Global Burden of Cardiovascular Disease, Risk Factors Detailed in New American College of Cardiology Report

“Cardiovascular diseases have collectively remained the leading causes of death worldwide and substantially contribute to loss of health and excess health system costs.” The sentence opens a new report published December 12 as a special issue of the Journal of the American College of Cardiology that provides a comprehensive picture of the global burden of cardiovascular disease (CVD) in all its presentations, estimated as responsbile for 19.1 million deaths in 2020.

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Across the globe the leading causes of CVD are hypertension, hypercholesterolemia, dietary risks, and air pollution, according to the report.

Titled The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health, the report also highlights 88 leading global modifiable CVD risk factors, their contribution to disease burden, and advances in measures to control and prevent them. Authors of the report focus on how these metabolic, behavioral, and environmental risks might be addressed through evidence-based clinical care and policy.

Described as an “almanac”-like publication, the report focuses on 18 specific CV conditions and 15 risk factors across 21 global regions with data gathered from 204 countries and territories. The primary goal for the final compendium is to provide clinicians and the general public with a more complete overview of the burden of CVD on health systems and societies worldwide.

“We need to keep shining a light on the current state of cardiovascular health across the globe. Cardiovascular health has a major impact on our quality of life and the health care system as a whole,” 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, in a statemement from the American College of Cardiology announcing the rerport.

“Over 80% of cardiovascular disease is preventable. With this update, we are measuring some alarming global trends and reviewing the current interventions that can help countries make good, evidence-based choices for their health systems.”

The report is a product of the Global Burden of Cardiovascular Diseases Collaboration, an alliance between JACC, the Institute for Health Metrics and Evaluation, and the National Heart, Lung, and Blood Institute and updates a similar 2019 publication, The Global Burden of Diseases, Injuries, and Risk Factors Study 2019. The almanac format includes more than 50 pages of detailed tables and graphics, making it convenient for clinicians and researchers in various parts of the world to quickly comprehend the disease burden for their region.

Investigators tapped data from 1990-2021 in the GBD study to calculate estimates of CVD prevalence and produce country-level estimates. Deaths were identified using vital and sample registration data. The report breaks down CVD mortality rates by location as well as by age, sex, and time categories since 1990. The analysis also includes disability-adjusted life years (DALYs), the years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) for each region included in report since 1990.

The ACC highlights several takeaways from the report as key:

In the conclusion to the report’s introduction, the authors write: “The Global Burden of Cardiovascular Diseases Collaboration is an ongoing effort to increase the quality and availability of evidence for health decisions.

The accompanying almanac of data on regional and national CVD and risk-related burden may serve as a new resource for those developing effective strategies for disease prevention. Updated estimates on CVD burden and risk factors can guide allocation and prioritization of resources for research, health care, and public health.”

Reference: Vaduganathan M, Mensah G, Turco JV, Fuster V, Roth GA. The global burden of cardiovascular disease and risk. J Am Coll Cardiol. 2022;80:20-27. doi.org/10.1016/j.jacc.2022.11.001