The Age-Specific Quantitative Effects of Metabolic Risk Factors on Cardiovascular Diseases and Diabetes

A Pooled Analysis

Gitanjali M. Singh, Goodarz Danaei, Farshad Farzadfar, Gretchen A. Stevens, Mark Woodward, David Wormser, Stephen Kaptoge, Gary Whitlock, Qing Qiao, Sarah Lewington, Emanuele Di Angelantonio, Stephen vander Hoorn, Carlene M M Lawes, Mohammed K. Ali, Dariush Mozaffarian, Elizabeth Selvin

Research output: Contribution to journalArticle

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/m2 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.

Original languageEnglish (US)
Article numbere65174
JournalPLoS One
Volume8
Issue number7
DOIs
StatePublished - Jul 30 2013

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Medical problems
cardiovascular diseases
diabetes
Cardiovascular Diseases
risk factors
stroke
Stroke
relative risk
Myocardial Ischemia
myocardial ischemia
Age Groups
Blood Pressure
Heart Diseases
Fasting
heart diseases
systolic blood pressure
Body Mass Index
Cholesterol
fasting
body mass index

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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The Age-Specific Quantitative Effects of Metabolic Risk Factors on Cardiovascular Diseases and Diabetes : A Pooled Analysis. / Singh, Gitanjali M.; Danaei, Goodarz; Farzadfar, Farshad; Stevens, Gretchen A.; Woodward, Mark; Wormser, David; Kaptoge, Stephen; Whitlock, Gary; Qiao, Qing; Lewington, Sarah; Di Angelantonio, Emanuele; vander Hoorn, Stephen; Lawes, Carlene M M; Ali, Mohammed K.; Mozaffarian, Dariush; Selvin, Elizabeth.

In: PLoS One, Vol. 8, No. 7, e65174, 30.07.2013.

Research output: Contribution to journalArticle

Singh, GM, Danaei, G, Farzadfar, F, Stevens, GA, Woodward, M, Wormser, D, Kaptoge, S, Whitlock, G, Qiao, Q, Lewington, S, Di Angelantonio, E, vander Hoorn, S, Lawes, CMM, Ali, MK, Mozaffarian, D & Selvin, E 2013, 'The Age-Specific Quantitative Effects of Metabolic Risk Factors on Cardiovascular Diseases and Diabetes: A Pooled Analysis', PLoS One, vol. 8, no. 7, e65174. https://doi.org/10.1371/journal.pone.0065174
Singh, Gitanjali M. ; Danaei, Goodarz ; Farzadfar, Farshad ; Stevens, Gretchen A. ; Woodward, Mark ; Wormser, David ; Kaptoge, Stephen ; Whitlock, Gary ; Qiao, Qing ; Lewington, Sarah ; Di Angelantonio, Emanuele ; vander Hoorn, Stephen ; Lawes, Carlene M M ; Ali, Mohammed K. ; Mozaffarian, Dariush ; Selvin, Elizabeth. / The Age-Specific Quantitative Effects of Metabolic Risk Factors on Cardiovascular Diseases and Diabetes : A Pooled Analysis. In: PLoS One. 2013 ; Vol. 8, No. 7.
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T2 - A Pooled Analysis

AU - Singh, Gitanjali M.

AU - Danaei, Goodarz

AU - Farzadfar, Farshad

AU - Stevens, Gretchen A.

AU - Woodward, Mark

AU - Wormser, David

AU - Kaptoge, Stephen

AU - Whitlock, Gary

AU - Qiao, Qing

AU - Lewington, Sarah

AU - Di Angelantonio, Emanuele

AU - vander Hoorn, Stephen

AU - Lawes, Carlene M M

AU - Ali, Mohammed K.

AU - Mozaffarian, Dariush

AU - Selvin, Elizabeth

PY - 2013/7/30

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N2 - 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/m2 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.

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