Demographic and epidemiologic drivers of global cardiovascular mortality
- PMID: 25830423
- PMCID: PMC4482354
- DOI: 10.1056/NEJMoa1406656
Demographic and epidemiologic drivers of global cardiovascular mortality
Abstract
Background: Global deaths from cardiovascular disease are increasing as a result of population growth, the aging of populations, and epidemiologic changes in disease. Disentangling the effects of these three drivers on trends in mortality is important for planning the future of the health care system and benchmarking progress toward the reduction of cardiovascular disease.
Methods: We used mortality data from the Global Burden of Disease Study 2013, which includes data on 188 countries grouped into 21 world regions. We developed three counterfactual scenarios to represent the principal drivers of change in cardiovascular deaths (population growth alone, population growth and aging, and epidemiologic changes in disease) from 1990 to 2013. Secular trends and correlations with changes in national income were examined.
Results: Global deaths from cardiovascular disease increased by 41% between 1990 and 2013 despite a 39% decrease in age-specific death rates; this increase was driven by a 55% increase in mortality due to the aging of populations and a 25% increase due to population growth. The relative contributions of these drivers varied by region; only in Central Europe and Western Europe did the annual number of deaths from cardiovascular disease actually decline. Change in gross domestic product per capita was correlated with change in age-specific death rates only among upper-middle income countries, and this correlation was weak; there was no significant correlation elsewhere.
Conclusions: The aging and growth of the population resulted in an increase in global cardiovascular deaths between 1990 and 2013, despite a decrease in age-specific death rates in most regions. Only Central and Western Europe had gains in cardiovascular health that were sufficient to offset these demographic forces. (Funded by the Bill and Melinda Gates Foundation and others.).
Figures
![Figure 1](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/4482354/bin/nihms696947f1.gif)
![Figure 2](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/4482354/bin/nihms696947f2.gif)
![Figure 3](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/4482354/bin/nihms696947f3.gif)
Similar articles
-
The burden of disease among the global poor.Lancet. 1999 Aug 14;354(9178):586-9. doi: 10.1016/S0140-6736(99)02108-X. Lancet. 1999. PMID: 10470717
-
Estimates of global and regional premature cardiovascular mortality in 2025.Circulation. 2015 Sep 29;132(13):1270-82. doi: 10.1161/CIRCULATIONAHA.115.016021. Circulation. 2015. PMID: 26408271
-
[Epidemiological transition in Latin America: a comparison of four countries].Rev Med Chil. 1997 Jun;125(6):719-27. Rev Med Chil. 1997. PMID: 9580335 Spanish.
-
Global Overview of the Epidemiology of Atherosclerotic Cardiovascular Disease.Arch Med Res. 2015 Jul;46(5):328-38. doi: 10.1016/j.arcmed.2015.06.006. Epub 2015 Jun 29. Arch Med Res. 2015. PMID: 26135634 Review.
-
Novel therapeutic concepts: the epidemic of cardiovascular disease in the developing world: global implications.Eur Heart J. 2010 Mar;31(6):642-8. doi: 10.1093/eurheartj/ehq030. Epub 2010 Feb 22. Eur Heart J. 2010. PMID: 20176800 Review.
Cited by
-
Epidemiology of cardiometabolic health in Latin America and strategies to address disparities.Nat Rev Cardiol. 2024 Jul 25. doi: 10.1038/s41569-024-01058-2. Online ahead of print. Nat Rev Cardiol. 2024. PMID: 39054376 Review.
-
Preliminary Effects of a Structured Educational Program in Cardiac Patients at Different Stages of Enrollment in Cardiovascular Rehabilitation.Community Health Equity Res Policy. 2024 Jul;44(4):365-376. doi: 10.1177/0272684X221080119. Epub 2022 May 5. Community Health Equity Res Policy. 2024. PMID: 38817096 Free PMC article.
-
A Novel Score for an Old Enemy: Atherogenic Plasma Index Predicts In-Stent Restenosis among Stable Angina Pectoris Patients.Sisli Etfal Hastan Tip Bul. 2024 Apr 5;58(1):75-81. doi: 10.14744/SEMB.2024.40336. eCollection 2024. Sisli Etfal Hastan Tip Bul. 2024. PMID: 38808058 Free PMC article.
-
Carotid Plaques and Hypertension as Risk Factors for Cardiovascular Disease and All-Cause Mortality in Middle-Aged Adults.J Clin Med. 2024 May 9;13(10):2804. doi: 10.3390/jcm13102804. J Clin Med. 2024. PMID: 38792345 Free PMC article.
-
Prognostic value of geriatric nutritional risk index in patients with stable coronary artery disease undergoing percutaneous coronary intervention.BMC Cardiovasc Disord. 2024 May 21;24(1):264. doi: 10.1186/s12872-024-03940-w. BMC Cardiovasc Disord. 2024. PMID: 38773437 Free PMC article.
References
-
- Beaglehole R, Bonita R, Horton R, et al. Measuring progress on NCDs: one goal and five targets. Lancet. 2012;380:1283–5. - PubMed
-
- A comprehensive global monitoring framework, including indicators, and a set of voluntary global targets for the prevention and control of noncommunicable diseases. Geneva: World Health Organization; Jul, 2012. http://who.int/nmh/events/2012/discussion_paper3.pdf.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical