NEJM: The Worldwide Impact of Modifiable Cardiovascular Risk Factors

פוסט זה זמין גם ב: עברית

Harlan M. Krumholz, MD, SM, reviewing 

Quantifying the region- and sex-specific consequences of these risk factors can help to shape policy efforts and patient care.

We know the traditionally identified modifiable cardiovascular risk factors: body-mass index, systolic blood pressure, non–high-density lipoprotein cholesterol level, tobacco smoking, and diabetes. But what are their quantifiable global consequences? Investigators pooled individual-level data from 112 cohort studies in 34 countries and 8 geographic regions to assess the regional and sex-specific prevalence of these risk factors and their worldwide impact (NCT05466825).

The combined studies involved more than 1.5 million participants (mean age, 54 years; 54% women). The incidence of age- and sex-standardized 10-year cardiovascular disease events varied by region (10% in North America, 8% in North Africa and the Middle East, 8% in Eastern Europe and Russia, 5% in Western Europe, and 3% in Asia). The event rates were 4% in women and 8% in men. The five risk factors accounted for 57% of the cardiovascular disease in women and 53% in men. For all five factors combined, the population-attributable fraction was similar across regions (ranging from 50% to 64%), with the highest contribution from systolic blood pressure (29% for women, 22% for men).


Not surprisingly, this study confirms that these five risk factors cause much harm from cardiovascular disease. The data’s novel value is in detailing the risk factors’ global and region-specific prevalence and in highlighting the opportunities to focus on improving large numbers of clinical outcomes worldwide.


The Global Cardiovascular Risk Consortium. Global impact of modifiable risk factors on cardiovascular disease and mortality. N Engl J Med 2023 Aug 26; [e-pub]. (

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