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Cited by 418Cardiovascular Health and Risk FactorsHealthcare Systems and Public HealthGlobal Public Health Policies and Epidemiology

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Contribution of six risk factors to achieving the 25×25 non-communicable disease mortality reduction target: a modelling study

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Kontis, Vasilis, Mathers, Colin D, Rehm, Jürgen, Stevens, Gretchen A, Shield, Kevin D, Bonita, Ruth, Riley, Leanne M, Poznyak, Vladimir, Beaglehole, Robert, Ezzati, Majid·2014·The Lancet
DOI 10.1016/s0140-6736(14)60616-4
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Abstract

Background Countries have agreed to reduce premature mortality (defined as the probability of dying between the ages of 30 years and 70 years) from four main non-communicable diseases (NCDs)--cardiovascular diseases, chronic respiratory diseases, cancers, and diabetes--by 25% from 2010 levels by 2025 (referred to as 25×25 target). Targets for selected NCD risk factors have also been agreed on. We estimated the contribution of achieving six risk factor targets towards meeting the 25×25 mortality target. Methods We estimated the impact of achieving the targets for six risk factors (tobacco and alcohol use, salt intake, obesity, and raised blood pressure and glucose) on NCD mortality between 2010 and 2025. Our methods accounted for multi-causality of NCDs and for the fact that when risk factor exposure increases or decreases, the harmful or beneficial effects on NCDs accumulate gradually. We used data for risk factor and mortality trends from systematic analyses of available country data. Relative risks for the effects of individual and multiple risks, and for change in risk after decreases or increases in exposure, were from re-analyses and meta-analyses of epidemiological studies. Findings If risk factor targets are achieved, the probability of dying from the four main NCDs between the ages of 30 years and 70 years will decrease by 22% in men and by 19% in women between 2010 and 2025, compared with a decrease of 11% in men and 10% in women under the so-called business-as-usual trends (ie, projections based on current trends with no additional action). Achieving the risk factor targets will delay or prevent more than 37 million deaths (16 million in people aged 30-69 years and 21 million in people aged 70 years or older) from the main NCDs over these 15 years compared with a situation of rising or stagnating risk factor trends. Most of the benefits of achieving the risk factor targets, including 31 million of the delayed or prevented deaths, will be in low-income and middle-income countries, and will help to reduce the global inequality in premature NCD mortality. A more ambitious target on tobacco use (a 50% reduction) will almost reach the target in men (>24% reduction in the probability of death), and enhance the benefits to a 20% reduction in women. Interpretation If the agreed risk factor targets are met, premature mortality from the four main NCDs will decrease to levels that are close to the 25×25 target, with most of these benefits seen in low-income and middle-income countries. On the basis of mortality benefits and feasibility, a more ambitious target than currently agreed should be adopted for tobacco use. Funding UK MRC.

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Authors
Kontis, V., Mathers, C. D., Rehm, J., Stevens, G. A., Shield, K. D., Bonita, R., Riley, L. M., Poznyak, V., Beaglehole, R., & Ezzati, M.
Affiliations
  • MRC Centre for Environment and Health (GB)
  • World Health Organization (CH)
  • Centre for Addiction and Mental Health (CA)
  • University of Auckland (NZ)
Corresponding author
Ezzati, Majid
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2014-08
Volume
384
Issue
9941
Pages
427-437
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(14)60616-4
OpenAlex
W2116291617
Cited by
418
References
74
Citations by year
2026: 10 · 2025: 18 · 2024: 29 · 2023: 25 · 2022: 26 · 2021: 35 · 2020: 51 · 2019: 36 · 2018: 32 · 2017: 42 · 2016: 40 · 2015: 47 · 2014: 24
FWCI
35.05
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • World Health Organization
  • Medical Research Council (MR/K005901/1)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
  • Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
Keywords
non-communicable disease mortality, premature mortality, tobacco use, alcohol consumption, salt intake, obesity, elevated blood pressure, cardiovascular disease, chronic respiratory disease, cancer, diabetes mellitus, low- and middle-income countries
MeSH terms
Adolescent, Adult, Aged, Alcohol Drinking, Blood Glucose, Blood Pressure, Female, Humans, Income, Male, Middle Aged, Mortality, Obesity, Risk Factors, Smoking, Models, Statistical, Sodium Chloride, Dietary

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