Researchers analyzed data from 133 countries from 1990 to 2015. Ten different causes of CVD-related deaths were reviewed, including ischemic stroke, ischemic heart disease, and hemorrhagic and other stroke.
Disability-adjusted life-years were also analyzed, which combined data on years of life lost and years lived with disability. The researchers developed a sociodemographic index to measure changes in CVD burden as global epidemiologic changes occurred.
An estimated 422.7 million cases of CVD were seen globally in 2015 (95% uncertainty interval [UI], 415.53 million-427.87 million). CVD-related deaths increased from 12.59 million in 1990 (95% UI, 12.38 million-12.8 million) to 17.92 million in 2015 (95% UI, 17.59 million-18.28 million).
After age adjustment, numerous countries did not show significant changes in the prevalence of CVD from 1990 to 2015, which may have been due to minimal data availability. CVD significantly declined after age adjustment in countries such as the United States, Canada, Australia, Brazil, Japan, New Zealand, South Korea, Cambodia, Kenya, India, Laos and those in Western Europe. CVD mortality typically declined in high-income regions, but has leveled out recently, according to the researchers.
These findings provide a much-needed global perspective on CVD prevalence and mortality. It is striking that although CVD mortality rates have generally declined in the last decade in the United States, this seems to be a phenomenon limited to well-developed, high-income populations. Most of the world, including Central Asia and Oceania, continue to have a significant burden of mortality related to CVD. These findings should spur the medical community to look outside of our own “home” and refocus our efforts on battling the global public health burden of CVD.Better access to health care and lifesaving and sustaining treatments, especially for those in disadvantaged regions, is certainly one strategy that can help reverse the negative trends in the developing world.Obesity, which is growing to be a global epidemic rather than just one localized to North America or well-developed countries, is probably the No. 1 health concern that will slow down our progress in prevention and treatment of CVD. Poor nutrition and lack of physical activity continue to be problems in the modern era of technology and fast food. These major risk factors for obesity will continue to drive the obesity epidemic, especially in the developing world.
- Ian J. Neeland, MD, FAHA
Cardiology Today Next Gen Innovator
University of Texas Southwestern Medical Center, Dallas