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

Abstract

Summary Background Elevated blood pressure and glucose, serum cholesterol, and body mass index (BMI) are risk factors for cardiovascular diseases (CVDs); some of these factors also increase the risk of chronic kidney disease (CKD) and diabetes. We estimated CVD, CKD, and diabetes mortality attributable to these four cardio-metabolic risk factors for all countries and regions between 1980 and 2010. Methods We used data on risk factor exposure by country, age group, and sex from pooled analysis of population-based health surveys. Relative risks for cause-specific mortality were obtained from pooling of large prospective studies. We calculated the population attributable fractions (PAF) for each risk factor alone, and for the combination of all risk factors, accounting for multi-causality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific PAFs by the number of disease-specific deaths from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all inputs to the final estimates. Findings In 2010, high blood pressure was the leading risk factor for dying from CVDs, CKD, and diabetes in every region, causing over 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths; and cholesterol for 10%. After accounting for multi-causality, 63% (10.8 million deaths; 95% confidence interval 10.1–11.5) of deaths from these diseases 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 between 1980 and 2010. At the country level, age-standardised death rates attributable to these four risk factors surpassed 925 deaths per 100,000 among men in Belarus, Mongolia, and Kazakhstan, but were below 130 deaths per 100,000 for women and below 200 for men in some high-income countries like Japan, Singapore, South Korea, France, Spain, The Netherlands, Australia, and Canada. Interpretations The salient features of the cardio-metabolic epidemic at the beginning of the twenty-first century are the large role of high blood pressure and an increasing impact of obesity and diabetes. There has been a shift in the mortality burden from high-income to low- and middle-income countries.

Retracted: Worldwide burden of cancer attributable to diabetes and high body-mass index: a comparative risk assessment

“…Our PAF analysis quantified the proportion and number of cancer cases that would be averted if diabetes and high BMI prevalence were reduced to optimal levels. However, if the cancer burden of diabetes and high BMI is removed, these risks could lead to populations developing other disorders such as cardiovascular disease and chronic kidney disease as quantified elsewhere 42 . Finally, we assumed an optimal diabetes prevalence of zero, and achieving a prevalence of less than 1% might not be feasible 22 .…”

Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants

“…Diabetes and its macrovascular and microvascular complications account for more than 2 million deaths every year, 1 and are the seventh leading cause of disability worldwide 53 . Diabetes is also a risk factor for tuberculosis, another disease with large burden in low-income and middle-income countries 54 .…”

“…Diabetes is an important cause of mortality, morbidity, and health-system costs in the world 1, 2. Therefore, there is an urgent need to implement population-based interventions that prevent diabetes, enhance its early detection, and use lifestyle and pharmacological interventions to prevent or delay its progression to complications.…”

Correlation Between Endothelial Dysfunction and Left Ventricular Remodeling in Patients with Chronic Kidney Disease

“…Cardiovascular disease continues to be a common complication and be the leading cause of morbidity and mortality among people with CKD [13]. The rates of cardiovascular events and mortality consistently increase as kidney function declines [14]. Approximately 50% of patients die from these lesions.…”