Division of Cardiology, Alessandro Manzoni Hospital, Lecco, Italy.
Insights
Eliminating hypertension and smoking significantly boosts life expectancy and reduces cardiovascular disease risk. Even without these factors, some residual risk remains, highlighting the complexity of cardiovascular health.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Five key modifiable risk factors (hypertension, diabetes, smoking, hypercholesterolemia, obesity) contribute to 50% of the global cardiovascular disease burden.
- Recent research indicates that absence of diabetes and smoking is linked to optimal life expectancy and cardiovascular disease-free years.
Purpose of the Study:
- To analyze the impact of modifiable cardiovascular risk factors on life expectancy and years lived free from cardiovascular disease.
- To identify the most influential risk factors and their combined effects on longevity and healthspan.
Main Methods:
- Utilized data from the Global Cardiovascular Risk Consortium.
- Analyzed associations between five modifiable risk factors (hypertension, diabetes, smoking, hypercholesterolemia, obesity) and cardiovascular outcomes.
- Assessed the impact of eliminating risk factors at midlife on life expectancy and all-cause mortality.
Main Results:
- Absence of diabetes and smoking correlates with the lowest cardiovascular risk and highest life expectancy.
- Lower systolic blood pressure (<130 mmHg), reduced non-HDL cholesterol, and normal body weight are associated with later disease onset and modest life expectancy gains.
- Eliminating hypertension and smoking in midlife yields the greatest increase in years lived free from cardiovascular disease and all-cause mortality.
- Male sex is a non-modifiable risk factor, and a residual risk of cardiovascular disease exists even in the absence of all considered modifiable factors.
Conclusions:
- Controlling modifiable risk factors, particularly hypertension and smoking, is crucial for extending life and improving cardiovascular health.
- While eliminating major risk factors significantly enhances longevity, a residual lifetime risk for cardiovascular disease persists.
- Public health strategies should focus on comprehensive risk factor management to maximize cardiovascular health and longevity.
Abstract:
Five modifiable cardiovascular risk factors-hypertension, diabetes, smoking, hypercholesterolemia, and obesity-account for approximately 50% of the global burden of cardiovascular disease. Recent data from the Global Cardiovascular Risk Consortium show that the absence of diabetes and smoking is associated with the lowest risk in terms of life expectancy and years lived free from cardiovascular disease. A systolic blood pressure below 130 mmHg, lower non-HDL cholesterol levels, and normal body weight are associated with a later onset of cardiovascular disease and a more modest increase in life expectancy. The absence of hypertension is correlated with the greatest number of years lived free from cardiovascular events. Smoking is confirmed as one of the most influential risk factors in terms of its impact on health and longevity. Individuals who eliminate hypertension and smoking in midlife gain the greatest number of additional years of life free from cardiovascular disease and all-cause mortality, respectively. Male sex emerges as a traditional, non-modifiable risk factor independent of modifiable risk factors. Finally, even the absence of all the risk factors considered remains associated with a residual lifetime probability of developing cardiovascular disease.
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