AsianScientist (Apr. 13, 2015) – Data from the Global Burden of Disease study has revealed that cardiovascular disease (CVD) is the leading cause of premature death in the world. The results, published in The New England Journal of Medicine, are an example of how Big Data can inform public health policy.
Globally, the number of deaths due to cardiovascular diseases such as heart attacks and strokes increased by 41 percent between 1990 and 2013, climbing from 12.3 million deaths to 17.3 million deaths. Over the same period, death rates within specific age groups dropped by 39 percent, according to an analysis of data from 188 countries. Death rates from cardiovascular diseases were steady or fell in every region of the world except Western sub-Saharan Africa, where the rates increased.
Progress in fighting cardiovascular diseases is evident around the world but varies by region. South Asia, which includes India, experienced the largest jump in total deaths due to cardiovascular diseases, with 1.8 million more deaths in 2013 than in 1990–an increase of 97 percent.
In line with global trends, the increase in deaths from cardiovascular disease in India is driven by population growth and aging without the decrease in age-specific death rates found in many other countries. In contrast, countries in the high-income Asia Pacific region such as Japan achieved the greatest decline in cardiovascular death rates.
“Cardiovascular diseases will remain a global threat as the population grows and people age,” said Dr. Gregory Roth, Assistant Professor at IHME from the Division of Cardiology at the University of Washington. “But the progress seen in some regions shows that reducing the toll of cardiovascular diseases is possible.”
Researchers found that population aging contributed to an estimated 55 percent increase in cardiovascular disease deaths globally and population growth contributed to a 25 percent increase. These demographic factors are not the only drivers behind the trend of increasing deaths and falling death rates. Changes in the epidemiology of cardiovascular diseases is another factor.
Ischemic heart disease is the leading cause of death worldwide and accounts for almost half of the increase in the number of cardiovascular deaths, despite a 34 percent decrease in age-specific death rates. Several other types of cardiovascular causes of death followed the same pattern, including aortic aneurysm, hypertensive heart diseases and endocarditis.
Two conditions that were exceptions to this pattern are atrial fibrillation and peripheral vascular disease, for which deaths have jumped significantly since 1990, due to both higher death rates within specific age groups as well as general aging and population growth.
Only rheumatic heart disease, which had a death rate decrease of more than 100 percent, had a lower number of total deaths in 2013 than in 1990; deaths fell by an estimated 27 percent over the 23-year period of the study.
Researchers also examined whether wealthier countries fared better than lower-income countries when it comes to cardiovascular deaths and found there was not a strong correlation between income per capita and lower age-specific death rates. The dramatic improvement in the death rates seen in some regions was attributed to prevention and treatment of cardiovascular diseases, in part by reducing risk factors including smoking. Primary care management of other risk factors for cardiovascular diseases, such as elevated blood pressure and blood sugar, are also important.
“Addressing the range of factors that contribute to cardiovascular disease will help ensure that fewer people around the world die from it prematurely,” said IHME Director Dr. Christopher Murray. “Investments and policies aimed at targeting preventable risk factors can reduce the impact of cardiovascular disease.”
The article can be found at: Roth et al. (2015) Demographic And Epidemiologic Drivers Of Global Cardiovascular Mortality.
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Source: Institute for Health Metrics and Evaluation.
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