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The age-specific quantitative effects of metabolic risk factors on cardiovascular diseases and diabetes: a pooled analysis.

TitleThe age-specific quantitative effects of metabolic risk factors on cardiovascular diseases and diabetes: a pooled analysis.
Publication TypeJournal Article
Year of Publication2013
AuthorsSingh GM, Danaei G, Farzadfar F, Stevens GA, Woodward M, Wormser D, Kaptoge S, Whitlock G, Qiao Q, Lewington S, Di Angelantonio E, Hoorn SVander, Lawes CMM, Ali MK, Mozaffarian D
Secondary AuthorsEzzati M
Corporate AuthorsGlobal Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group; Asia-Pacific Cohort Studies Collaboration(APCSC), Diabetes Epidemiology: Collaborative analysis of Diagnostic criteria in Europe(DECODE), Emerging Risk Factor Collaboration(ERFC), Prospective Studies Collaboration(PSC)
JournalPLoS One
Volume8
Issue7
Paginatione65174
Date Published2013
ISSN1932-6203
KeywordsAdult, Age Factors, Aged, Aged, 80 and over, Blood Glucose, Blood Pressure, Body Mass Index, Cardiovascular Diseases, Cholesterol, Diabetes Mellitus, Female, Humans, Male, Middle Aged, Patient Outcome Assessment, Risk, Sex Factors
Abstract

BACKGROUND: The effects of systolic blood pressure (SBP), serum total cholesterol (TC), fasting plasma glucose (FPG), and body mass index (BMI) on the risk of cardiovascular diseases (CVD) have been established in epidemiological studies, but consistent estimates of effect sizes by age and sex are not available.

METHODS: We reviewed large cohort pooling projects, evaluating effects of baseline or usual exposure to metabolic risks on ischemic heart disease (IHD), hypertensive heart disease (HHD), stroke, diabetes, and, as relevant selected other CVDs, after adjusting for important confounders. We pooled all data to estimate relative risks (RRs) for each risk factor and examined effect modification by age or other factors, using random effects models.

RESULTS: Across all risk factors, an average of 123 cohorts provided data on 1.4 million individuals and 52,000 CVD events. Each metabolic risk factor was robustly related to CVD. At the baseline age of 55-64 years, the RR for 10 mmHg higher SBP was largest for HHD (2.16; 95% CI 2.09-2.24), followed by effects on both stroke subtypes (1.66; 1.39-1.98 for hemorrhagic stroke and 1.63; 1.57-1.69 for ischemic stroke). In the same age group, RRs for 1 mmol/L higher TC were 1.44 (1.29-1.61) for IHD and 1.20 (1.15-1.25) for ischemic stroke. The RRs for 5 kg/m(2) higher BMI for ages 55-64 ranged from 2.32 (2.04-2.63) for diabetes, to 1.44 (1.40-1.48) for IHD. For 1 mmol/L higher FPG, RRs in this age group were 1.18 (1.08-1.29) for IHD and 1.14 (1.01-1.29) for total stroke. For all risk factors, proportional effects declined with age, were generally consistent by sex, and differed by region in only a few age groups for certain risk factor-disease pairs.

CONCLUSION: Our results provide robust, comparable and precise estimates of the effects of major metabolic risk factors on CVD and diabetes by age group.

DOI10.1371/journal.pone.0065174
Alternate JournalPLoS One
PubMed ID23935815
PubMed Central IDPMC3728292
Grant ListG19/35 / / Medical Research Council / United Kingdom
P30 ES005605 / ES / NIEHS NIH HHS / United States
G0100222 / / Medical Research Council / United Kingdom
DK007703 / DK / NIDDK NIH HHS / United States
RG/08/014/24067 / / British Heart Foundation / United Kingdom
G8802774 / / Medical Research Council / United Kingdom
G1000143 / / Medical Research Council / United Kingdom
RG/08/013/25942 / / British Heart Foundation / United Kingdom
G0902037 / / Medical Research Council / United Kingdom
MC_U137686857 / / Medical Research Council / United Kingdom
MR/L003120/1 / / Medical Research Council / United Kingdom
G1000616 / / Medical Research Council / United Kingdom
G0401527 / / Medical Research Council / United Kingdom
T32 DK007703 / DK / NIDDK NIH HHS / United States
MR/K005901/1 / / Medical Research Council / United Kingdom
RG/07/008/23674 / / British Heart Foundation / United Kingdom