Cardiovascular risk factors: updated worldwide population statistics

Background: Hypertension, low-density lipoprotein (LDL) hypercholesterolemia, diabetes, obesity, smoking and physical inactivity are the six major, independent and modifiable risk factors for ischemic heart disease (IHD). This article provides updated worldwide population statistics for these six factors. Methods: An electronic search was performed in the Global Health Data Exchange (GHDx) registry, using the keywords “high body-mass index” AND “high fasting plasma glucose” AND “high LDL cholesterol” AND “high systolic blood pressure” AND “low physical activity” AND “smoking” combined with “ischemic heart disease” and “deaths”. Results: The absolute number of IHD deaths attributable to each of these six risk factors has increased between 1990–2017. Mortality for high body mass index (BMI) exhibited the sharpest increase (+1.84-fold), followed by high fasting plasma glucose (+1.74-fold), high systolic blood pressure and low physical activity (both +1.48-fold) and high LDL cholesterol (+1.41-fold). The increase of IHD mortality for smoking remained marginal. High systolic blood pressure is responsible for the largest number of deaths for IHD (32.4%), followed by high LDL cholesterol (25.1%), high fasting plasma glucose (15.0%), high BMI (10.8%), smoking (10.7%) and low physical activity (5.9%). In most circumstances, the impact of cardiovascular risk factors on mortality for IHD is similar between genders except for smoking, which has larger impact in men, and low physical inactivity, which exhibits a borderline significantly larger impact in women. The age-related impact on IDH mortality of all factors follows a similar pattern, with curves in men anticipating those in women, and larger impact occurring after 50 years of age. The geographical impact on IDH mortality of all factors is heterogeneous. Conclusions: Targeted healthcare interventions shall be scaled up around this evolving epidemiology.