Abstract 3666: Remaining Lifetime Risks for Cardiovascular Disease Death by Risk Factor Burden at Selected Ages in Black and White Men and Women

BACKGROUND: Although the effect of risk factor (RF) burden at age 50 years has been reported, the effect of RF burden measured at other ages on lifetime risk for cardiovascular diseases (CVD) is unknown and no data are available for non-whites. METHODS: Using limited access data from the National Heart Lung and Blood Institute, we pooled participants from the Framingham Heart Study, the Framingham Offspring Study, the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, and the Chicago Heart Association Detection Project in Industry with RFs measured at or near ages 45, 55, and 65 years for blacks and whites separately in sex-stratified analyses. Blood pressure and cholesterol levels, smoking, and diabetes status were used to stratify the pooled cohort into 5 risk strata. Lifetime risks for CVD events to 85 years of age were estimated for men and women, with death free of CVD as a competing event. RESULTS: We included 21,534 men (15.7% black) and 24,063 women (9.3% black) who were followed for 651,144 person-years. With more adverse levels of single risk factors, lifetime risks were greater for both men and women in both races. Compared with white participants with ≥2 major RFs, those with all optimal RF levels had substantially lower lifetime risks (see Table ). There was a similar pattern of results observed in blacks for lifetime risks for CVD death. Additional analyses of the endpoints of fatal/non-fatal coronary heart disease and fatal/non-fatal stroke revealed a similar pattern of results. CONCLUSIONS: Remaining lifetime risks for CVD are dramatically higher with greater RF burden at all ages studied. The absence of established RFs is associated with very low remaining lifetime risk for CVD, particularly for men and women at age 65 years.