Global Effect of Cardiovascular Risk Factors on Lifetime Estimates.
Creators
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Magnussen, Christina1, 2, 3
- Alegre-Diaz, Jesus4, 5
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Al-Nasser, Lubna A6
- Amouyel, Philippe7, 8
- Aviles-Santa, Larissa9
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Bakker, Stephan J L10, 11
- Ballantyne, Christie M12, 13
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Bernabé-Ortiz, Antonio14
- Bobak, Martin15, 16
- Boffetta, Paolo17, 18, 19, 20, 21
- Brenner, Hermann22, 23, 24
- Brunström, Mattias25, 26
- Can, Gunay27
- Carrillo-Larco, Rodrigo M28, 29
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Checkley, William30, 31
- Dallongeville, Jean32
- De Bacquer, Dirk33, 34
- de Gaetano, Giovanni35, 36
- de Lemos, James A37, 38
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di Carluccio, Eleonora39, 40
- Dobson, Annette41, 42
- Donfrancesco, Chiara43
- Dörr, Marcus44, 45
- d'Orsi, Eleonora46, 47
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Drygas, Wojciech48, 49, 50
- Dullaart, Robin P F10, 11
- Engström, Gunnar51, 52
- Ferrario, Marco M53
- Ferrières, Jean54, 8
- Figtree, Gemma A55, 56, 57, 58
- Gaye, Bamba59, 60, 61, 29
- Ghayour-Mobarhan, Majid62, 63
- Goldbourt, Uri64, 65
- Gonzalez, Clicerio66
- Gossling, Alina1, 3
- Grassi, Guido67, 68
- Gupta, Prakash C69
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He, Jiang70, 38
- Hodge, Allison M71, 72, 73
- Hozawa, Atsushi74, 75
- Hveem, Kristian76, 77, 78
- Iacoviello, Licia35, 36, 79
- Ikram, M Kamran80
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Inoue, Manami81
- Irazola, Vilma82
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Jobe, Modou59, 83
- Jousilahti, Pekka84
- Kaleebu, Pontiano85
- Kavousi, Maryam86
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Kee, Frank87
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Khalili, Davood88
- Klotsche, Jens89
- Koenig, Wolfgang90, 91, 92, 93, 94
- Kontsevaya, Anna95
- Kowlessur, Sudhirsen96
- Kuri-Morales, Pablo4, 5, 97
- Kuulasmaa, Kari84
- Kweon, Sun-Seog98
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Lackner, Karl J99, 100
- Landmesser, Ulf101, 102, 103, 104, 105
- Leistner, David M106, 107, 108, 109
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Leiva Sisnieguez, Carlos E110, 111
- Leong, Darryl112, 113
- Lind, Lars114
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Linneberg, Allan115, 116, 117
- Lorenz, Thiess1, 2, 3, 59
- Lyngbakken, Magnus N118, 119, 120
- Malekzadeh, Reza121, 122, 123
- Malyutina, Sofia124, 125
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Mathiesen, Ellisiv B126, 127
- McElduff, Patrick128, 129
- Melander, Olle130, 52
- Metspalu, Andres131
- Miranda, J Jaime55, 56, 132
- Moitry, Marie133
- Mugisha, Joseph85
- Munzinger, Julia1, 2, 3
- Nalini, Mahdi123, 122
- Nambi, Vijay12, 13, 134
- Nilsson, Peter M130, 52
- Ninomiya, Toshiharu135, 136
- Omland, Torbjørn118, 119, 120
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Ong, Sok King137
- Oppermann, Karen138
- Pajak, Andrzej139, 140
- Palmieri, Luigi43
- Panagiotakos, Demosthenes141
- Park, Sue K142, 143, 144, 145
- Pednekar, Mangesh S69
- Perianayagam, Arokiasamy146, 147
- Peters, Annette92, 148, 149, 150
- Poustchi, Hossein121, 122, 123
- Prabhakaran, Dorairaj151, 152
- Prentice, Andrew M83
- Prescott, Eva153
- Quyyumi, Arshed154, 29
- Risérus, Ulf155, 156
- Sakata, Satoko135, 136
- Salazar, Martin110, 111
- Salomaa, Veikko84
- Sans, Susana157
- Sattler, E Lilian P59, 158, 159, 160, 161, 29
- Schöttker, Ben22, 23, 24
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Schutte, Aletta E162, 163, 164, 165
- Sepanlou, Sadaf G123, 122
- Sharma, Sanjib K166
- Shaw, Jonathan167
- Simons, Leon A168, 163
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Söderberg, Stefan25, 26
- Tamosiunas, Abdonas169, 170
- Tapia-Conyer, Roberto4, 5
- Thorand, Barbara148, 149, 150
- Tunstall-Pedoe, Hugh171
- Tuomilehto, Jaakko172, 173
- Twerenbold, Raphael1, 2, 3
- Vanuzzo, Diego174
- Veronesi, Giovanni53
- Wannamethee, S Goya175, 16
- Watanabe, Masafumi176
- Weimann, Jessica1, 3
- Wild, Philipp S177, 100, 178, 179, 180
- Yao, Yao181, 182, 183
- Zeng, Yi184, 182, 185, 186
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Ziegler, Andreas1, 3, 40, 187
- Ojeda, Francisco M1, 3
- Blankenberg, Stefan1, 2, 3, 40
- and 116 more
- 1. University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- 2. German Center for Cardiovascular Research (DZHK), Partner Site Hamburg-Kiel-Luebeck, Hamburg, Germany.
- 3. Center for Population Health Innovation, Hamburg, Germany.
- 4. Experimental Medicine Research Unit from the School of Medicine, National Autonomous University of Mexico, Mexico City.
- 5. National Autonomous University of Mexico
- 6. Department of Population Health, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- 7. University Lille, INSERM, Centre Hospital University Lille, Institut Pasteur de Lille, Unité Mixte de Recherche (UMR) 1167-Risk Factors and Molecular Determinants of Aging-Related Diseases, Epidemiology and Public Health Department, Lille, France.
- 8. French Institute of Health and Medical Research
- 9. Division of Clinical and Health Services Research, National Institute on Minority Health and Health Disparities, Bethesda, MD.
- 10. Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
- 11. University of Groningen
- 12. Department of Medicine, Baylor College of Medicine, Houston.
- 13. Baylor College of Medicine
- 14. Universidad Científica del Sur, Lima, Peru.
- 15. Institute of Epidemiology and Health Care, University College London, London.
- 16. University College London
- 17. Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, NY.
- 18. Stony Brook University
- 19. Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY.
- 20. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
- 21. University of Bologna
- 22. Division of Clinical Epidemiology and Aging Research, DKFZ, Heidelberg, Germany.
- 23. Network Aging Research, Heidelberg University, Heidelberg, Germany.
- 24. Heidelberg University
- 25. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
- 26. Umeå University
- 27. Department of Public Health, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
- 28. Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta.
- 29. Emory University
- 30. Division of Pulmonary and Critical Care and Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore.
- 31. Johns Hopkins University
- 32. Institut Pasteur de Lille, University Lille, Lille, France.
- 33. Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
- 34. Ghent University
- 35. Research Unit of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy.
- 36. Scientific Institute for Research, Hospitalization and Healthcare
- 37. Department of Medicine, University of Texas Southwestern Medical Center, Dallas.
- 38. University of Texas Southwestern Medical Center
- 39. University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- 40. Cardio-CARE, Davos, Switzerland.
- 41. School of Public Health, University of Queensland, Brisbane, Australia.
- 42. University of Queensland
- 43. Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome.
- 44. Institute for Community Medicine, Study of Health in Pomerania-Klinisch-Epidemiologische Forschung, University Medicine Greifswald, Greifswald, Germany.
- 45. DZHK Partner Site Greifswald, Greifswald, Germany.
- 46. Department of Public Health, Postgraduate Program in Public Health, Federal University of Santa Catarina, Florianopolis, Brazil.
- 47. Universidade Federal de Santa Catarina
- 48. National Institute of Cardiology, Warsaw, Poland.
- 49. Department of Social and Preventive Medicine, Medical University, Lodz, Poland.
- 50. Calisia University, World Institute for Patient Safety, Kalisz, Poland.
- 51. Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden.
- 52. Lund University
- 53. Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
- 54. Department of Cardiology, Toulouse Rangueil University Hospital, Department of Epidemiology, INSERM UMR 1295, Toulouse, France.
- 55. Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
- 56. University of Sydney
- 57. Cardiovascular Discovery Group, Kolling Institute of Medical Research, St. Leonards, NSW, Australia.
- 58. Department of Cardiology, Royal North Shore Hospital, St. Leonards, NSW, Australia.
- 59. Alliance for Medical Research in Africa, Dakar, Senegal.
- 60. Department of Medicine, Cheikh Anta Diop University, Dakar, Senegal.
- 61. Department of Biomedical Informatics, Emory University School of Medicine, Atlanta.
- 62. Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- 63. International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
- 64. Department of Epidemiology, Tel Aviv University School of Public Health, Tel Aviv, Israel.
- 65. Tel Aviv University
- 66. Centro de Estudios en Diabetes, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico.
- 67. Department of Medicine and Surgery, University of Milano-Bicocca, Milan.
- 68. University of Milano-Bicocca
- 69. Healis-Sekhsaria Institute for Public Health, Navi Mumbai, India.
- 70. Department of Epidemiology, University of Texas Southwestern Medical Center Peter O'Donnell Jr. School of Public Health, Dallas.
- 71. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia.
- 72. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia.
- 73. University of Melbourne
- 74. Tohoku University Graduate School of Medicine, Sendai, Japan.
- 75. Tohoku University
- 76. HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
- 77. Norwegian University of Science and Technology
- 78. Department of Research and Education, St. Olav's Hospital, Trondheim, Norway.
- 79. Department of Medicine and Surgery, LUM University, Casamassima, Italy.
- 80. Departments of Neurology and Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
- 81. National Cancer Center Institute for Cancer Control, Tokyo.
- 82. Department of Research in Chronic Diseases, Institute for Clinical Effectiveness and Health Policy, Buenos Aires.
- 83. Medical Research Council (MRC) Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia.
- 84. Department of Public Health, Finnish Institute for Health and Welfare, Helsinki.
- 85. MRC-Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.
- 86. Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.
- 87. Centre for Public Health, Queens University Belfast, Belfast, United Kingdom.
- 88. Prevention of Metabolic Disorders Research Center, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- 89. German Rheumatism Research Center, Epidemiologic Unit, Berlin.
- 90. Technical University of Munich, School of Medicine and Health, German Heart Center, TUM University Hospital, Munich, Germany.
- 91. Technische Universität München
- 92. DZHK Partner Site Munich Heart Alliance, Munich, Germany.
- 93. Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
- 94. University of Ulm
- 95. National Medical Research Center for Therapy and Preventive Medicine, Moscow.
- 96. Ministry of Health and Wellness, Port Louis, Mauritius.
- 97. Proyecto oriGen, Tecnológico de Monterrey, Monterrey, Mexico.
- 98. Department of Preventive Medicine, Chonnam National University Medical School, Hwasun-eup, South Korea.
- 99. University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
- 100. University of Mainz
- 101. Department of Cardiology, Angiology, and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Berlin.
- 102. Charité
- 103. Charité Universitätsmedizin Berlin, Berlin.
- 104. Friede Springer Cardiovascular Prevention Center @Charité, Berlin.
- 105. DZHK Partner Site Berlin, Berlin.
- 106. Goethe University Frankfurt, University Hospital, Department of Cardiology, Frankfurt, Germany.
- 107. Goethe University Frankfurt
- 108. DZHK Partner Site Rhine-Main, Frankfurt, Germany.
- 109. Cardio-Pulmonary Institute, Partner Site Frankfurt, Frankfurt am Main, Germany.
- 110. Faculty of Medical Sciences, National University of La Plata, La Plata, Argentina.
- 111. Argentinian Society of Arterial Hypertension, Buenos Aires.
- 112. Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada.
- 113. McMaster University
- 114. Department of Medical Sciences, Uppsala, Sweden.
- 115. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen.
- 116. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen.
- 117. University of Copenhagen
- 118. Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway.
- 119. K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo.
- 120. University of Oslo
- 121. Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
- 122. Tehran University of Medical Sciences
- 123. Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
- 124. Research Institute of Internal and Preventive Medicine, Branch of Federal Research Center Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia.
- 125. Russian Academy of Sciences
- 126. Department of Clinical Medicine, UiT Arctic University of Norway, Tromsø, Norway.
- 127. Department of Neurology, University Hospital of North Norway, Tromsø, Norway.
- 128. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
- 129. University of Newcastle
- 130. Lund University, Lund, Sweden.
- 131. University of Tartu, Tartu, Estonia.
- 132. CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
- 133. Department of Public Health, University Hospital of Strasbourg, Strasbourg, France.
- 134. Michael E. DeBakey Veterans Affairs Hospital, Houston.
- 135. Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
- 136. Kyushu University
- 137. PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Bandar Seri Begawan, Brunei Darussalam.
- 138. Department of Gynecology, Faculty of Medicine, University of Passo Fundo, Passo Fundo, Brazil.
- 139. Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
- 140. Jagiellonian University
- 141. Harokopio University, Athens.
- 142. Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea.
- 143. Seoul National University
- 144. Cancer Research Institute, Seoul National University, Seoul, South Korea.
- 145. Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, South Korea.
- 146. Social and Economic Survey Research Institute, Qatar University, Doha, Qatar.
- 147. National Council of Applied Economic Research, Delhi, India.
- 148. Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Munich, Germany.
- 149. Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU Munich, Pettenkofer School of Public Health, Munich, Germany.
- 150. German Center for Diabetes Research, Partner Munich-Neuherberg, Neuherberg, Germany.
- 151. Public Health Foundation of India, New Delhi, India.
- 152. Center for Chronic Disease Control, New Delhi, India.
- 153. Department of Cardiology, Bispebjerg Hospital, Copenhagen.
- 154. Emory University School of Medicine, Division of Cardiology, Department of Medicine, Atlanta.
- 155. Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
- 156. Uppsala University
- 157. Department of Health, Generalitat of Catalonia, Barcelona.
- 158. Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens.
- 159. University of Georgia
- 160. Department of Nutritional Sciences, College of Family and Consumer Sciences, University of Georgia, Athens.
- 161. Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta.
- 162. School of Population Health, University of New South Wales, Kensington, Australia.
- 163. University of New South Wales
- 164. George Institute for Global Health, Sydney.
- 165. Hypertension in Africa Research Team, South African Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
- 166. Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
- 167. Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
- 168. University of New South Wales Sydney, Kensington, Australia.
- 169. Laboratory of Population Studies, Institute of Cardiology, Kaunas, Lithuania.
- 170. Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.
- 171. Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, Dundee, United Kingdom.
- 172. Department of Public Health, University of Helsinki, Helsinki.
- 173. University of Helsinki
- 174. MONICA (Monitoring Cardiovascular Diseases)-Friuli Study Group, Udine, Italy.
- 175. Research Department of Primary Care and Population Health, University College London, London.
- 176. Global Center of Excellence Program Study Group, Yamagata University School of Medicine, Yamagata, Japan.
- 177. Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany.
- 178. Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany.
- 179. DZHK Partner Site Rhine-Main, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany.
- 180. Systems Medicine, Institute of Molecular Biology, Mainz, Germany.
- 181. Center for Healthy Aging Transdisciplinary Sciences, China Center for Health Development Studies, Peking University, Beijing.
- 182. Peking University
- 183. State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing.
- 184. National School of Development, Peking University, Beijing.
- 185. Center for the Study of Aging and Human Development and Geriatrics Division, School of Medicine, Duke University, Durham, NC.
- 186. Duke University
- 187. School of Mathematics, Statistics, and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Description
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.
We 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. Risk-factor trajectories were analyzed to predict lifetime differences according to risk-factor variation.
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.
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.).
Copyright © 2025 Massachusetts Medical Society.
Publication Details
Journal article
Journal:
The New England journal of medicine
Publisher:
Massachusetts Medical Society
ISSN:
15334406
Volume:
393
Pages:
125-138
Funding
References
Scholarly Citations
MeSH Terms
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