title: Lifetime risks of cardiovascular disease.
abstract: BACKGROUND
  The lifetime risks of cardiovascular disease have not been reported across the age spectrum in black adults and white adults.
  
  
  METHODS
  We conducted a meta-analysis at the individual level using data from 18 cohort studies involving a total of 257,384 black men and women and white men and women whose risk factors for cardiovascular disease were measured at the ages of 45, 55, 65, and 75 years. Blood pressure, cholesterol level, smoking status, and diabetes status were used to stratify participants according to risk factors into five mutually exclusive categories. The remaining lifetime risks of cardiovascular events were estimated for participants in each category at each age, with death free of cardiovascular disease treated as a competing event.
  
  
  RESULTS
  We observed marked differences in the lifetime risks of cardiovascular disease across risk-factor strata. Among participants who were 55 years of age, those with an optimal risk-factor profile (total cholesterol level, <180 mg per deciliter [4.7 mmol per liter]; blood pressure, <120 mm Hg systolic and 80 mm Hg diastolic; nonsmoking status; and nondiabetic status) had substantially lower risks of death from cardiovascular disease through the age of 80 years than participants with two or more major risk factors (4.7% vs. 29.6% among men, 6.4% vs. 20.5% among women). Those with an optimal risk-factor profile also had lower lifetime risks of fatal coronary heart disease or nonfatal myocardial infarction (3.6% vs. 37.5% among men, <1% vs. 18.3% among women) and fatal or nonfatal stroke (2.3% vs. 8.3% among men, 5.3% vs. 10.7% among women). Similar trends within risk-factor strata were observed among blacks and whites and across diverse birth cohorts.
  
  
  CONCLUSIONS
  Differences in risk-factor burden translate into marked differences in the lifetime risk of cardiovascular disease, and these differences are consistent across race and birth cohorts. (Funded by the National Heart, Lung, and Blood Institute.).
authors.affiliation: University of Texas Southwestern Medical Center, Department of Medicine, Division of Cardiology, Dallas, USA.
authors.forename: Jarett D
authors.initials: JD
authors.lastname: Berry
authors.forename: Alan
authors.initials: A
authors.lastname: Dyer
authors.forename: Xuan
authors.initials: X
authors.lastname: Cai
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Garside
authors.forename: Hongyan
authors.initials: H
authors.lastname: Ning
authors.forename: Avis
authors.initials: A
authors.lastname: Thomas
authors.forename: Philip
authors.initials: P
authors.lastname: Greenland
authors.forename: Linda
authors.initials: L
authors.lastname: Van Horn
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.forename: Donald M
authors.initials: DM
authors.lastname: Lloyd-Jones
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology; D015988:Cohort Effect; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People