Despite claiming a staggering 17.9 million lives globally in 2019, cardiovascular disease is often a silent and preventable threat that connects us all.
Key Takeaways
- In 2019, cardiovascular diseases (CVDs) caused 17.9 million deaths worldwide, equivalent to 32% of all global deaths
- Globally, 38% of premature deaths due to CVDs occur before the age of 70
- Of the 17.9 million CVD deaths in 2019, 85% were due to heart attack and stroke
- Global DALYs from CVD reached 520 million in 2019
- Nearly 523 million people worldwide were living with CVD in 2019
- Heart failure prevalence is 1-2% in general adult population, rising to 10% over age 70
- In women, 44% of CVD burden is attributable to behavioral risks
- Smoking causes 1.74 million CVD deaths yearly worldwide
- High body-mass index led to 5 million CVD deaths in 2019
- Statins reduce CVD events by 25% per 1 mmol/L LDL reduction
- Aspirin reduces CVD mortality by 23% in secondary prevention
- Blood pressure lowering reduces stroke risk by 35-40%
- Global CVD economic cost is $1 trillion yearly in health and productivity loss
- US spends $363 billion annually on CVD care
- Heart disease costs US $219 billion yearly including lost productivity
Cardiovascular disease remains the world's leading cause of death and disability.
Economic
- Global CVD economic cost is $1 trillion yearly in health and productivity loss
- US spends $363 billion annually on CVD care
- Heart disease costs US $219 billion yearly including lost productivity
- Stroke costs US $56 billion in direct medical costs 2020
- In EU, CVD costs €210 billion yearly, 51% healthcare
- China CVD costs $128 billion in 2019
- India faces $2.5 trillion cumulative CVD cost 2010-2050
- Low/middle-income countries lose $3.7 trillion GDP to CVD 2011-2025
- UK CVD costs £19 billion yearly to economy
- Australia spends $14.2 billion on CVD in 2020-21
- Brazil CVD healthcare cost $5.7 billion yearly
- Canada CVD costs $22 billion annually
- South Africa loses 1.5% GDP to CVD
- Global productivity loss from CVD is $470 billion yearly
- US Medicare spends 25% of budget on CVD
Economic Interpretation
The planet's cardiovascular system is hemorrhaging money, with a global trillion-dollar band-aid barely stemming the flow from productivity and healthcare budgets alike.
Mortality
- In 2019, cardiovascular diseases (CVDs) caused 17.9 million deaths worldwide, equivalent to 32% of all global deaths
- Globally, 38% of premature deaths due to CVDs occur before the age of 70
- Of the 17.9 million CVD deaths in 2019, 85% were due to heart attack and stroke
- Over three-quarters of CVD deaths take place in low- and middle-income countries
- In 2019, 160 million people were living with heart failure globally
- Age-standardized CVD mortality rate declined by 28.2% globally from 2000 to 2019
- In 2019, ischemic heart disease caused 8.9 million deaths worldwide
- Stroke accounted for 6.6 million deaths globally in 2019
- CVD death rates are 1.5 times higher in rural areas than urban areas in the US
- In the US, heart disease is the leading cause of death, killing nearly 700,000 people in 2021
- Stroke kills about 160,000 Americans annually
- Black Americans have the highest death rate from heart disease at 211.6 per 100,000
- In Europe, CVD causes over 4 million deaths yearly, representing 45% of all deaths
- Age-standardized mortality rate from CVD in EU was 172.3 per 100,000 in 2019
- In low-income countries, 37.5% of CVD deaths occur under age 70
- High systolic blood pressure accounted for 10.8 million CVD deaths in 2019
- In 2020, COVID-19 increased CVD mortality by 10-15% in high-income countries
- Global CVD mortality projected to rise to 23.6 million by 2030
- In India, CVD causes 2.8 million deaths annually, 25% of all deaths
- China sees 4.5 million CVD deaths per year
- In sub-Saharan Africa, rheumatic heart disease mortality is 0.15 million yearly
- US men have a CVD mortality rate of 179.8 per 100,000 vs 126.1 for women
- In the UK, CVD mortality fell 76% from 1979 to 2019
- Australia reports 47,000 CVD deaths in 2020
- Japan has the lowest CVD mortality at 110 per 100,000
- Russia has high CVD mortality at 500 per 100,000
- In Brazil, CVD causes 400,000 deaths yearly
- Canada sees 55,000 CVD deaths annually
- In South Africa, CVD mortality rate is 250 per 100,000
Mortality Interpretation
While the global battle against heart disease has seen impressive victories, the sobering reality is that it remains a brutally efficient killer, disproportionately claiming lives in the prime of adulthood and in the world's most vulnerable communities.
Prevalence
- Global DALYs from CVD reached 520 million in 2019
- Nearly 523 million people worldwide were living with CVD in 2019
- Heart failure prevalence is 1-2% in general adult population, rising to 10% over age 70
- Atrial fibrillation prevalence is 2-3% in people over 65
- Globally, hypertension affects 1.28 billion adults aged 30-79
- In the US, 127.9 million adults have CVD
- About 48% of US adults have some form of CVD
- Coronary heart disease affects 20.1 million US adults
- Heart failure prevalence in US is 6.7 million people age 20+
- Stroke prevalence in US adults is 3%, or 7.4 million people
- In Europe, 49 million people live with CVD
- Hypertension prevalence in EU is 30-45% of adults
- In China, 330 million people have CVD
- India has 75 million hypertension cases
- In low-income countries, CVD prevalence is rising 2% annually
- Australia has 1.2 million with coronary heart disease
- UK prevalence of CVD is 7.6% in adults
- In Brazil, 35 million adults have hypertension
- Canada reports 2.6 million with heart disease
- South Africa has 7.5 million hypertensives
- Japan has 15 million CVD patients
- Russia sees 20 million with hypertension
- In sub-Saharan Africa, 100 million have hypertension
- Global atrial fibrillation cases numbered 59 million in 2019
- US peripheral artery disease affects 8.5 million adults
Prevalence Interpretation
The staggering global march of cardiovascular disease, a relentless pandemic of preventable suffering, paints a picture of 520 million years of healthy life lost and nearly every nation counting its casualties in the millions.
Risk Factors
- In women, 44% of CVD burden is attributable to behavioral risks
- Smoking causes 1.74 million CVD deaths yearly worldwide
- High body-mass index led to 5 million CVD deaths in 2019
- Ambient particulate matter pollution causes 1.1 million CVD deaths annually
- Hypertension is the leading modifiable risk factor, causing 29% of CVD deaths
- Diabetes prevalence increases CVD risk by 2-4 fold
- In US, 47% of adults have high blood pressure
- Obesity affects 42% of US adults, doubling CVD risk
- Smoking is responsible for 20% of CVD deaths in US
- Physical inactivity contributes to 6% of global CVD burden
- High LDL cholesterol raises CVD risk by 25-30%
- In Europe, 26% of adults smoke, major CVD risk
- Air pollution PM2.5 increases CVD risk by 10-20%
- Poor diet causes 11 million CVD deaths yearly
- Family history doubles CVD risk if first-degree relative affected before 60
- Chronic kidney disease triples CVD risk
- In women, oral contraceptives increase stroke risk 2-fold if hypertensive
- HIV infection raises CVD risk by 50-100%
- Socioeconomic disadvantage increases CVD risk by 40%
- Shift work elevates CVD risk by 40%
- High sodium intake causes 1.89 million CVD deaths yearly
- Low fruit intake responsible for 2.5 million CVD deaths
- In US Blacks, hypertension prevalence is 56% vs 48% Whites
- Alcohol consumption >14 drinks/week raises CVD risk 20%
- Depression increases CVD risk by 30-50%
Risk Factors Interpretation
It is a grim irony that our hearts are being defeated by a largely self-inflicted pandemic of stubbornly widespread killers we already know how to stop.
Treatment
- Statins reduce CVD events by 25% per 1 mmol/L LDL reduction
- Aspirin reduces CVD mortality by 23% in secondary prevention
- Blood pressure lowering reduces stroke risk by 35-40%
- SGLT2 inhibitors reduce heart failure hospitalization by 30%
- Cardiac rehab reduces CVD mortality by 20-30%
- In US, 90% of eligible get statins for secondary prevention
- ICD implantation reduces sudden death by 30% in high-risk patients
- PCI success rate for STEMI is 95%, reducing mortality to 5%
- CABG improves survival by 20% over PCI in multivessel disease
- Anticoagulation for AF reduces stroke by 64%
- Lifestyle intervention reduces CVD events by 30% in diabetes
- GLP-1 agonists cut major CVD events by 12-26%
- Smoking cessation reduces CVD risk by 50% within 1 year
- Mediterranean diet lowers CVD recurrence by 30%
- In Europe, BP control rates are 40% in hypertensives
- Beta-blockers post-MI reduce mortality by 23%
- TAVR success rate is 95% for aortic stenosis
- Renal denervation lowers BP by 10 mmHg in resistant HTN
- Exercise training improves ejection fraction by 3-4% in HF
- DOACs have 50% lower intracranial bleed risk vs warfarin
- Colchicine reduces CVD events by 31% post-ACS
Treatment Interpretation
It's a pharmacological and lifestyle armada, firing a salvo of 20-35% relative risk reductions, yet still utterly dependent on us to actually deploy these remarkably effective tools to conquer the stubbornly human problems of access, adherence, and inertia.
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