Published Wednesday in the Journal of the American College of Cardiology, the research shows that the highest ratios of cardiovascular-related deaths are found throughout the Middle East, Central Asia, Eastern Europe, South America, Oceania and sub-Saharan Africa.
The study also found that the significant declines of deaths from cardiovascular disease in the United States, Japan, Canada and Western Europe over the past two decades have begun to plateau.
“It is an alarming threat to global health,” said Gregory Roth, lead author of the study and assistant professor at the Institute for Health Metrics and Evaluation at the University of Washington. “Trends in CVD mortality are no longer declining for high-income regions and low- and middle-income countries are also seeing more CVD-related deaths.”
As of 2015, there were more than 400 million people living with cardiovascular disease and nearly 18 million related deaths globally. Driven by improvements in high-income nations, the age-standardized death rate from cardiovascular disease dropped worldwide from 1990 to 2010. But that trend has slowed over the past five years.
In 1990, there were about 393 deaths from cardiovascular disease for every 100,000 people worldwide. That figure dropped 22 percent over the following two decades, to 307 deaths per 100,000 in 2010. The rate barely decreased over the next five years, to 286 deaths per 100,000 – a 7 percent drop.
“This paper is the manifestation of two paradoxes,” Valentin Fuster, the journal’s editor in chief, said. “First, we keep discussing how much we have progressed among our subspecialty, yet the paradox is that the disease state remains the number 1 killer in the world. The second paradox is that medicine remains very expensive, yet we don’t put efforts into promoting health at younger ages, which could be a cost-effective method to preventing the onset of the disease.
“Instead, we continue to only invest in treating advanced manifestations of cardiovascular disease.”
The highest death rates from cardiovascular disease were found throughout Eastern Europe and Central Asia, as well as in nations like Afghanistan and Iraq. Elevated rates also occurred in many South Pacific island nations. The lowest rates were in Israel, France, Japan, Spain, Peru and Andorra.
“High levels of cardiovascular disease are seen throughout the world, both in high-income countries and those with more limited access to effective and inexpensive treatments,” Roth said. “Risk factors for CVD, like high blood pressure, poor diet, high cholesterol, tobacco smoking, excessive alcohol use, and obesity, are common throughout most of the world.”
Ischemic heart disease – also known as heart artery or coronary artery disease – was the leading cause of health loss in every region of the world besides sub-Saharan Africa, among the cardiovascular conditions studied. In 2005, there were an estimated 7.3 million heart attacks and 110.6 million people living with coronary artery disease.
Other cardiovascular conditions the study reviewed include atrial fibrillation, rheumatic heart disease, hypertensive heart disease and cardiomyopathy.
Roth believes the findings present opportunities for public health officials on the local, national and international levels to work together to develop effective strategies for addressing risk factors.
“The population health community realizes that CVD is a global problem,” he said. “Now we need to find innovative ways to deliver our low-cost, effective treatments to the hundreds of millions of people who can’t access them.”