Lifetime risks of cardiovascular disease

Jarett D. Berry, Alan Dyer, Xuan Cai, Daniel B. Garside, Hongyan Ning, Avis Thomas, Philip Greenland, Linda Van Horn, Russell P. Tracy, Donald M. Lloyd-Jones

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: The lifetime risks of cardiovascular disease have not been reported across the age spectrum in black adults and white adults. METHODS: We conducted a meta-analysis at the individual level using data from 18 cohort studies involving a total of 257,384 black men and women and white men and women whose risk factors for cardiovascular disease were measured at the ages of 45, 55, 65, and 75 years. Blood pressure, cholesterol level, smoking status, and diabetes status were used to stratify participants according to risk factors into five mutually exclusive categories. The remaining lifetime risks of cardiovascular events were estimated for participants in each category at each age, with death free of cardiovascular disease treated as a competing event. RESULTS: We observed marked differences in the lifetime risks of cardiovascular disease across risk-factor strata. Among participants who were 55 years of age, those with an optimal risk-factor profile (total cholesterol level, <180 mg per deciliter [4.7 mmol per liter]; blood pressure, <120 mm Hg systolic and 80 mm Hg diastolic; nonsmoking status; and nondiabetic status) had substantially lower risks of death from cardiovascular disease through the age of 80 years than participants with two or more major risk factors (4.7% vs. 29.6% among men, 6.4% vs. 20.5% among women). Those with an optimal risk-factor profile also had lower lifetime risks of fatal coronary heart disease or nonfatal myocardial infarction (3.6% vs. 37.5% among men, <1% vs. 18.3% among women) and fatal or nonfatal stroke (2.3% vs. 8.3% among men, 5.3% vs. 10.7% among women). Similar trends within risk-factor strata were observed among blacks and whites and across diverse birth cohorts. CONCLUSIONS: Differences in risk-factor burden translate into marked differences in the lifetime risk of cardiovascular disease, and these differences are consistent across race and birth cohorts. (Funded by the National Heart, Lung, and Blood Institute.)

Original languageEnglish (US)
Pages (from-to)321-329
Number of pages9
JournalNew England Journal of Medicine
Volume366
Issue number4
DOIs
StatePublished - Jan 26 2012

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Cardiovascular Diseases
Cholesterol
Parturition
Blood Pressure
National Heart, Lung, and Blood Institute (U.S.)
Coronary Disease
Meta-Analysis
Cohort Studies
Smoking
Stroke
Myocardial Infarction

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Berry, J. D., Dyer, A., Cai, X., Garside, D. B., Ning, H., Thomas, A., ... Lloyd-Jones, D. M. (2012). Lifetime risks of cardiovascular disease. New England Journal of Medicine, 366(4), 321-329. https://doi.org/10.1056/NEJMoa1012848

Lifetime risks of cardiovascular disease. / Berry, Jarett D.; Dyer, Alan; Cai, Xuan; Garside, Daniel B.; Ning, Hongyan; Thomas, Avis; Greenland, Philip; Van Horn, Linda; Tracy, Russell P.; Lloyd-Jones, Donald M.

In: New England Journal of Medicine, Vol. 366, No. 4, 26.01.2012, p. 321-329.

Research output: Contribution to journalArticle

Berry, JD, Dyer, A, Cai, X, Garside, DB, Ning, H, Thomas, A, Greenland, P, Van Horn, L, Tracy, RP & Lloyd-Jones, DM 2012, 'Lifetime risks of cardiovascular disease', New England Journal of Medicine, vol. 366, no. 4, pp. 321-329. https://doi.org/10.1056/NEJMoa1012848
Berry JD, Dyer A, Cai X, Garside DB, Ning H, Thomas A et al. Lifetime risks of cardiovascular disease. New England Journal of Medicine. 2012 Jan 26;366(4):321-329. https://doi.org/10.1056/NEJMoa1012848
Berry, Jarett D. ; Dyer, Alan ; Cai, Xuan ; Garside, Daniel B. ; Ning, Hongyan ; Thomas, Avis ; Greenland, Philip ; Van Horn, Linda ; Tracy, Russell P. ; Lloyd-Jones, Donald M. / Lifetime risks of cardiovascular disease. In: New England Journal of Medicine. 2012 ; Vol. 366, No. 4. pp. 321-329.
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abstract = "BACKGROUND: The lifetime risks of cardiovascular disease have not been reported across the age spectrum in black adults and white adults. METHODS: We conducted a meta-analysis at the individual level using data from 18 cohort studies involving a total of 257,384 black men and women and white men and women whose risk factors for cardiovascular disease were measured at the ages of 45, 55, 65, and 75 years. Blood pressure, cholesterol level, smoking status, and diabetes status were used to stratify participants according to risk factors into five mutually exclusive categories. The remaining lifetime risks of cardiovascular events were estimated for participants in each category at each age, with death free of cardiovascular disease treated as a competing event. RESULTS: We observed marked differences in the lifetime risks of cardiovascular disease across risk-factor strata. Among participants who were 55 years of age, those with an optimal risk-factor profile (total cholesterol level, <180 mg per deciliter [4.7 mmol per liter]; blood pressure, <120 mm Hg systolic and 80 mm Hg diastolic; nonsmoking status; and nondiabetic status) had substantially lower risks of death from cardiovascular disease through the age of 80 years than participants with two or more major risk factors (4.7{\%} vs. 29.6{\%} among men, 6.4{\%} vs. 20.5{\%} among women). Those with an optimal risk-factor profile also had lower lifetime risks of fatal coronary heart disease or nonfatal myocardial infarction (3.6{\%} vs. 37.5{\%} among men, <1{\%} vs. 18.3{\%} among women) and fatal or nonfatal stroke (2.3{\%} vs. 8.3{\%} among men, 5.3{\%} vs. 10.7{\%} among women). Similar trends within risk-factor strata were observed among blacks and whites and across diverse birth cohorts. CONCLUSIONS: Differences in risk-factor burden translate into marked differences in the lifetime risk of cardiovascular disease, and these differences are consistent across race and birth cohorts. (Funded by the National Heart, Lung, and Blood Institute.)",
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AU - Cai, Xuan

AU - Garside, Daniel B.

AU - Ning, Hongyan

AU - Thomas, Avis

AU - Greenland, Philip

AU - Van Horn, Linda

AU - Tracy, Russell P.

AU - Lloyd-Jones, Donald M.

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N2 - BACKGROUND: The lifetime risks of cardiovascular disease have not been reported across the age spectrum in black adults and white adults. METHODS: We conducted a meta-analysis at the individual level using data from 18 cohort studies involving a total of 257,384 black men and women and white men and women whose risk factors for cardiovascular disease were measured at the ages of 45, 55, 65, and 75 years. Blood pressure, cholesterol level, smoking status, and diabetes status were used to stratify participants according to risk factors into five mutually exclusive categories. The remaining lifetime risks of cardiovascular events were estimated for participants in each category at each age, with death free of cardiovascular disease treated as a competing event. RESULTS: We observed marked differences in the lifetime risks of cardiovascular disease across risk-factor strata. Among participants who were 55 years of age, those with an optimal risk-factor profile (total cholesterol level, <180 mg per deciliter [4.7 mmol per liter]; blood pressure, <120 mm Hg systolic and 80 mm Hg diastolic; nonsmoking status; and nondiabetic status) had substantially lower risks of death from cardiovascular disease through the age of 80 years than participants with two or more major risk factors (4.7% vs. 29.6% among men, 6.4% vs. 20.5% among women). Those with an optimal risk-factor profile also had lower lifetime risks of fatal coronary heart disease or nonfatal myocardial infarction (3.6% vs. 37.5% among men, <1% vs. 18.3% among women) and fatal or nonfatal stroke (2.3% vs. 8.3% among men, 5.3% vs. 10.7% among women). Similar trends within risk-factor strata were observed among blacks and whites and across diverse birth cohorts. CONCLUSIONS: Differences in risk-factor burden translate into marked differences in the lifetime risk of cardiovascular disease, and these differences are consistent across race and birth cohorts. (Funded by the National Heart, Lung, and Blood Institute.)

AB - BACKGROUND: The lifetime risks of cardiovascular disease have not been reported across the age spectrum in black adults and white adults. METHODS: We conducted a meta-analysis at the individual level using data from 18 cohort studies involving a total of 257,384 black men and women and white men and women whose risk factors for cardiovascular disease were measured at the ages of 45, 55, 65, and 75 years. Blood pressure, cholesterol level, smoking status, and diabetes status were used to stratify participants according to risk factors into five mutually exclusive categories. The remaining lifetime risks of cardiovascular events were estimated for participants in each category at each age, with death free of cardiovascular disease treated as a competing event. RESULTS: We observed marked differences in the lifetime risks of cardiovascular disease across risk-factor strata. Among participants who were 55 years of age, those with an optimal risk-factor profile (total cholesterol level, <180 mg per deciliter [4.7 mmol per liter]; blood pressure, <120 mm Hg systolic and 80 mm Hg diastolic; nonsmoking status; and nondiabetic status) had substantially lower risks of death from cardiovascular disease through the age of 80 years than participants with two or more major risk factors (4.7% vs. 29.6% among men, 6.4% vs. 20.5% among women). Those with an optimal risk-factor profile also had lower lifetime risks of fatal coronary heart disease or nonfatal myocardial infarction (3.6% vs. 37.5% among men, <1% vs. 18.3% among women) and fatal or nonfatal stroke (2.3% vs. 8.3% among men, 5.3% vs. 10.7% among women). Similar trends within risk-factor strata were observed among blacks and whites and across diverse birth cohorts. CONCLUSIONS: Differences in risk-factor burden translate into marked differences in the lifetime risk of cardiovascular disease, and these differences are consistent across race and birth cohorts. (Funded by the National Heart, Lung, and Blood Institute.)

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