Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality

This study pooled individual level data from 112 cohort studies across 34 countries (1,518,028 participants; 54.1% women) to evaluate the impact of five modifiable risk factors body mass index, systolic blood pressure, non HDL cholesterol, smoking, and diabetes on cardiovascular disease (CVD) incidence and all cause mortality. Over a median follow up of 7.3 years for CVD and 8.7 years for mortality, 80,596 CVD events and 177,369 deaths were recorded. The aggregate global population attributable fractions (PAFs) for these risk factors were 57.2% (95% CI, 52.4–62.1) among women and 52.6% (95% CI, 49.0–56.1) among men for 10 year CVD incidence, and 22.2% (95% CI, 16.8–27.5) and 19.1% (95% CI, 14.6–23.6), respectively, for 10 year mortality. Elevated systolic blood pressure was the largest contributor to CVD risk globally. Regional variations were notable, with higher PAFs in North Africa and the Middle East (64.2% for women) and lower PAFs in Western Europe (55.8% for women). The findings underscore the potential for targeted risk-factor modification to reduce global CVD burden and mortality disparities.

This study pooled individual level data from 112 cohort studies across 34 countries (1,518,028 participants; 54.1% women) to evaluate the impact of five modifiable risk factors body mass index, systolic blood pressure, non HDL cholesterol, smoking, and diabetes on cardiovascular disease (CVD) incidence and all cause mortality. Over a median follow up of 7.3 years for CVD and 8.7 years for mortality, 80,596 CVD events and 177,369 deaths were recorded. The aggregate global population attributable fractions (PAFs) for these risk factors were 57.2% (95% CI, 52.4–62.1) among women and 52.6% (95% CI, 49.0–56.1) among men for 10 year CVD incidence, and 22.2% (95% CI, 16.8–27.5) and 19.1% (95% CI, 14.6–23.6), respectively, for 10 year mortality. Elevated systolic blood pressure was the largest contributor to CVD risk globally. Regional variations were notable, with higher PAFs in North Africa and the Middle East (64.2% for women) and lower PAFs in Western Europe (55.8% for women). The findings underscore the potential for targeted risk-factor modification to reduce global CVD burden and mortality disparities.