Reducing the Global Burden of Cardiovascular Disease: The Role of Risk Factors

James W. Levenson, MD, MPH, Patrick J. Skerrett, MS, J. Michael Gaziano, MD, MPH


Prev Cardiol. 2002;5(4) 

In This Article

Regional Trends In CVD

Since the DevE countries account for more than 80% of the world's population, global rates of CVD are largely driven by rates in these countries. In this section, we summarize global and regional estimates for 1990 and 2020 provided by Murray and Lopez[2] in their comprehensive analysis of the global burden of disease. In 1990, world population stood at 5.3 billion. CVD accounted for 14.3 million deaths, or 28.5% of the world's 50 million deaths ( Table II ). Of these, 6.3 million deaths were due to CHD and 4.4 million were due to stroke. An estimated 133 million lost disability-adjusted life-years (DALYs) -- a time-based health outcome measure that includes weights for time spent in less-than-perfect health -- or 9.7% of the total DALYs, were due to CVD. By 2020, the world's population is estimated to reach 7.8 billion, with much of the growth occurring in the developing economies. CVD will account for nearly 25 million deaths, or 36.3% of the estimated 68 million deaths worldwide ( Table II ). Of these, 11.1 million will be due to CHD and 7.7 million to stroke. CVD will also account for an estimated 204 million lost DALYs, or 14.7% of the total DALYs. In contrast, over this same period, the proportion of deaths attributable to communicable diseases and malnutrition is expected to drop from 28.4% to 13.6%, and the proportion of DALYs from 40.1% to 17.3%.

These worldwide changes mask substantial regional differences. In the EstME, CVD death rates will continue to decline, although more slowly than they did over the last 40 years of the 20th century. Because the population continues to age, both the absolute number of deaths and the prevalence of CVD will continue to increase. In terms of lost DALYs, the proportion due to CVD will remain stable at about 19%. In the EmgMEs, there will be little change in the overall proportion of deaths due to CVD (54.6% in 1990 vs. 53.7% in 2020) and a slight increase in the proportion of DALYs due to CVD (23.2% in 1990 vs. 26% in 2020). The average age of those afflicted with CVD will increase. In the DevEs, the number of deaths due to CVD will more than double, from 9 million in 1990 to more than 22 million in 2020, accounting for more than three fourths of all CVD deaths worldwide.