Global Trends in Cardiovascular Health

Cardiovascular disease is the leading cause of death worldwide; High blood pressure, high cholesterol, dietary risks and air pollution are the leading causes of cardiovascular diseases worldwide

Cardiovascular disease (CVD) remains the leading cause of death worldwide, according to a new special issue of the Journal of the American College of Cardiology (JACC).

The issue analyzes 18 specific cardiovascular conditions and 15 risk factors across 21 global regions to provide a broad view of the global burden of cardiovascular disease. While CVD rates are high globally, Central Asia and Eastern Europe were estimated to have the highest CVD mortality rates. High blood pressure, high cholesterol, dietary risks and air pollution were the leading causes of CVD worldwide.

The Global Burden of Cardiovascular Disease Collaborative is a partnership between JACC, the Institute for Health Metrics and Evaluation, and the National Heart, Lung, and Blood Institute. Serving as an update to "The Global Burden of Diseases, Injuries, and Risk Factors Study 2019," the 2022 publication includes data from 204 countries and territories, highlighting the main global modifiable cardiovascular risk factors, their contribution to the burden of disease and recent advances in prevention.

“We need to continue to shed light on the current state of cardiovascular health around the world. Cardiovascular health has a major impact on our quality of life and the overall health care system,” said Gregory A. Roth, MD, MPH, senior author of the paper and associate professor in the Division of Cardiology and director of the Program in Cardiovascular Health Metrics at the Institute for Health Metrics and Evaluation at the University of Washington. “More than 80% of cardiovascular diseases can be prevented. With this update, we are measuring some alarming global trends and reviewing current interventions that can help countries make good evidence-based decisions for their health systems.”

This special report evaluated deaths using vital registration and specimen data and produced estimates for 15 major environmental (air pollution, household air pollution, lead exposure, low temperature, high temperature), metabolic (blood pressure, systolic, LDL cholesterol, body mass index). , fasting plasma glucose, renal dysfunction) and behavioral (diet, smoking, secondhand smoke, alcohol consumption, physical activity) risks of cardiovascular diseases.

CVD mortality rates are broken down by location, along with age, sex, and time categories since 1990. The report also looked at disability-adjusted life years (DALY), years of life lost due to premature mortality (YLL ) and years lived with disability (YLD).

"It’s really exciting to see this multi-year Global Burden of Cardiovascular Disease Collaboration culminate in a dedicated issue of the journal to inform the global cardiovascular community," said paper author Valentin Fuster, MD, PhD, director of Mount Sinai Heart, physician-in-chief of Mount Sinai Hospital and editor-in-chief of JACC. “This issue focuses on both modifiable risk factors and global rates of cardiovascular disease and mortality in 21 regions around the world.”

Key points from the report:

Ischemic heart disease is the leading cause of cardiovascular death, with 9.44 million deaths in 2021 and 185 million DALYs.
High systolic blood pressure remains the leading modifiable risk factor for premature cardiovascular deaths, accounting for 10.8 million CV deaths and 11.3 million overall deaths in 2021. All-cause DALYs due to high blood pressure high blood pressure were 2,770 per 100,000 people.
Dietary risks accounted for 6.58 million CV deaths and 8 million overall deaths in 2021. Dietary risks include types of foods that are under-consumed globally (fruits, vegetables, legumes, whole grains, nuts and seeds, milk, fiber, calcium, omega-3 fatty acids and polyunsaturated fatty acids) and with excessive consumption (red and processed meats, sugary drinks, trans fatty acids and sodium). All-cause DALYs due to dietary risks were 2340 per 100,000 people.
Central Asia, Central Sub-Saharan Africa, and Eastern Europe were the regions with the highest rates of CVD burden attributable to elevated systolic blood pressure. The regions with the highest rates of CVD burden attributable to dietary risk were Central Asia, Oceania, and Eastern Europe.
Central Asia had the highest age-standardized total CVD mortality with 516.9 deaths per 100,000. In contrast, high-income Asia Pacific had the lowest age-standardized total CVD mortality with 76.6 deaths per 100,000 people.
Since 1990, Australasia had the largest percentage reduction (64.2%) in age-standardized CVD per 100,000 of all other regions. This percentage decrease was highest in ischemic heart disease at 71.8%.

“This visual atlas serves as a timely reminder about the importance of modifiable risk factors for heart disease, such as high blood pressure,” said George A. Mensah, MD, author of the paper and director of the Center for Heart Disease Research. Translation and Implementation Science at the National Heart, Lung, and Blood University. Institute. “Deaths from hypertension have steadily increased in the U.S. over the past 20 years, mirroring trends in other regions and leaving researchers eager to find practical, innovative solutions.”

"Of real concern is the finding that high blood pressure control rates have progressively declined in the US over the past decade," he added.

Global Trends in Cardiovascular Health

Ischemic heart disease emerges as the leading cause of cardiovascular-related deaths worldwide, highlighting the urgent need for preventive strategies.