Global Cardiovascular Disease Burden

Jun 27, 2017
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Authors:
Roth GA, Johnson C, Abajobir A, et al.
Citation:
Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol 2017;70:1-25.
Summary By:
Elizabeth A. Jackson, MD, FACC

Study Questions:

What are the current estimates of cardiovascular disease (CVD) burden?

Methods:

The Global Burden of Disease 2015 study used data from health surveys, prospective cohorts, health system administrative data, and registries across the world to estimate CVD prevalence. CVD mortality was estimated using vital statistics and verbal autopsy data. Years lived with disability were estimated by multiplying prevalence by disability weights. Years of life lost were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index was created for each location based on income per capita, educational attainment, and fertility.

Results:

An estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) occurred in 2015. An estimated 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths) occurred in 2015. Among all high-income countries, declines in age-standardized CVD death rate occurred between 1990 and 2015. Among middle-income countries, declines in CVD death rates were noted in some but not all countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region. Stroke was the second leading cause of CVD health lost. As sociodemographic index increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with a sociodemographic index >0.75.

Conclusions:

The authors concluded that CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high sociodemographic index, but only a gradual decrease or no change in most regions.

Perspective:

The investigators are to be congratulated for combining data from across the globe to provide a detailed picture of CVD. Efforts to provide primary and secondary prevention worldwide are required to reduce the burden of ischemic heart disease, stroke, and peripheral arterial disease.

Keywords: Cardiovascular Diseases, Coronary Artery Disease, Cost of Illness, Life Expectancy, Myocardial Ischemia, Peripheral Arterial Disease, Prevalence, Primary Prevention, Secondary Prevention, Stroke


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