Das PoM-Archiv finden Sie hier:

PoM Archiv

UKE Paper of the Month April 2025

Global effect of cardiovascular risk factors on lifetime estimates

Magnussen C, Alegre-Diaz J, AlNasser LA, Amouyel P, Aviles-Santa L, Bakker SJL, Ballantyne CM, Bernabé-Ortiz A, Bobak M, Boffetta P, Brenner H, Brunström M, Can G, Carrillo-Larco RM, Checkley W, Dallongeville J, De Bacquer D, de Gaetano G, de Lemos JA, di Carluccio E, Dobson A, Donfrancesco C, Dörr M, d'Orsi E, Drygas W, Dullaart RPF, Engström G, Ferrario MM, Ferrieres J, Figtree G, Gaye B, Ghayour-Mobarhan M, Goldbourt U, Gonzalez C, Gossling A, Grassi G, Gupta PC, He J, Hodge A, Hozawa A, Hveem K, Iacoviello L, Ikram M.K., Inoue M, Irazola V, Jobe M, Jousilahti P, Kaleebu P, Kavousi M, Kee F, Khalili D, Klotsche J, Koenig W, Kontsevaya A, Kowlessur S, Kuri-Morales P, Kuulasmaa K, Kweon SS, Lackner KJ, Landmesser U, Leistner D. M., Leiva Sisnieguez CE, Leong D, Lind L, Linneberg A, Lorenz T, Lyngbakken MN, Malekzadeh R, Malyutina S, Mathiesen EB, McElduff P, Melander O, Metspalu A, Miranda JJ, Moitry M, Mugisha J, Munzinger J, Nalini M, Nambi V, Nilsson PM, Ninomiya T, Omland T, Ong S, Oppermann K, Pajak A, Palmieri L, Panagiotakos D, Park SK, Pednekar MS, Perianayagam A, Peters A, Poustchi H, Prabhakaran D, Prentice AM, Prescott E, Quyyumi A, Risérus U, Salazar M, Salomaa V, Sans S, Sakata S, Sattler ELP, Schöttker B, Schutte AE, Sepanlou GS, Sharma SK, Shaw J, Simons LA, Söderberg S, Tamosiunas A, Tapia-Conyer R, Thorand B, Tunstall-Pedoe H, Tuomilehto J, Twerenbold R, Vanuzzo D, Veronesi G, Wannamethee SG, Watanabe M, Weimann J, Wild PS, Yao Y, Zeng Y, Ziegler A, Ojeda F*, Blankenberg S**Drs. Ojeda and Blankenberg contributed equally to this article.

ABSTRACT:
Background
Five risk factors account for approximately 50% of the global burden of cardiovascular disease. How the presence or absence of classic risk factors affects lifetime estimates of cardiovascular disease and death from any cause remains unclear.MethodsWe harmonized individual-level data from 2,078,948 participants across 133 cohorts,39 countries, and 6 continents. Lifetime risk of cardiovascular disease and death from any cause was estimated up to 90 years of age according to the presence or absence of arterial hypertension, hyperlipidemia, underweight and overweight or obesity, diabetes, and smoking at 50 years of age. Differences in life span (in terms of additional life-years free of cardiovascular disease or death from any cause) according to the presence or absence of these risk factors were also estimated. Riskfactor trajectories were analyzed to predict lifetime differences according to riskfactor variation.
Results
The lifetime risk of cardiovascular disease was 24% (95% confidence interval [CI], 21 to 30) among women and 38% (95% CI, 30 to 45) among men for whom all five risk factors were present. In the comparison between participants with none of the risk factors and those with all the risk factors, the estimated number of additional life-years free of cardiovascular disease was 13.3 (95% CI, 11.2 to 15.7) for women and 10.6 (95% CI, 9.2 to 12.9) for men; the estimated number of additional life-years free of death was 14.5 (95% CI, 9.1 to 15.3) for women and 11.8 (95% CI, 10.1 to 13.6) for men. As compared with no changes in the presence of all risk factors, modification of hypertension at an age of 55 to less than 60 years was associated with the most additional life-years free of cardiovascular disease, and modification of smoking at an age of 55 to less than 60 years was associated with the most additional life-years free of death.
Conclusions
The absence of five classic risk factors at 50 years of age was associated with more than a decade greater life expectancy than the presence of all five risk factors, in both sexes. Persons who modified hypertension and smoking in midlife had the most additional life-years free of cardiovascular disease and death from any cause, respectively. (Funded by the German Center for Cardiovascular Research [DZHK]; ClinicalTrials.gov number, NCT05466825.)

STATEMENT:
This study qualifies as the UKE Paper of the Month because it provides one of the most comprehensive analyses to date on the impact of cardiovascular risk factors on life expectancy. With an unprecedented global perspective, it highlights regional differences in risk factor effects and calls for regionally-tailored preventive action. Beyond recognizing risk, this study marks a paradigm shift by exploring the potential association between risk factor modification and additional healthy life-years, emphasizing the role of individual self-empowerment in cardiovascular health.

BACKGROUND:
This study was led by Prof. Christina Magnussen and Prof. Stefan Blankenberg of the Department of Cardiology at the University Heart and VasculNew Engl J Med Center (UHZ). Both have a strong research focus on data science in population health. Thiess Lorenz, Alina Gossling, Jessica Weimann, Julia Munzinger and Raphael Twerenbold, Elisa Grossmann and Aisouda Hoshiyar, all UHZ scientists, were part of the study group with its lead statistician Francisco M. Ojeda. The study was conducted within the framework of the Center for Population Health Innovation (POINT) at the UHZ and supported by the German Center for Cardiovascular Research (DZHK).

DOI:10.1056/NEJMoa2415879

Congratulations to all authors!

Next PoM: To apply, the publication must have been published in May2025. Applications will be considered in two rounds of the selection process, i.e. two months. Please send your completed PoM application to Dr. Anne Wulf by 31/05/2025.