Abstract
Purpose of Review
The last 2–3 decades have witnessed a decline in age-standardized cardiovascular mortality rates in high-income regions, whereas this has only slightly decreased or even increased in most of the low- and middle-income countries. A systematic comparison of global CVD mortality by regions attributable to various modifiable risk factors such as diabetes, obesity, hypertension, poor diet, and physical inactivity is not available.
Recent Findings
We present a summary of time trends and heterogeneity in the distribution of global CVD mortality and the attribution of risk factors between 1990 and 2017 using the Global Burden of Disease (GBD) 2017 study. Globally, an estimated ~ 17.8 million (233.1 per 100,000) people died of CVD in 2017. The rate of CVD death was decreased in high-income countries (1990: 271.8 (95% UI (uncertainty interval), 270.9–273.5); 2017: 128.5 (95% UI, 126.4–130.7) per 100,000)) whereas it remained the same in lower- and middle-income countries (1990: 368.2 (95% UI, 335.6–383.3); 2017: 316.9 (95% UI, 307.0–325.5) per 100,000). Among the various traditional risk factors, high systolic blood pressure, unhealthy diet, high fasting plasma glucose, and high low-density lipoprotein levels were attributed to most of the CVD death and disability-adjusted life year lost. We also observed gender variations in tobacco and increased alcohol consumption. In addition to the traditional risk factors, poor air quality is associated with increased CVD burden in developing countries.
Summary
Surveillance, country-specific guidelines, evidence-based policies, reinforcement of multisectoral health systems, and innovative solutions are urgently needed in resource-challenged settings to curb CVD risk factors and overall burden.
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Abbreviations
- NCD:
-
Non-communicable diseases
- CVD:
-
Cardiovascular diseases
- HIC:
-
High-income countries
- LMIC:
-
Low-middle income countries
- WHO:
-
World Health Organization
- GBD:
-
Global Burden of Diseases
- UI:
-
Uncertainty intervals
- DALYs:
-
Disability-adjusted life years
- CRA:
-
Comparative risk assessment
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Acknowledgments
Research reported in this publication was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under award numbers: R01HL125442 (KMVN, JR, MKA) and U01HL138635 (SAP, KMVN) and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award number P30DK111024 (SAP, MKA, KMVN). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Jagannathan, R., Patel, S.A., Ali, M.K. et al. Global Updates on Cardiovascular Disease Mortality Trends and Attribution of Traditional Risk Factors. Curr Diab Rep 19, 44 (2019). https://doi.org/10.1007/s11892-019-1161-2
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DOI: https://doi.org/10.1007/s11892-019-1161-2