Format

Send to

Choose Destination
Lancet Diabetes Endocrinol. 2014 Aug;2(8):634-47. doi: 10.1016/S2213-8587(14)70102-0. Epub 2014 May 16.

Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment.

Collaborators (342)

Danaei G, Lu Y, Singh GM, Carnahan E, Stevens GA, Cowan MJ, Farzadfar F, Lin JK, Finucane MM, Rao M, Khang YH, Riley LM, Mozaffarian D, Lim SS, Ezzati M, Aamodt G, Abdeen Z, Abdella NA, Rahim HF, Addo J, Aekplakorn W, Afifi MM, Agabiti-Rosei E, Salinas CA, Agyemang C, Ali MK, Ali MM, Al-Nsour M, Al-Nuaim AR, Ambady R, Di Angelantonio E, Aro P, Azizi F, Babu BV, Bahalim AN, Barbagallo CM, Barbieri MA, Barceló A, Barreto SM, Barros H, Bautista LE, Benetos A, Bjerregaard P, Björkelund C, Bo S, Bobak M, Bonora E, Botana MA, Bovet P, Breckenkamp J, Breteler MM, Broda G, Brown IJ, Bursztyn M, de León AC, Campos H, Cappuccio FP, Capuano V, Casiglia E, Castellano M, Castetbon K, Cea L, Chang CJ, Chaouki N, Chatterji S, Chen CJ, Chen Z, Choi JS, Chua L, Cífková R, Cobiac LJ, Cooper RS, Corsi AM, Costanza MC, Craig CL, Dankner RS, Dastgiri S, Delgado E, Dinc G, Doi Y, Dong GH, Dorsi E, Dragano N, Drewnowski A, Eggertsen R, Elliott P, Engeland A, Erem C, Esteghamati A, Fall CH, Fan JG, Ferreccio C, Fezeu L, Firmo JO, Florez HJ, Fornés NS, Fowkes FG, Franceschini G, Frisk F, Fuchs FD, Fuller EL, Getz L, Giampaoli S, Gómez LF, Gomez-Zumaquero JM, Graff-Iversen S, Grant JF, Carvajal RG, Gulliford MC, Gupta R, Gupta PC, Gureje O, Gutierrez HR, Hansen TW, Hata J, He J, Heim N, Heinrich J, Hemmingsson T, Hennis A, Herman WH, Herrera VM, Ho S, Holdsworth M, Frisman GH, Hopman WM, Hussain A, Husseini A, Ibrahim MM, Ikeda N, Jacobsen BK, Jaddou HY, Jafar TH, Janghorbani M, Jasienska G, Joffres MR, Jonas JB, Kadiki OA, Kalter-Leibovici O, Kamadjeu RM, Kaptoge S, Karalis I, Kastarinen MJ, Katz J, Keinan-Boker L, Kelly P, Khalilzadeh O, Kiechl S, Kim KW, Kiyohara Y, Kobayashi J, Krause MP, Kubínová R, Kurjata P, Kusuma YS, Lam TH, Langhammer A, Lawes CM, Le C, Lee J, Lévy-Marchal C, Lewington S, Li Y, Li Y, Lim TO, Lin X, Lin CC, Lin HH, Lind L, Lissner L, Liu X, Lopez-Jaramillo P, Lorbeer R, Ma G, Ma S, Macià F, MacLean DR, Maggi S, Magliano DJ, Makdisse M, Mancia G, Mannami T, Marques-Vidal P, Mbanya JC, McFarlane-Anderson N, Miccoli R, Miettola J, Minh HV, Miquel JF, Miranda JJ, Mohamed MK, Mohan V, Mohanna S, Mokdad A, Mollentze WF, Morales DD, Morgan K, Muiesan LM, Muntoni S, Nabipour I, Nakagami T, Nangia V, Nemesure B, Neovius M, Nerhus KA, Nervi F, Neuhauser H, Nguyen M, Ninomiya T, Noale M, Oh SW, Ohkubo T, Olivieri O, Önal AE, Onat A, Oróstegui M, Ouedraogo H, Pan WH, Panagiotakos DB, Panza F, Park Y, Passos VM, Pednekar MS, Pelizzari PM, Peres MA, Pérez C, Pérez-Fernández R, Pichardo R, Phua HP, Pistelli F, Plans P, Polakowska M, Poulter N, Prabhakaran D, Qiao Q, Rafiei M, Raitakari OT, Ramos LR, Rampal S, Rampal L, Rasmussen F, Reddy KK, Redon J, Revilla L, Reyes-García V, Roaeid RB, Robinson CA, Rodriguez-Artalejo F, Rojas-Martinez R, Ronkainen K, Rosero-Bixby L, Roth GA, Sachdev HS, Sánchez JR, Sanisoglu SY, Sans S, Sarraf-Zadegan N, Scazufca M, Schaan BD, Schapochnik N, Schelleman H, Schneider IJ, Schooling CM, Schwarz B, Sekuri C, Sereday MS, Serra-Majem L, Shaw J, Shera AS, Shi Z, Shiri R, Shu XO, Silva DA, Silva E, Simons LA, Smith M, Söderberg S, Soebardi S, Solfrizzi V, Sonestedt E, Soysal A, Stattin P, Stein AD, Stergiou GS, Stessman J, Sudo A, Suka M, Sundh V, Sundquist K, Sundström J, Swai AB, Tai ES, Tambs K, Tesfaye F, Thomas GN, Thorogood M, Tilvis RS, Tobias M, Torheim LE, Trenkwalder P, Tuomilehto JO, Tur JA, Tzourio C, Uhernik AI, Ukoli FA, Unwin N, Hoorn SV, Vanderpump MP, Varo JJ, Veierød MB, Velásquez-Meléndez G, Verschuren M, Viet L, Villalpando S, Vioque J, Vollenweider P, Volpato S, Wang N, Wang YX, Ward M, Waspadji S, Welin LX, Whitlock G, Wilhelmsen L, Willeit J, Woodward M, Wormser D, Xavier AJ, Xu F, Xu L, Yamamoto A, Yang G, Yang X, Yeh LC, Yoon JS, You Q, Yu Z, Zhang J, Zhang L, Zheng W, Zhou M, Ward M.

Abstract

BACKGROUND:

High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010.

METHODS:

We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates.

FINDINGS:

In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10·8 million deaths, 95% CI 10·1-11·5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7·1 million deaths, 6·6-7·6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined effects of these four risk factors surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France, Japan, the Netherlands, Singapore, South Korea, and Spain.

INTERPRETATION:

The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of the 21st century are high blood pressure and an increasing effect of obesity and diabetes. The mortality burden of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the global response to non-communicable diseases.

FUNDING:

UK Medical Research Council, US National Institutes of Health.

PMID:
24842598
PMCID:
PMC4572741
DOI:
10.1016/S2213-8587(14)70102-0
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center