Blood pressure, cholesterol, and body weight predict heart attacks and strokes even in people over 85. The research analysed data from more than two million participants across 125 population-based studies worldwide, focusing on 532,221 individuals without prior vascular disease. It mapped how three major risk factors—body mass index, systolic blood pressure, and total cholesterol—relate to death, coronary heart disease, and stroke across age groups from 55 to 85 and older. This matters because doctors lack clear evidence on whether standard cardiovascular risk factors remain useful for guiding preventive treatment in older adults, especially those who are frail or have short life expectancies. The findings show that these risk factors continue to predict cardiovascular outcomes at very old ages, though their relative effects weaken with age. The plots also reveal that very high and very low blood pressure and BMI are linked to excess mortality from non-heart causes in younger groups. If applied, these results could help clinicians identify which older patients would benefit most from tailored interventions—such as blood pressure or cholesterol management—rather than applying one-size-fits-all guidelines. This is fundamental epidemiological research that directly informs clinical decision-making for an ageing population.
View original technical description
Introduction: There is contradictory evidence on several common risk factors linked to preventive interventions in the older population as a whole, and in specific subgroups such as younger healthy groups or the frail groups with short life expectancies. We used the Emerging Risk Factor Collaboration Database (ERFC), which comprises over two million participants from 125 population-based cohort studies conduct across the world. We explored the associations between advancing age and known risk factors for cardiovascular outcomes. Methods: We analysed data from 532,221 individual participants who were involved in the cohort studies included in the ERFC database. We focused on individuals who had no previous vascular disease at baseline and at least one year follow-up. We estimated their risk for 3 core outcomes: death from any causes, cardiovascular heart disease (CHD) or stroke. We grouped individual on the basis of their age, i.e. by 10-year bands from age 55 to 85+ and prepared simple plots to map the association between the three outcomes and selected risk factor, including body mass index (BMI), systolic blood pressure and total cholesterol. Results: body mass index, systolic blood pressure and total cholesterol are predictive of CHD and stroke to very old ages, with relative effects reducing with age. The almost linear increase in CHD risk in most age-groups contrasts with all cause mortality estimates, which suggest excess mortality at the top end of the systolic blood pressure and BMI distributions as well as at the lower end of the distribution in the youngest groups (probably due to non-CHD causes). Conclusions: The plots provide valuable information on modifiable factors that have the greatest potential to impact older people’s health, and on high-risk groups that are more likely to benefit from tailored interventions.
NIHR School for Public Health Research - Public Health
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know