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Journal Article•DOI•

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

Stephen S Lim1, Theo Vos, Abraham D. Flaxman1, Goodarz Danaei2  +207 more•Institutions (92)
15 Dec 2012-The Lancet (Elsevier)-Vol. 380, Iss: 9859, pp 2224-2260
TL;DR: In this paper, the authors estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010.
About: This article is published in The Lancet.The article was published on 2012-12-15 and is currently open access. It has received 9324 citations till now. The article focuses on the topics: Disease burden & Risk factor.

Summary (1 min read)

Jump to: [Convincing evidence] – [Probable evidence] – [Possible evidence] and [Insufficient evidence]

Convincing evidence

  • Evidence based on epidemiological studies showing consistent associations between exposure and disease, with little or no evidence to the contrary.
  • The available evidence is based on a substantial number of studies including prospective observational studies and where relevant, randomised controlled trials of sufficient size, duration, and quality showing consistent effects.

Probable evidence

  • Evidence based on epidemiological studies showing fairly consistent associations between exposure and disease, but for which there are perceived shortcomings in the available evidence or some evidence to the contrary, which precludes a more definite judgment.
  • Shortcomings in the evidence may be any of the following: insufficient duration of trials (or studies); insufficient trials (or studies) available; inadequate sample sizes; or incomplete follow-up.

Possible evidence

  • Evidence based mainly on findings from case-control and cross-sectional studies.
  • Insufficient randomised controlled trials, observational studies, or non-randomised controlled trials are available.
  • Evidence based on non-epidemiological studies, such as clinical and laboratory investigations, is supportive.
  • More trials are needed to support the tentative associations, which should be biologically plausible.

Insufficient evidence

  • Evidence based on findings of a few studies which are suggestive, but insufficient to establish an association between exposure and disease.
  • Burden of disease attributable to individual risk factors are shown sequentially for ease of presentation.

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Citations
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Journal Article•DOI•
Blood-Pressure Lowering in Intermediate-Risk Persons without Cardiovascular Disease

[...]

Eva Lonn1, Eva Lonn2, Jackie Bosch1, Jackie Bosch2, Patricio Lopez-Jaramillo, Jun Zhu3, Lisheng Liu3, Prem Pais4, Rafael Diaz, Denis Xavier4, Karen Sliwa5, Antonio L. Dans6, Alvaro Avezum, Leopoldo S. Piegas, Katalin Keltai7, Matyas Keltai7, Irina Chazova, Ron J.G. Peters8, Claes Held9, Khalid Yusoff10, Basil S. Lewis11, Petr Jansky12, Petr Jansky1, Alexander Parkhomenko13, Kamlesh Khunti7, William D. Toff14, William D. Toff15, Christopher M. Reid16, Christopher M. Reid17, John Varigos16, Lawrence A. Leiter18, Dora I. Molina19, Robert S. McKelvie2, Robert S. McKelvie1, Janice Pogue2, Joanne Wilkinson2, Hyejung Jung2, Gilles R. Dagenais20, Salim Yusuf2, Salim Yusuf1 •
McMaster University1, Population Health Research Institute2, Peking Union Medical College3, St. John's University4, University of Cape Town5, University of the Philippines Manila6, Semmelweis University7, University of Amsterdam8, Uppsala University9, UCSI University10, Technion – Israel Institute of Technology11, Charles University in Prague12, National Academy of Sciences of Ukraine13, University of Leicester14, Glenfield Hospital15, Monash University16, Curtin University17, University of Toronto18, University of Caldas19, Laval University20
02 Apr 2016-The New England Journal of Medicine
TL;DR: Therapy with candesartan at a dose of 16 mg per day plus hydrochlorothiazide at a doses of 12.5mg per day was not associated with a lower rate of major cardiovascular events than placebo among persons at intermediate risk who did not have cardiovascular disease.
Abstract: BackgroundAntihypertensive therapy reduces the risk of cardiovascular events among high-risk persons and among those with a systolic blood pressure of 160 mm Hg or higher, but its role in persons at intermediate risk and with lower blood pressure is unclear. MethodsIn one comparison from a 2-by-2 factorial trial, we randomly assigned 12,705 participants at intermediate risk who did not have cardiovascular disease to receive either candesartan at a dose of 16 mg per day plus hydrochlorothiazide at a dose of 12.5 mg per day or placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke; the second coprimary outcome additionally included resuscitated cardiac arrest, heart failure, and revascularization. The median follow-up was 5.6 years. ResultsThe mean blood pressure of the participants at baseline was 138.1/81.9 mm Hg; the decrease in blood pressure was 6.0/3.0 mm Hg greater in the active-treatment group than in the placebo...

512 citations

Journal Article•DOI•
Central blood pressure: current evidence and clinical importance

[...]

Carmel M. McEniery1, John R. Cockcroft2, Mary J. Roman3, Stanley S. Franklin4, Ian B. Wilkinson1 •
University of Cambridge1, The Heart Research Institute2, Cornell University3, University of California, Irvine4
07 Jul 2014-European Heart Journal
TL;DR: Emerging evidence now suggests that central pressure is better related to future cardiovascular events than is brachial pressure, and basing treatment decisions on central pressure, is likely to have important implications for the future diagnosis and management of hypertension.
Abstract: Pressure measured with a cuff and sphygmomanometer in the brachial artery is accepted as an important predictor of future cardiovascular risk. However, systolic pressure varies throughout the arterial tree, such that aortic (central) systolic pressure is actually lower than corresponding brachial values, although this difference is highly variable between individuals. Emerging evidence now suggests that central pressure is better related to future cardiovascular events than is brachial pressure. Moreover, anti-hypertensive drugs can exert differential effects on brachial and central pressure. Therefore, basing treatment decisions on central, rather than brachial pressure, is likely to have important implications for the future diagnosis and management of hypertension. Such a paradigm shift will, however, require further, direct evidence that selectively targeting central pressure, brings added benefit, over and above that already provided by brachial artery pressure.

508 citations

Journal Article•DOI•
Ambient air pollution and low birthweight: a European cohort study (ESCAPE)

[...]

Marie Pedersen1, Lise Giorgis-Allemand1, Claire Bernard1, Inmaculada Aguilera, Anne-Marie Nybo Andersen2, Ferran Ballester, Rob Beelen3, Leda Chatzi4, Marta Cirach, Asta Danileviciute, Audrius Dedele, Manon van Eijsden, Marisa Estarlich, Ana Fernández-Somoano5, Mariana F. Fernández6, Francesco Forastiere, Ulrike Gehring3, Regina Grazuleviciene, Olena Gruzieva7, Barbara Heude8, Barbara Heude1, Gerard Hoek3, Kees de Hoogh9, Edith H. van den Hooven10, Siri E. Håberg, Vincent W. V. Jaddoe10, Claudia Klümper11, Michal Korek7, Ursula Krämer11, Aitana Lerchundi12, Johanna Lepeule1, Johanna Lepeule13, Per Nafstad14, Wenche Nystad, Evridiki Patelarou15, Evridiki Patelarou4, Daniela Porta, Dirkje S. Postma16, Ole Raaschou-Nielsen, Peter Rudnai17, Jordi Sunyer18, Euripides G. Stephanou4, Mette Sørensen, Elisabeth Thiering, Derek Tuffnell, Mihály J. Varró17, Tanja G. M. Vrijkotte19, Alet H. Wijga20, Michael Wilhelm21, John Wright, Mark J. Nieuwenhuijsen, Göran Pershagen7, Göran Pershagen22, Bert Brunekreef3, Bert Brunekreef23, Manolis Kogevinas, Rémy Slama1 •
French Institute of Health and Medical Research1, University of Copenhagen2, Utrecht University3, University of Crete4, University of Oviedo5, University of Granada6, Karolinska Institutet7, University of Paris-Sud8, Health Protection Agency9, Erasmus University Rotterdam10, University of Düsseldorf11, University of the Basque Country12, Harvard University13, University of Oslo14, Florence Nightingale School of Nursing and Midwifery15, University Medical Center Groningen16, National Institutes of Health17, Pompeu Fabra University18, University of Amsterdam19, Centre for Health Protection20, Ruhr University Bochum21, Stockholm County Council22, University Medical Center Utrecht23
01 Nov 2013-The Lancet Respiratory Medicine
TL;DR: Exposure to ambient air pollutants and traffic during pregnancy is associated with restricted fetal growth and a substantial proportion of cases of low birthweight at term could be prevented in Europe if urban air pollution was reduced.

497 citations

Journal Article•DOI•
Long working hours and risk of coronary heart disease and stroke : a systematic review and meta-analysis of published and unpublished data for 603 838 individuals

[...]

Mika Kivimäki1, Mika Kivimäki2, Markus Jokela1, Solja T. Nyberg3, Archana Singh-Manoux4, Archana Singh-Manoux2, Eleonor I. Fransson5, Eleonor I. Fransson6, Eleonor I. Fransson7, Lars Alfredsson8, Lars Alfredsson7, Jakob B. Bjorner, Marianne Borritz, Hermann Burr9, Annalisa Casini10, Els Clays11, Dirk De Bacquer11, Nico Dragano12, Raimund Erbel13, Goedele A. Geuskens, Mark Hamer2, Wendela E. Hooftman, Irene L. Houtman, Karl-Heinz Jöckel13, Anders Knutsson14, Markku Koskenvuo1, Thorsten Lunau12, Ida E. H. Madsen, Martin L. Nielsen, Maria Nordin15, Maria Nordin5, Tuula Oksanen3, Jan H. Pejtersen, Jaana Pentti3, Reiner Rugulies16, Paula Salo17, Paula Salo3, Martin J. Shipley2, Johannes Siegrist12, Andrew Steptoe2, Sakari Suominen18, Sakari Suominen17, Töres Theorell5, Jussi Vahtera19, Jussi Vahtera3, Jussi Vahtera17, Peter Westerholm20, Hugo Westerlund5, Dermot O'Reilly21, Meena Kumari2, Meena Kumari22, G. David Batty2, G. David Batty23, Jane E. Ferrie2, Jane E. Ferrie24, Marianna Virtanen3 •
University of Helsinki1, University College London2, Finnish Institute of Occupational Health3, French Institute of Health and Medical Research4, Stockholm University5, RMIT University6, Karolinska Institutet7, Stockholm County Council8, Federal Institute for Occupational Safety and Health9, Université libre de Bruxelles10, Ghent University11, University of Düsseldorf12, University of Duisburg-Essen13, Mid Sweden University14, Umeå University15, University of Copenhagen16, University of Turku17, University of Skövde18, Turku University Hospital19, Uppsala University20, Queen's University Belfast21, University of Essex22, University of Edinburgh23, University of Bristol24
31 Oct 2015-The Lancet
TL;DR: Employees who work long hours have a higher risk of stroke than those working standard hours; the association with coronary heart disease is weaker; these findings suggest that more attention should be paid to the management of vascular risk factors in individuals whoWork long hours.

497 citations

Journal Article•DOI•
Production diversity and dietary diversity in smallholder farm households

[...]

Kibrom T. Sibhatu1, Vijesh V. Krishna1, Matin Qaim1•
University of Göttingen1
25 Aug 2015-Proceedings of the National Academy of Sciences of the United States of America
TL;DR: It is suggested that increasing on-farm diversity is not always the most effective way to improve dietary diversity in smallholder households and should not be considered a goal in itself.
Abstract: Undernutrition and micronutrient malnutrition remain problems of significant magnitude in large parts of the developing world. Improved nutrition requires not only better access to food for poor population segments, but also higher dietary quality and diversity. Because many of the poor and undernourished people are smallholder farmers, diversifying production on these smallholder farms is widely perceived as a useful approach to improve dietary diversity. However, empirical evidence on the link between production and consumption diversity is scarce. Here, this issue is addressed with household-level data from Indonesia, Kenya, Ethiopia, and Malawi. Regression models show that on-farm production diversity is positively associated with dietary diversity in some situations, but not in all. When production diversity is already high, the association is not significant or even turns negative, because of foregone income benefits from specialization. Analysis of other factors reveals that market access has positive effects on dietary diversity, which are larger than those of increased production diversity. Market transactions also tend to reduce the role of farm diversity for household nutrition. These results suggest that increasing on-farm diversity is not always the most effective way to improve dietary diversity in smallholder households and should not be considered a goal in itself. Additional research is needed to better understand how agriculture and food systems can be made more nutrition-sensitive in particular situations.

481 citations

References
More filters
Journal Article•DOI•
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.

[...]

William C. Knowler1, Elizabeth Barrett-Connor1, Sarah E. Fowler1, Richard F. Hamman1, John M. Lachin1, Elizabeth A. Walker, David M. Nathan1 •
George Washington University1
07 Feb 2002-The New England Journal of Medicine
TL;DR: In this paper, the authors compared a lifestyle intervention with metformin to prevent or delay the development of Type 2 diabetes in nondiabetic individuals. And they found that the lifestyle intervention was significantly more effective than the medication.
Abstract: Background Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors — elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle — are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes. Methods We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The mean age of the participants was 51 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 34.0; 68 percent were women, and 45 percent were members of minority groups. Results The average follow-up was 2.8 years. The incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively. The lifestyle intervention reduced the incidence by 58 percent (95 percent confidence interval, 48 to 66 percent) and metformin by 31 percent (95 percent confidence interval, 17 to 43 percent), as compared with placebo; the lifestyle intervention was significantly more effective than metformin. To prevent one case of diabetes during a period of three years, 6.9 persons would have to participate in the lifestyle-intervention program, and 13.9 would have to receive metformin. Conclusions Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin.

17,333 citations

Journal Article•DOI•
Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010

[...]

Rafael Lozano1, Mohsen Naghavi1, Kyle J Foreman2, Stephen S Lim1  +192 more•Institutions (95)
15 Dec 2012-The Lancet
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex, using the Cause of Death Ensemble model.

11,809 citations

Journal Article•DOI•
Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies.

[...]

Sarah Lewington, Robert Clarke, Nawab Qizilbash, Richard Peto, Rory Collins 
14 Dec 2002-The Lancet
TL;DR: Throughout middle and old age, usual blood pressure is strongly and directly related to vascular (and overall) mortality, without any evidence of a threshold down to at least 115/75 mm Hg.

9,101 citations

Book•
The global burden of disease: a comprehensive assessment of mortality and disability from diseases injuries and risk factors in 1990 and projected to 2020.

[...]

Christopher J L Murray, Alan D. Lopez
01 Jan 1996
TL;DR: This is the first in a planned series of 10 volumes that will attempt to "summarize epidemiological knowledge about all major conditions and most risk factors" and use historical trends in main determinants to project mortality and disease burden forward to 2020.
Abstract: This is the first in a planned series of 10 volumes that will attempt to "summarize epidemiological knowledge about all major conditions and most risk factors;...generate assessments of numbers of deaths by cause that are consistent with the total numbers of deaths by age sex and region provided by demographers;...provide methodologies for and assessments of aggregate disease burden that combine--into the Disability-Adjusted Life Year or DALY measure--burden from premature mortality with that from living with disability; and...use historical trends in main determinants to project mortality and disease burden forward to 2020." This first volume includes chapters summarizing results from the project as a whole. (EXCERPT)

7,154 citations

Journal Article•DOI•
Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

[...]

Theo Vos, Abraham D. Flaxman1, Mohsen Naghavi1, Rafael Lozano1  +360 more•Institutions (143)
15 Dec 2012-The Lancet
TL;DR: Prevalence and severity of health loss were weakly correlated and age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010, but population growth and ageing have increased YLD numbers and crude rates over the past two decades.

7,021 citations

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Frequently Asked Questions (4)
Q1. What are the contributions mentioned in the paper "A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990—2010: a systematic analysis for the global burden of disease study 2010 author" ?

Lim, Stephen S, Vos, Umer, Shibuya, Shibaya, Kenji, AdairRohani, Heather, Amann, Markus, Anderson, H Ross, Andrews, Kathryn G, Aryee, Martin, Gmel, Gerhard, Graham, Kathryn, Grainger, Rebecca, Grant, Bridget, Gunnell, David, Gutierrez, Hialy R, Hall, Wayne, Hoek, Hans W, Hogan, Anne-Charlson, H Dean, this paper, Nolla, Nissim, Nelson, Paul K 

Shortcomings in the evidence may be any of the following: insufficient duration of trials (or studies); insufficient trials (or studies) available; inadequate sample sizes; or incomplete follow-up. 

The available evidence is based on a substantial number of studies including prospective observational studies and where relevant, randomised controlled trials of sufficient size, duration, and quality showing consistent effects. 

In reality, the burden attributable to different risks overlaps because of multicausality and because the effects of some risk factors are partly mediated throughLim et al.