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Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010 : a comparative risk assessment
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The Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (Including: Cappuccio, Francesco). (2014) Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010 : a comparative risk assessment. The Lancet - Diabetes and Endocrinology, Volume 2 (Number 8). pp. 634-647. doi:10.1016/S2213-8587
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Official URL: http://dx.doi.org/10.1016/S2213-8587(14)70102-0
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 populationbased
health surveys. We obtained relative risks for the eff ects of risk factors on cause-specifi c mortality from metaanalyses
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 eff ects of BMI by
the other three risks. We calculated attributable deaths by multiplying the cause-specifi c population attributable
fractions by the number of disease-specifi c deaths. We obtained cause-specifi c mortality from the Global Burden of
Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the fi nal 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 eff ects 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
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RC Internal medicine | ||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Kidneys -- Diseases -- Mortality, Diabetes -- Mortality, Blood sugar, Hypertension , Blood cholesterol, Body mass index | ||||||
| Journal or Publication Title: | The Lancet - Diabetes and Endocrinology | ||||||
| Publisher: | Lancet Publishing Group | ||||||
| ISSN: | 0140-6736 | ||||||
| Official Date: | August 2014 | ||||||
| Dates: |
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| Volume: | Volume 2 | ||||||
| Number: | Number 8 | ||||||
| Page Range: | pp. 634-647 | ||||||
| DOI: | 10.1016/S2213-8587 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access | ||||||
| Funder: | Medical Research Council (Great Britain) (MRC), National Institutes of Health (U.S.) (NIH) |
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