April 2nd, 2015
Global Cardiovascular Deaths Continue to Rise Despite Gains in Prevention and Treatment
Improvements in the treatment and prevention of cardiovascular disease haven’t been able to prevent a worldwide rise in cardiovascular deaths in a growing and aging population, according to the authors of a paper published in the New England Journal of Medicine. Using mortality data from the Global Burden of Disease Study 2013, the authors set out to “disentangle” the effects on cardiovascular mortality of population growth, an aging population, and epidemiological changes (defined as changes in risk factors and the effect of efforts to prevent and treat CV disease).
From 1990 to 2013 the total number of deaths caused by cardiovascular disease increased by 40%, from more than 12 million to more than 17 million a year. This growth was fueled by a 55% increase in the number of deaths caused by the aging population and a 25% increase in the number of deaths due to population growth. These increases occurred despite a 39% reduction in cardiovascular deaths explained by epidemiological changes over the same period.
There were broad variations in the pattern based on the region and income of countries. The absolute number of deaths from CV disease declined in Central Europe and Western Europe but increased everywhere else. The biggest absolute increase occurred in South Asia, where the number of CV deaths almost doubled, reaching 1.7 million in 2013. The number of deaths remained fairly constant in Southern Latin America, Australasia, and high-income North America because, the authors said, “population aging and growth balanced out declines in age-specific death rates.”
Particularly in high-income countries, the “dramatic reductions” in CV deaths not related to the growth or aging of the population “are probably due to the combined effect of birth cohorts’ decreased exposure to tobacco smoking, improvements in diet, and improved treatment of cardiovascular disease and cardiometabolic risk factors targeting the prevention of cardiovascular disease, and improved treatment of cardiovascular disease.”