The absolute cardiovascular disease burden in Asia has sharply increased despite declines in the age-standardized disability-adjusted life years (DALYs) and age-standardized mortality rate, according to an analysis using data from the Global Burden of Disease (GBD) 2021 study published Nov. 7 in JACC: Asia. Risk factor profiles and regional disparities in cardiovascular disease burden highlight the need for targeted interventions.

Using the data from the multinational, collaborative GBD study, Yuxin Zhang, et al., estimated the prevalence, DALYs and cardiovascular disease mortality from 1990 to 2021 across six Asian regions, age groups and sex. Of note, 27 environmental, behavioral and metabolic risk factors were examined.

The analysis showed that Asia accounted for 270 million DALYs and 12 million cardiovascular disease-related deaths in 2021, which represents 61% of global cardiovascular disease mortality. Additionally, the age-standardized DALYs rate (ASDR) exceeded the global average by 8%, and the ASDR was lowest in the high-income Asia Pacific region and highest in Central Asia among the six included Asian regions.

ASDR and age-standardized mortality rates declined by 28% and 25%, respectively, and age-standardized prevalence increased by 72%. Ischemic heart disease and stroke collectively contributed to more than 80% of cardiovascular disease-related deaths. Of note, high systolic blood pressure is the leading risk factor and particulate pollution a leading contributor to Asia’s cardiovascular disease burden.

Zhang and colleagues refer to cardiovascular disease in Asia as a “major public health issue and a growing health challenge.” They emphasize that “public health policies should focus on addressing the rising prevalence of metabolic risk factors, improving air quality and promoting healthier lifestyles to mitigate the burden of [cardiovascular disease] in Asia.”

Citation: Zhang Y, Deng, Q, Hu P. et al. Burden and risk factors of cardiovascular diseases in asia, 1990–2021: an analysis for GBD 2021. JACC: Asia. Published online Nov. 7, 2025. Doi: https://doi.org/10.1016/j.jacasi.2025.08.024

Clinical Topics: Cardiovascular Care Team

Keywords: Asia, Global Health, Global Burden of Disease, Air Pollution, Public Health