Written by Babatunde Carew
Spoon Feed
Absence of five modifiable cardiovascular risk factors in midlife is associated with over a decade of additional life expectancy and cardiovascular disease (CVD) free years.
Decades of life gained by managing five key CVD risk factors
CVD prevention remains critical as CVD is the leading cause of death globally, driving substantial morbidity, mortality, and healthcare costs. This global cohort study pooled data from over 2 million adults across 133 cohorts to assess how five modifiable CVD risk factors (hypertension, hyperlipidemia, diabetes, smoking, and abnormal BMI) influence lifetime risk of CVD and all-cause mortality. At age 50, absence of all risk factors was associated with 10.6-13.3 additional CVD free years, and 11.8–14.5 additional years of life. Participants aged 50-55 who improved hypertension or quit smoking by age 60 gained the most additional life-years. The study’s observational design limits its ability to determine causality, but findings suggest substantial gains from risk factor modification.
How does this change my practice?
This study reinforces my current approach of aggressively modifying cardiovascular risk factors while also offering practical guidance for patients who are treatment resistant or hesitant to adopt lifestyle changes. It helps clarify which interventions – particularly targeting hypertension and smoking – are likely to yield the greatest impact, allowing for more focused, high-yield counseling in challenging encounters.
Source
Global Effect of Cardiovascular Risk Factors on Lifetime Estimates. N Engl J Med. 2025 Mar 30. doi: 10.1056/NEJMoa2415879. Epub ahead of print. PMID: 40162648
