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

Summary and Conclusions

While CVD rates are declining in EstME countries, they are increasing in virtually all others. From a worldwide perspective, the rate of change in the burden of CVD is accelerating. This primarily reflects changes in the developing economies, which represent over 80% of the world's population, as they move rapidly through the second and third phases of the epidemiologic transition. The consequences of the CVD epidemic will be substantial on many levels -- increased morbidity, mortality, and family suffering, as well as staggering economic costs, both the direct costs of diagnosis and treatment and the indirect costs of lost productivity.

Each region of the world faces major challenges presented by the epidemic of CVD. Given the vast differences in social, cultural, and economic circumstances, there is no single global solution to the rising burden of CVD. The EstME countries must reverse unfavorable trends in CVD risk factors and behaviors and deal with the increasing prevalence of CVD in an aging population. The EmgME countries must find ways to efficiently care for increasing numbers of individuals with CVD as well as to deploy lower-cost prevention strategies in order to hasten the transition from the third to the fourth phase of the epidemiologic transition. The most complex challenges are those facing the DevE countries. They must dedicate often minuscule resources to better assessment of rates of disease, death, and CVD risk factors, then allocate resources to lower-cost preventive strategies, which will likely be more cost-effective than dedicating resources to high-cost management of CVD.

In addition to expanding their health aid to the developing world, the EstME countries must continue to lead the way in researching and developing all aspects of prevention and treatment. Through further expansion of the knowledge base, particularly regarding the economic consequences of various treatment and prevention strategies, it is possible that the efficient transfer of low-cost preventive and therapeutic strategies may alter the natural course of the epidemiologic transition in every part of the world and thus reduce the excess global burden of preventable CVD.