<div> Multifactorial Cardiovascular Risk Control and All-cause Mortality in Older Adults: A Pooled&nbsp;<span>Cohort Study</span><span>&nbsp;from Costa Rica, Mexico, and the UK</span> </div>

Background: Comprehensive control of cardiovascular risk factors (CVRFs) is a cornerstone of preventive care, yet its combined impact on long-term mortality in older adults across diverse populations remains insufficiently characterised. We aimed to evaluate the association between multifactorial cardiovascular risk control and 10-year all-cause mortality in older adults from three countries. <div> <br> </div> <div> Methods: We conducted a pooled cohort study including 91,990 adults aged 65 years and older from Costa Rica, Mexico, and the UK. Six CVRFs (blood pressure, lipids, glycaemic status, body-mass index, smoking, and physical activity) were assessed and categorised as controlled or not controlled. Participants were grouped according to the number of controlled CVRFs (0–5). The primary outcome was 10-year all-cause mortality. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95% CIs. </div> <div> <br> </div> <div> Findings: During follow-up, 14,440 (15·7%) deaths occurred. A graded inverse association was observed between the number of controlled CVRFs and mortality risk. Compared with participants with no controlled factors, adjusted HRs were 0·86 (95% CI 0·79–0·93) for one factor, 0·75 (0·69–0·81) for two, 0·64 (0·59–0·69) for three, 0·56 (0·51–0·62) for four, and 0·41 (0·34–0·50) for five controlled factors. Among individual components, physical activity (HR 0·80, 95% CI 0·76–0·84) and non-smoking (0·81, 0·79–0·84) showed the strongest associations with lower mortality risk, whereas lipid control was not associated with reduced risk. </div> <div> <br> </div> <div> Interpretation: Greater multifactorial control of cardiovascular risk factors is strongly and progressively associated with lower mortality in older adults. These findings support integrated prevention strategies that simultaneously target multiple risk factors to improve survival in ageing populations.&nbsp; </div>

Duke Scholars

Author Gabriel Torrealba-Acosta Neurology, Neurocritical Care