Nine potentially modifiable risk factors collectively accounted for 90% of the population attributable risk of myocardial infarction in men and 94% in women worldwide.
Do nine potentially modifiable risk factors account for the majority of the risk of acute myocardial infarction globally?
29,972 individuals (15,152 cases of acute myocardial infarction and 14,820 controls) from 52 countries representing every inhabited continent.
Presence of 9 potentially modifiable risk factors (smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, lack of daily fruits/vegetables, lack of regular alcohol, lack of regular physical activity, raised ApoB/ApoA1 ratio).
Absence or lower levels of these risk factors (e.g., never smoking, lowest quintile of ApoB/ApoA1 ratio).
Acute myocardial infarction.hard clinical
Nine potentially modifiable risk factors account for over 90% of the population attributable risk of acute myocardial infarction globally across both sexes and all ages.
SummaryBackgroundAlthough more than 80% of the global burden of cardiovascular disease occurs in low-income and middle-income countries, knowledge of the importance of risk factors is largely derived from developed countries. Therefore, the effect of such factors on risk of coronary heart disease in most regions of the world is unknown.MethodsWe established a standardised case-control study of acute myocardial infarction in 52 countries, representing every inhabited continent. 15152 cases and 14820 controls were enrolled. The relation of smoking, history of hypertension or diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol, blood apolipoproteins (Apo), and psychosocial factors to myocardial infarction are reported here. Odds ratios and their 99% CIs for the association of risk factors to myocardial infarction and their population attributable risks (PAR) were calculated.FindingsSmoking (odds ratio 2·87 for current vs never, PAR 35·7% for current and former vs never), raised ApoB/ApoA1 ratio (3·25 for top vs lowest quintile, PAR 49·2% for top four quintiles vs lowest quintile), history of hypertension (1·91, PAR 17·9%), diabetes (2·37, PAR 9·9%), abdominal obesity (1·12 for top vs lowest tertile and 1·62 for middle vs lowest tertile, PAR 20·1% for top two tertiles vs lowest tertile), psychosocial factors (2·67, PAR 32·5%), daily consumption of fruits and vegetables (0·70, PAR 13·7% for lack of daily consumption), regular alcohol consumption (0·91, PAR 6·7%), and regular physical activity (0·86, PAR 12·2%), were all significantly related to acute myocardial infarction (pInterpretationAbnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity account for most of the risk of myocardial infarction worldwide in both sexes and at all ages in all regions. This finding suggests that approaches to prevention can be based on similar principles worldwide and have the potential to prevent most premature cases of myocardial infarction.Published online September 3, 2004 http://image.thelancet.com/extras/04art8001web.pdf
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Salim Yusuf
Steven Hawken
Stephanie Ôunpuu
The Lancet
Population Health Research Institute
Hamilton General Hospital
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Yusuf et al. (Wed,) reported a other. Nine potentially modifiable risk factors collectively accounted for 90% of the population attributable risk of myocardial infarction in men and 94% in women worldwide.
www.synapsesocial.com/papers/69d56c2775589c71d767cc32 — DOI: https://doi.org/10.1016/s0140-6736(04)17018-9