Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study

Gregory A. Roth* (Member of author collaboration), George A. Mensah* (Member of author collaboration), Catherine O. Johnson (Member of author collaboration), Giovanni Addolorato (Member of author collaboration), Enrico Ammirati (Member of author collaboration), Larry M. Baddour (Member of author collaboration), Nöel C. Barengo (Member of author collaboration), Andrea Beaton (Member of author collaboration), Emelia J. Benjamin (Member of author collaboration), Catherine P. Benziger (Member of author collaboration), Aimé Bonny (Member of author collaboration), Michael Brauer (Member of author collaboration), Marianne Brodmann (Member of author collaboration), Thomas J. Cahill (Member of author collaboration), Jonathan R. Carapetis (Member of author collaboration), Alberico L. Catapano (Member of author collaboration), Sumeet S. Chugh (Member of author collaboration), Leslie T. Cooper (Member of author collaboration), Josef Coresh (Member of author collaboration), Michael Criqui (Member of author collaboration)Nicole DeCleene (Member of author collaboration), Kim A. Eagle (Member of author collaboration), Sophia Emmons-Bell (Member of author collaboration), Valery L. Feigin (Member of author collaboration), Joaquim Fernández-Sola (Member of author collaboration), Gerry Fowkes (Member of author collaboration), Emmanuela Gakidou (Member of author collaboration), Scott M. Grundy (Member of author collaboration), Feng J. He (Member of author collaboration), George Howard (Member of author collaboration), Frank Hu (Member of author collaboration), Lesley Inker (Member of author collaboration), Ganesan Karthikeyan (Member of author collaboration), Nicholas Kassebaum (Member of author collaboration), Walter Koroshetz (Member of author collaboration), Carl Lavie (Member of author collaboration), Donald Lloyd-Jones (Member of author collaboration), Hong S. Lu (Member of author collaboration), Antonio Mirijello (Member of author collaboration), Awoke Misganaw Temesgen (Member of author collaboration), Ali Mokdad (Member of author collaboration), Andrew E. Moran (Member of author collaboration), Paul Muntner (Member of author collaboration), Jagat Narula (Member of author collaboration), Bruce Neal (Member of author collaboration), Mpiko Ntsekhe (Member of author collaboration), Glaucia Moraes de Oliveira (Member of author collaboration), Catherine Otto (Member of author collaboration), Mayowa Owolabi (Member of author collaboration), Michael Pratt (Member of author collaboration), Sanjay Rajagopalan (Member of author collaboration), Marissa Reitsma (Member of author collaboration), Antonio Luiz P. Ribeiro (Member of author collaboration), Nancy Rigotti (Member of author collaboration), Anthony Rodgers (Member of author collaboration), Craig Sable (Member of author collaboration), Saate Shakil (Member of author collaboration), Karen Sliwa-Hahnle (Member of author collaboration), Benjamin Stark (Member of author collaboration), Johan Sundström (Member of author collaboration), Patrick Timpel (Member of author collaboration), Imad M. Tleyjeh (Member of author collaboration), Marco Valgimigli (Member of author collaboration), Theo Vos (Member of author collaboration), Paul K. Whelton (Member of author collaboration), Magdi Yacoub (Member of author collaboration), Liesl Zuhlke (Member of author collaboration), Christopher Murray (Member of author collaboration), Valentin Fuster (Member of author collaboration), GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group

*Corresponding author for this work

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Abstract

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global 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 the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019.
Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 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 its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate 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 world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases.
Original languageEnglish
JournalJournal of the American College of Cardiology
Volume76
Issue number25
Pages (from-to)2982-3021
Number of pages40
ISSN0735-1097
DOIs
Publication statusPublished - 2020

Keywords

  • Cardiovascular diseases
  • Global health
  • Health policy
  • Population health

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