Global burden of cardiovascular diseases and risk factors, 1990–2019

Journal article

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause ofglobal mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden,including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from theGlobal Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to providecomparable and consistent estimates of population health over time, used all available population-level datasources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204countries and territories from 1990 to 2019.Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deathssteadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost alsoincreased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risensteadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95%UI: 93.2 to 111 million) prevalent cases of stroke in 2019.Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues itsdecades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardizedrate of CVD has begun to rise in some locations where it was previously declining in high-income countries.There is an urgent need to focus on implementing existing cost-effective policies and interventions if the worldis to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortalitydue to noncommunicable diseases.

Authors: Roth, GA; Mensah, GA; Johnson, CO; Addolorato, G; Ammirati, E

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: Journal of the American College of Cardiology
• Volume: 76
• Issue: 25
• Pages: 2982-3021
• Publication date: 2020-12-09
• Acceptance date: 2020-11-06
• DOI: 10.1016/j.jacc.2020.11.010
• ISSN: 0735-1097
• Language: English
• Keywords: FFR