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Lifetime Risks of Cardiovascular Disease
Open accessAbstract
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 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]
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“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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Metadata
- 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)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2012-01-26
- Volume
- 366
- Issue
- 4
- Pages
- 321-329
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC3336876
- 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
- bronze
- doi.org
- 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 › Cardiology and Cardiovascular Medicine › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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