Age-Associated Patterns of Cardiovascular Risk and Disease Phenotypes Across Diverse Care Settings: The GLOB-cAGE...

Reported prevalence of cardiovascular disease (CVD) risk factors and phenotypes varies widely. In multi-cohort analyses, such variation reflects population risk, care setting, and data capture. We harmonized baseline data from four analytic cohorts (N=54,188, aged ≥50 years) in five GLOB-cAGE member studies: pooled community (n=956), primary care (n=49,849), acute CVD registry (n=2,723), and chronic CVD cohort (n=660). Any risk-factor was hypertension, diabetes, or dyslipidemia. Any CVD phenotype was ischemic heart disease, heart failure, or atrial fibrillation/flutter. At age 60-74 years, any risk-factor prevalence ranged from 10.4% in primary care to 91.4% in the acute CVD registry (P<0.001); any CVD phenotype prevalence ranged from 4.4% to 47.0% (P<0.001). In the pooled community cohort, any risk-factor prevalence increased from 28.9% at age 50-59 to 85.0% at ≥75 (adjacent q<0.001), while age-sex-standardized any CVD phenotype prevalence remained comparatively low (10.6%). Any CVD phenotype prevalence increased with risk-factor-count, with the clearest gradients in the acute CVD registry (35.8% to 64.2%; P for trend<0.001) and pooled community cohort (6.4% to 19.6%; P for trend<0.001). Among participants with any CVD phenotype, female age distributions were older than male distributions in primary care and the acute CVD registry (female-minus-male median age difference, +3.7 and +5.0 years; both P<0.001). Across diverse care settings, harmonized summary constructs identified interpretable patterns in cardiovascular risk and CVD burden. These real-world data support cardiovascular prevention across ageing, highlight substantial CVD burden among women at older ages, and provide a framework for longitudinal analyses across real-world cohorts.