GENEVA, 20 May 2023 – Deaths from cardiovascular disease (CVD) jumped globally from 12.1 million in 1990 to 20.5 million in 2021, according to a new report from the World Heart Federation (WHF). CVD was the leading cause of death worldwide in 2021, with four in five CVD deaths occurring in low- and middle-income countries (LMICs).
The World Heart Report—launched at the 2023 World Heart Summit—provides the first in-depth analysis of CVD risk and mortality data worldwide, and unique analysis of country-level policy implementation to mitigate CVDs.
The highest CVD death rates occur in the Central Europe, Eastern Europe, and Central Asia region. Though the overall number of CVD deaths increased in the last three decades—largely due to an ageing and growing population—the CVD death rate fell globally from 354.5 deaths per 100,000 people in 1990 to 239.9 deaths per 100,000 people in 2019. This decline was however uneven across regions; the fastest decline in death rate was experienced in high-income countries.
Professor Fausto Pinto, co-author of the report and former WHF President, said: “The data doesn’t lie. This report confirms the serious threat that cardiovascular disease poses all over the world, particularly in low- and middle-income countries. Up to 80 per cent of premature heart attacks and strokes can be prevented. It’s vital that countries prioritise rolling out tools and policies to protect people from CVD.”
The report highlighted that high blood pressure, air pollution, tobacco use, and elevated LDL cholesterol were among the leading contributors to CVD deaths. Overall, a key finding is that risk factors vary across regions, making it vital that countries be aware of their risk profile. It also found that countries that invest more in healthcare as a percentage of gross domestic product (GDP) have lower CVD death rates, while CVD death rates are higher in countries where people pay more out-of-pocket for healthcare.
“Investing in healthcare saves lives. This evidence is indisputable. In line with WHO recommendations, countries must invest at least 5 per cent of their GDP to help bring down CVD death rates and morbidity,” said Professor Mariachiara Di Cesare of the Institute of Public Health and Wellbeing at the University of Essex, which compiled and analysed the data in collaboration with WHF.
In its analysis of country-level policies to improve CVD health, WHF found that 64 per cent of countries have implemented at least seven of eight recommended policies, including national tobacco control programmes, availability of CVD drug treatments, and operational units within Ministries of Health. The lowest level of policy implementation was found in Sub-Saharan Africa, where over 50 per cent of countries do not have availability of CVD drugs in primary care facilities, a CVD National Plan, or a Non-communicable diseases (NCD) Unit.
The report includes five recommendations to get progress on CVD health back on track. These recommendations cover implementing all key policies to combat CVD, ensuring CVD health interventions are adequately funded, and continuing efforts to improve data on CVDs and their risk factors, particularly in LMICs.
“Good data can help drive good policy – the report´s recommendations make clear that the opportunity is still there to accelerate action toward the goal of reducing premature mortality from NCDs by one-third by 2030,” said Pinto.
Notes to Editors:
Methodology and data sources – For overall burden and trends in CVD mortality, estimates from the Global Burden of Disease from 1990 to 2019 were used, as this is the last year for which estimates are available at the level of disaggregation needed for the report. The report occasionally references 2021 data on global disease burden, though more detailed disaggregation is not available for that year. In addition to the Global Burden of Disease Study, the main data sources used are the NCD Risk Factor Collaboration, the NCD Countdown 2030 initiative, WHO and the World Bank.
Death rates – All death rates used are “age-standardized,” a technique to better compare disease outcomes across populations. It calculates disease outcome if the population age structure were the same for all countries, allowing for assessment of observed differences due to disease-related factors rather than the age structure of the population.
The WHF Policy Index – This assigns a score of 0 if no implementation of a measure is recorded in the country and 1 if the policy has been implemented. The Index is calculated by adding up each country’s overall score. The source of data for each country is the WHO Global Health Observatory.
This first World Heart Report was made possible through support from the Novartis Foundation and WHF intends to publish the World Heart Report annually ahead of future World Health Assemblies.