Cited by 945Cardiovascular Health and Risk FactorsHealth Promotion and Cardiovascular PreventionLipoproteins and Cardiovascular Health

Lifetime risks of cardiovascular disease

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Berry, Jarett D., Dyer, Alan, Cai, Xuan, Garside, Daniel B., Ning, Hongyan, Thomas, Avis, Greenland, Philip, Van Horn, Linda +2 more·2012·New England Journal of Medicine

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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  • Several studies show that a healthy lifestyle early in life prevents CVD in older age and reduces lifetime CVD risk.

    “Several studies have shown that a healthy lifestyle early in life prevents CVD in older age and reduces lifetime risk for CVD. 53,323-325”

    From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [323]

  • Differences in risk factor burden early in life translate into marked differences in the risk of adverse health outcomes later in life.

    “This is critical because differences in risk factor burden early in life translate into marked differences in the risk of adverse health outcomes later in life (64).”

    From The CardioMetabolic Health Alliance (2015) · cites this paper as [64]

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Authors
Berry, J. D., Dyer, A., Cai, X., Garside, D. B., Ning, H., Thomas, A., Greenland, P., Van Horn, L., Tracy, R. P., & Lloyd-Jones, D. M.
Affiliations
  • Northwestern University (US)
  • University of Minnesota (US)
  • University of Vermont (US)
Venue
New England Journal of Medicine
Published
2012-01-26
Volume
366
Issue
4
Pages
321-329
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2119984740
Cited by
945
References
46
Citations by year
2026: 25 · 2025: 38 · 2024: 58 · 2023: 60 · 2022: 51 · 2021: 60 · 2020: 70 · 2019: 70 · 2018: 66 · 2017: 57 · 2016: 76 · 2015: 73 · 2014: 80 · 2013: 103 · 2012: 55
FWCI
63.20
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (n01wh42124-20-0-0, n01wh32105-27-0-1, n01wh42120-22-0-1, n01wh32106-28-0-1, n01hc085082-026, N01-WH-4-2107, n01hc085081-021, n01wh42125-19-0-1, n01wh32108-30-0-1, n01hc045133-001, n01wh042116-008, n01wh32112-26-0-1, N01-WH-4-2122, n01wh32100-28-0-1, n01hc085079-024, N01-WH-3-2109, n01hc015103-009, n01wh42130-23-0-1, n01wh42123-22-0-1, N01-WH-3-2106, n01wh42108-21-0-1, n01hc085084-005, N01-WH-3-2111, n01wh042114-008, n01wh32118-27-0-1, N01-WH-3-2119, n01hc085085-011, n01hc085083-027, n01wh42110-25-0-0, n01hc085080-026, n01wh42122-22-0-1, N01-WH-4-2126, N01-WH-4-2111, N01-WH-3-2105, N01-WH-3-2100, N01-WH-4-2129, n01wh42131-22-0-1, N01-WH-4-2130, n01wh44221-7-0-1, N01-WH-3-2118, n01wh42129-23-0-1, N01-WH-4-2116, N01-WH-3-2108, N01-WH-4-2110, n01wh42115-19-0-1, n01hc085086-022, N01-WH-3-2101, n01wh32111-28-0-1, n01wh32115-26-0-1, N01 WH 44221, n01wh22110-38-0-0, N01-WH-3-2115, N01-WH-4-2117, N01WH24152, n01wh42132-22-0-1, n01wh42121-21-0-1, n01wh32101-25-0-1, n01wh42111-19-0-1, N01-WH-4-2124, n01wh24152-12-0-0, n01wh42113-23-0-1, N01-WH-4-2131, n01wh32113-30-0-1, N01-WH-4-2113, n01wh42119-25-0-1, N01-WH-4-2109, N01-WH-4-2115, N01-WH-4-2132, N01-WH-3-2112, n01hc55222-0-0-0, N01-WH-4-2121, n01wh42126-26-0-1, n01wh32122-31-0-1, n01wh42118-20-0-1, N01-WH-4-2119, n01wh32119-24-0-1, N01-WH-3-2122, n01wh42107-22-0-1, N01-WH-4-2125, n01wh42109-28-0-1, n01wh042112-013, N01-WH-4-2120, N01-WH-2-2110, n01hc075150-004, n01hc035129-010, N01-WH-4-2114, n01wh42117-21-0-1, n01wh32102-33-0-0, N01-WH-4-2123, N01-WH-4-2118, N01-WH-3-2102, N01-WH-4-2112, N01-WH-4-2108, N01 WH022110, n01wh32109-27-0-1, N01-WH-3-2113)
  • National Heart, Lung, and Blood Institute (N01-HC-85081, N01HC85085, N01 HC085086, N01HC-85083, N01HC15103, N01 HC085079, N01HC85082, N01HC‐75150, N01 HC85086, R01HL068140, N01HC85080, N01 HC55222, K23HL092229, N01‐HC‐45133, U01HL080295, R01HL043232, R21HL085375, N01-HC85079, ­N01-HC85084, N01HC35129)
  • National Center for Research Resources (UL1RR025741)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Keywords
lifetime risk, cardiovascular disease, cardiovascular risk factors, racial differences, Black people, White adults, coronary artery disease, myocardial infarction, stroke, blood pressure, cholesterol, smoking, diabetes mellitus, birth cohort, competing risk of death
MeSH terms
Adult, Aged, Black or African American, Cardiovascular Diseases, Female, Humans, Male, Middle Aged, Risk, Risk Factors, United States, Cohort Effect, Risk Assessment, White People

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