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00925njm 22002777a 4500 dc Danaei, Goodarz author Lu, Yuan author Singh, Gitanjali M. author Carnahan, Emily author Stevens, Gretchen A. author Cowan, Melanie J. author Farzadfar, Farshad author Lin, John K. author Finucane, Mariel M. author Rao, Mayuree author Khang, Young-Ho author Riley, Leanne M. author Mozaff, Dariush author Lim, Stephen S. author Ezzati, Majid author Aamodt, Geir author Abdeen, Ziad author Abdella, Nabila A. author Abdul Rahim, Hanan F. author Addo, Juliet author Aekplakorn, Wichai author Afifi, Mustafa M. author Agabiti-Rosei, Enrico author Salinas, Carlos A. Aguilar author Agyemang, Charles author Ali, Mohammed K. author Ali, Mohamed M. author Al-Nsour, Mohannad author Al-Nuaim, Abdul R. author Ambady, Ramachandran author Di Angelantonio, Emanuele author Aro, Pertti author Azizi, Fereidoun author Babu, Bontha V. author Bahalim, Adil N. author Barbagallo, Carlo M. author Barbieri, Marco A. author Barcelo, Alberto author Barreto, Sandhi M. author Barros, Henrique author Bautista, Leonelo E. author Benetos, Athanase author Bjerregaard, Peter author Bjoerkelund, Cecilia author Bo, Simona author Bobak, Martin author Bonora, Enzo author Botana, Manuel A. author Bovet, Pascal author Breckenkamp, Juergen author Breteler, Monique M. author Broda, Grazyna author Brown, Ian J. author Bursztyn, Michael author de Leon, Antonio Cabrera author Campos, Hannia author Cappuccio, Francesco P. author Capuano, Vincenzo author Casiglia, Edoardo author Castellano, Maurizio author Castetbon, Katia author Cea, Luis author Chang, Chih-Jen author Chaouki, Noureddine author Chatterji, Somnath author Chen, Chien-Jen author Chen, Zhengming author Choi, Jin-Su author Chua, Lily author Cifkova, Renata author Cobiac, Linda J. author Cooper, Richard S. author Corsi, Anna Maria author Costanza, Michael C. author Craig, Cora L. author Dankner, Rachel S. author Dastgiri, Saeed author Delgado, Elias author Dinc, Gonul Horasan author Doi, Yasufumi author Dong, Guang-Hui author Dorsi, Eleonora author Dragano, Nico author Drewnowski, Adam author Eggertsen, Robert author Elliott, Paul author Engeland, Anders author Erem, Cihangir author Esteghamati, Alireza author Fall, Caroline H. author Fan, Jian-Gao author Ferreccio, Catterina author Fezeu, Leopold author Firmo, Joselia O. author Florez, Hermes J. author Fornes, Nelida S. author Fowkes, F. Gerry R. author Franceschini, Guido author Frisk, Fredrik author Fuchs, Flavio D. author Fuller, Eva L. author Getz, Linn author Giampaoli, Simona author Gomez, Luis F. author Gomez-Zumaquero, Juan M. author Graff-Iversen, Sidsel author Grant, Janet F. author Carvajal, Ramiro Guerrero author Gulliford, Martin C. author Gupta, Rajeev author Gupta, Prakash C. author Gureje, Oye author Gutierrez, Hialy R. author Hansen, Tine W. author Hata, Jun author He, Jiang author Heim, Noor author Heinrich, Joachim author Hemmingsson, Tomas author Hennis, Anselm author Herman, William H. author Herrera, Victor M. author Ho, Suzanne author Holdsworth, Michelle author Frisman, Gunilla Hollman author Hopman, Wilma M. author Hussain, Akhtar author Husseini, Abdullatif author Ibrahim, M. Mohsen author Ikeda, Nayu author Jacobsen, Bjarne K. author Jaddou, Hashem Y. author Jafar, Tazeen H. author Janghorbani, Mohsen author Jasienska, Grazyna author Joffres, Michel R. author Jonas, Jost B. author Kadiki, Othman A. author Kalter-Leibovici, Ofra author Kamadjeu, Raoul M. author Kaptoge, Stephen author Karalis, Ioannis author Kastarinen, Mika J. author Katz, Joanne author Keinan-Boker, Lital author Kelly, Paul author Khalilzadeh, Omid author Kiechl, Stefan author Kim, Ki Woong author Kiyohara, Yutaka author Kobayashi, Junji author Krause, Maressa P. author Kubinova, Ruzena author Kurjata, Pawel author Kusuma, Yadlapalli S. author Lam, Tai H. author Langhammer, Arnulf author Lawes, Carlene M. M. author Le, Cai author Lee, Jeannette author Levy-Marchal, Claire author Lewington, Sarah author Li, Yanping author Li, Yuqiu author Lim, T. O. author Lin, Xu author Lin, Cheng-Chieh author Lin, Hsien-Ho author Lind, Lars author Lissner, Lauren author Liu, Xiaoqing author Lopez-Jaramillo, Patricio author Lorbeer, Roberto author Ma, Guansheng author Ma, Stefan author Macia, Francesc author MacLean, David R. author Maggi, Stefania author Magliano, Dianna J. author Makdisse, Marcia author Mancia, Giuseppe author Mannami, Toshifumi author Marques-Vidal, Pedro author Mbanya, Jean Claude N. author McFarlane-Anderson, Norma author Miccoli, Roberto author Miettola, Juhani author Minh, Hoang V. author Miquel, Juan Francisco author Miranda, J. Jaime author Mohamed, Mostafa K. author Mohan, V. author Mohanna, Salim author Mokdad, Ali author Mollentze, Willem F. author Morales, Dante D. author Morgan, Karen author Muiesan, Lorenza M. author Muntoni, Sergio author Nabipour, Iraj author Nakagami, Tomoko author Nangia, Vinay author Nemesure, Barbara author Neovius, Martin author Nerhus, Kjersti A. author Nervi, Flavio author Neuhauser, Hannelore author Nguyen, Minh author Ninomiya, Toshiharu author Noale, Marianna author Oh, Sang W. author Ohkubo, Takayoshi author Olivieri, Oliviero author Oenal, Ayse Emel author Onat, Altan author Orostegui, Myriam author Ouedraogo, Hermann author Pan, Wen-Harn author Panagiotakos, Demosthenes B. author Panza, Francesco author Park, Yongsoo author Passos, Valeria M. A. author Pednekar, Mangesh S. author Pelizzari, Pamela M. author Peres, Marco A. author Perez, Cynthia author Perez-Fernandez, Roman author Pichardo, Rafael author Phua, Hwee Pin author Pistelli, Francesco author Plans, Pedro author Polakowska, Maria author Poulter, Neil author Prabhakaran, Dorairaj author Qiao, Qing author Rafiei, Masoud author Raitakari, Olli T. author Ramos, Luiz R. author Rampal, Sanjay author Rampal, Lekhraj author Rasmussen, Finn author Reddy, Kanala K. R. author Redon, Josep author Revilla, Luis author Reyes-Garcia, Victoria author Roaeid, Ragab B. author Robinson, Carolyn A. author Rodríguez-Artalejo, Fernando author Rojas-Martinez, Rosalba author Ronkainen, Kimmo author Rosero-Bixby, Luis author Roth, Gregory A. author Sachdev, Harshpal S. author Sanchez, Jose R. author Sanisoglu, Selim Y. author Sans, Susana author Sarraf-Zadegan, Nizal author Scazufca, Marcia author Schaan, Beatriz D. author Schapochnik, Norberto author Schelleman, Hedi author Schneider, Ione J. C. author Schooling, C. Mary author Schwarz, Bernhard author Sekuri, Cevad author Sereday, Martha S. author Serra-Majem, Lluis author Shaw, Jonathan author Shera, Abdul S. author Shi, Zumin author Shiri, Rahman author Shu, Xiao Ou author Silva, Diego Augusto Santos author Silva, Egle author Simons, Leon A. author Smith, Margaret author Soederberg, Stefan author Soebardi, Suharko author Solfrizzi, Vincenzo author Sonestedt, Emily author Soysal, Ahmet author Stattin, Paer author Stein, Aryeh D. author Stergiou, George S. author Stessman, Jochanan author Sudo, Akihiro author Suka, Machi author Sundh, Valter author Sundquist, Kristina author Sundstroem, Johan author Swai, Andrew B. author Tai, E-Shyong author Tambs, Kristian author Tesfaye, Fikru author Thomas, George N. author Thorogood, Margaret author Tilvis, Reijo S. author Tobias, Martin author Torheim, Liv E. author Trenkwalder, Peter author Tuomilehto, Jaakko O. author Tur, Josep AAutor/a del sistema sanitario público de las Islas Baleares author Tzourio, Christophe author Uhernik, Ana I. author Ukoli, Flora A. author Unwin, Nigel author Hoorn, Stephen Vander author Vanderpump, Mark P. author Varo, Jose Javier author Veierod, Marit B. author Velasquez-Melendez, Gustavo author Verschuren, Monique author Viet, Lucie author Villalpando, Salvador author Vollenweider, Peter author Volpato, Stefano author Wang, Ningli author Wang, Ya X. author Ward, Mark author Waspadji, Sarwono author Welin, Lennart X. author Whitlock, Gary author Wilhelmsen, Lars author Willeit, Johann author Woodward, Mark author Wormser, David author Xavier, Andre J. author Xu, Fei author Xu, Liang author Yamamoto, Akira author Yang, Gonghuan author Yang, Xiaoguang author Yeh, Li-Chia author Yoon, Jin-Sang author You, Qisheng author Yu, Zhijie author Zhang, Jian author Zhang, Lei author Zheng, Wei author Zhou, Maigeng author 2014-08 Background High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. Methods We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for- each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates. Findings In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10.8 million deaths, 95% CI 10.1-11.5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7.1 million deaths, 6.6-7.6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined effects of these four risk factors surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France, Japan, the Netherlands, Singapore, South Korea, and Spain. Interpretation The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of the 21st century are high blood pressure and an increasing effect of obesity and diabetes. The mortality burden of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the global response to non-communicable diseases. Danaei G, Lu Y, Singh Gitanjali M, Carnahan E, Stevens Gretchen A, Cowan MJ, et al. Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment. Lancet Diabetes Endocrinol. 2014 Aug;2(8):634-47. Epub 2014 May 16. 10.1016/S2213-8587(14)70102-0 2213-8595 2213-8587 Lancet Diabetes & Endocrinology http://hdl.handle.net/20.500.13003/11179 24842598 L373855250 2-s2.0-84906769195 http://hdl.handle.net/20.500.12105/20003 341799900023 Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment