American College of Cardiology Releases Global Report on Cardiovascular Disease Burden

Gregory Roth, MD, MPH

The American College of Cardiology has released a special “almanac-style” issue of their flagship journal they hope will bring new attention to troubling trends related to the global burden of cardiovascular disease.

Published on December 12, the special issue of the journal of the American College of Cardiology shines a spotlight on 18 specific cardiovascular conditions and 15 risk factors across 21 global regions to provide clinicians and the general public with a more complete overview of burden cardiovascular disease is placing on health systems and societies across the globe, with the document serving as an update to their previous iteration, titled “The Global Burden of Diseases, Injuries, and Risk Factors Study 2019”.

“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 statement announcing the report. “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.”

A product of the Global Burden of Cardiovascular Diseases Collaboration, which is an alliance between JACC, the Institute for Health Metrics and Evaluation, and the National Heart, Lung, and Blood Institute, the report clocks in at 54 pages in length and boasts reports related to cardiovascular disease burden for 21 distinct regions, with these regions defined by location and further stratified according to income. The report itself was created by using vital and sample registration data. Within the report is estimates for the leading 15 environmental, metabolic, and behavioral risks of cardiovascular disease. Additionally, the report breaks down cardiovascular disease mortality rates, 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.

In the aforementioned statement, the ACC called attention to 6 specific trends within the report they deemed noteworthy. These 6 are listed below:

• Ischemic heart disease is the leading cause of cardiovascular death, accounting for 9.44 million deaths in 2021 and 185 million DALYs.
• High systolic blood pressure remains the leading modifiable risk factor for premature cardiovascular deaths, accounting for 10.8 million CV deaths and 11.3 million deaths overall in 2021. The all-cause DALYs due to high blood pressure were 2,770 per 100,000 people.
• Dietary risks accounted for 6.58 million CV deaths and 8 million deaths overall in 2021. Dietary risks include food types that are under-consumed globally (fruits, vegetables, legumes, whole grains, nuts and seeds, milk, fiber, calcium, omega-3 fatty acids and poly unsaturated fatty acids) and over-consumed (red and processed meats, sugar-sweetened beverages, trans-fatty acids and sodium). All-cause DALYs due to dietary risks were 2,340 per 100,000 people.
• Central Asia, Central Sub-Saharan Africa and Eastern Europe were the regions with the highest rates of CVD burden attributable to elevated systolic blood pressure. The regions with the highest rates of CVD burden attributable to dietary risk were Central Asia, Oceania and Eastern Europe.
• Central Asia had the highest age-standardized total CVD mortality at 516.9 deaths per 100,000. In contrast, high-income Asia Pacific had the lowest age-standardized total CVD mortality at 76.6 deaths per 100,000 people.
• Since 1990, Australasia had the largest percent reduction (64.2%) in age-standardized CVD per 100,000 out of all other regions. This percent decrease was highest in ischemic heart disease at 71.8%.

“It is truly exciting to see this multi-year Global Burden of Cardiovascular Diseases Collaboration culminate into a dedicated issue of the Journal to inform the global cardiovascular community,” said Valentin Fuster, MD, PhD, an author of the paper, director of Mount Sinai Heart, physician-in-chief of The Mount Sinai Hospital and editor-in-chief of JACC. “This issue focuses both on the modifiable risk factors, as well as the global cardiovascular disease and death rates in 21 regions across the world.”

This special report, titled “Global Burden of Cardiovascular Diseases and Risks Collaboration,” was published in the Journal of the American College of Cardiology.