Demographic and Epidemiologic Drivers of Global Cardiovascular Mortality

By Gregory A. Roth, M. Forouzanfar, A. Moran, Ryan Barber, Grant Nguyen, Valery Feigin, M. Naghavi, G. Mensah, Christopher J. L. Murray. New England Journal of Medicine, 2015

1,064 citations recorded by the source corpus.

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.)

Subfields: Cardiology and Cardiovascular Medicine, Health, Organizational Behavior and Human Resource Management

View Paper: https://www.semanticscholar.org/paper/27a6b9a739f391969318dbfd3ffe6b84aa566d21

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Cardiology and Cardiovascular Medicine

1. Massimo F. Piepoli
2. Sonia S Anand
3. Jeroen J. Bax
4. I. Graham
5. T. Ivanova
6. Pablo Perel

In Health

1. Massimo F. Piepoli
2. T. Ivanova

In Organizational Behavior and Human Resource Management

1. Massimo F. Piepoli
2. I. Graham
3. Christopher J. L. Murray

Citations in the corpus

• Global and Regional Patterns in Cardiovascular Mortality From 1990 to 2013 (2015, background): “therefore, we have restricted our discussion to these conditions (Table 1).(3) We have organized our discussion around 7 areas of the world, which are expanded to 21 globally exhaustive regions”
• 2016 European Guidelines on cardiovascular disease prevention in clinical practice. (2016, background): “Aging of the population also increases CVD events.(21)”
• 2016 European Guidelines on cardiovascular disease prevention in clinical practice (2016, background): “Aging of the population also increases CVD events.(21)”
• 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. (2016, background): “16 Ageing of the population also contributes to increasing the absolute number of CVD events.(17) Several population-level interventions have proven to efficiently affect lifestyle in individuals, leading to this success: awareness and knowledge of how lifestyle risk factors lead to CVD increased in”
• Periodontitis and cardiovascular diseases: Consensus report (2020, background): “Ischaemic heart disease, stroke, hypertension (leading to heart failure), rheumatic heart disease, car‐ diomyopathy and atrial fibrillation cause over 95% of CVD‐related deaths (Roth et al., 2015).”
• Cardiovascular Effects and Benefits of Exercise (2018, background): “In the United States, CVD accounts for ∼600,000 deaths (25%) each year (1, 2), and after a continuous decline over the last 5 decades, its incidence is increasing again (3).”
• European Society of Cardiology: Cardiovascular Disease Statistics 2017. (2018, background): “Declines in CVD mortality have been driven largely by reductions in the numbers of people presenting with myocardial infarction and stroke, with health gains, particularly in the more prosperous countries of Western Europe, tending to offset the effects of population ageing and growth [52].”