Abstract 21180: Lifetime Risk for Total Cardiovascular Disease by Sex and Risk Factor Burden: Cardiovascular Lifetime Risk Pooling Project
Background: To date, no estimates of the lifetime risk (LTR) for total CVD (tCVD; including coronary heart disease [CHD], CHD death, stroke, and heart failure [HF]) have been reported.
Methods: We used data from the NHLBI's limited access datasets from the Framingham Heart, Framingham Offspring, Atherosclerosis Risk in Communities, and Cardiovascular Health Studies, and internal data from the Chicago Heart Association Detection Project in Industry. Findings from the different cohorts were remarkably similar, so we pooled participants and performed individual-level analyses. We stratified men and women into 5 mutually exclusive categories based on risk factor (RF) burden (including blood pressure and cholesterol levels, smoking and diabetes status) measured at or near index ages 45 and 55 years. Lifetime risks were estimated with death free of any CVD as a competing event.
Results: At index age 45 years, there were 24,031 men and 25,459 women followed for 905,114 person-years; 15,152 CVD events and 20,042 CVD-free deaths occurred. Overall LTR for total CVD to age 95 was 60.3% (95% CI, 59.3-61.2%) for men and 56.3% (54.5-56.7%) for women. Prior studies that excluded HF estimated the LTR for atherosclerotic CVD to be 50% for men and 40% for women. LTR estimates for total CVD to age 85, stratified by RF burden at age 45, are shown in the Table. Results were similar at index age 55 years, and the effect of RF burden was similar for blacks and whites at both ages.
Discussion: Lifetime risk for total CVD to age 95 is remarkably high, at approximately 60% for both men and women. Traditional risk factor burden in middle age is highly correlated with remaining lifetime risk for total CVD. Compared to prior studies that did not include HF, the present data suggest that HF contributes importantly to overall lifetime risk for total CVD. These results underscore the significant public health burden of total CVD and the importance of primordial prevention of traditional risk factors.
- © 2010 by American Heart Association, Inc.