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

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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, Tracy, Russell P., Lloyd-Jones, Donald M.·2012·New England Journal of Medicine

DOI 10.1056/nejmoa1012848PMC PMC3336876

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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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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: Berry, Jarett D.
Dyer, Alan
Cai, Xuan
Garside, Daniel B.
Ning, Hongyan
Greenland, Philip
Tracy, Russell P.
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
DOI: 10.1056/nejmoa1012848
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

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