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Reducing the Global Burden of Cardiovascular Disease, Part 1: The Epidemiology and Risk Factors
Abstract
Current global health policy goals include a 25% reduction in premature mortality from noncommunicable diseases by 2025. In this 2-part review, we provide an overview of the current epidemiological data on cardiovascular diseases (CVD), its risk factors, and describe strategies aimed at reducing its burden. In part 1, we examine the global epidemiology of cardiac conditions that have the greatest impact on CVD mortality; the predominant risk factors; and the impact of upstream, societal health determinants (eg, environmental factors, health policy, and health systems) on CVD. Although age-standardized mortality from CVD has decreased in many regions of the world, the absolute number of deaths continues to increase, with the majority now occurring in middle- and low-income countries. It is evident that multiple factors are causally related to CVD, including traditional individual level risk factors (mainly tobacco use, lipids, and elevated blood pressure) and societal level health determinants (eg, health systems, health policies, and barriers to CVD prevention and care). Both individual and societal risk factors vary considerably between different regions of the world and economic settings. However, reliable data to estimate CVD burden are lacking in many regions of the world, which hampers the establishment of nationwide prevention and management strategies. A 25% reduction in premature CVD mortality globally is feasible but will require better implementation of evidence-based policies (particularly tobacco control) and integrated health systems strategies that improve CVD prevention and management. In addition, there is a need for better health information to monitor progress and guide health policy decisions.
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Cites
1 retracted
RETRACTED: Primary Prevention of Cardiovascular Disease with a Mediterranean Diet
Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M.-I., Corella, D., Arós, F., Gómez-Gracia, E., Ruiz-Gutiérrez, V., Fiol, M., Lapetra, J., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1200303 · Cited by 4,257
RetractedVos, T., Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abdulkader, R. S., Abdulle, A. M., Abebo, T. A., Abera, S. F., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32154-2 · Cited by 13,220
Self-citationYusuf, S., Hawken, S., Ôunpuu, S., Dans, T., Avezum, A., Lanas, F., McQueen, M., Budaj, A., Pais, P., Varigos, J., et al. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17018-9 · Cited by 12,026
Self-citationVos, T., Allen, C., Arora, M., Barber, R. M., Bhutta, Z. A., Brown, A., Carter, A., Casey, D. C., Charlson, F. J., Chen, A. Z., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31678-6 · Cited by 7,253
Self-citationA Randomized Trial of Intensive versus Standard Blood-Pressure Control
The SPRINT Research Group (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1511939 · Cited by 6,325
Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease
Sabatine, M. S., Giugliano, R. P., Keech, A. C., Honarpour, N., Wiviott, S. D., Murphy, S. A., Kuder, J. F., Wang, H., Liu, T., Wasserman, S. M., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1615664 · Cited by 6,138
Global physical activity levels: surveillance progress, pitfalls, and prospects
Hallal, P. C., Andersen, L. B., Bull, F. C., Guthold, R., Haskell, W., & Ekelund, U. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60646-1 · Cited by 5,711
Worldwide Epidemiology of Atrial Fibrillation: A Global Burden of Disease 2010 Study
Chugh, S. S., Havmoeller, R., Narayanan, K., Singh, D., Rienstra, M., Benjamin, E. J., Gillum, R. F., Kim, Y.-H., McAnulty, J. H., Zheng, Z.-J., et al. (2014) · Circulation · doi:10.1161/circulationaha.113.005119 · Cited by 4,506
Feigin, V. L., Forouzanfar, M. H., Krishnamurthi, R., Mensah, G. A., Connor, M., Bennett, D. A., Moran, A. E., Sacco, R. L., Anderson, L., Truelsen, T., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(13)61953-4 · Cited by 3,899
Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015
Roth, G. A., Johnson, C., Abajobir, A., Abd-Allah, F., Abera, S. F., Abyu, G., Ahmed, M., Aksut, B., Alam, T., Alam, K., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.04.052 · Cited by 3,791
Zhou, B., Bentham, J., Di Cesare, M., Bixby, H., Danaei, G., Cowan, M. J., Paciorek, C. J., Singh, G., Hajifathalian, K., Bennett, J. E., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(16)31919-5 · Cited by 2,579
Body-mass index and mortality among 1.46 million white adults
Berrington de Gonzalez, A., Hartge, P., Cerhan, J. R., Flint, A. J., Hannan, L., MacInnis, R. J., Moore, S. C., Tobias, G. S., Anton-Culver, H., Freeman, L. B., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1000367 · Cited by 2,317
O'Donnell, M. J., Chin, S. L., Rangarajan, S., Xavier, D., Liu, L., Zhang, H., Rao-Melacini, P., Zhang, X., Pais, P., Agapay, S., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30506-2 · Cited by 2,296
Self-citationMozaffarian, D. (2016) · Circulation · doi:10.1161/circulationaha.115.018585 · Cited by 2,216
Kassebaum, N. J., Arora, M., Barber, R. M., Bhutta, Z. A., Brown, J., Carter, A., Casey, D. C., Charlson, F. J., Coates, M. M., Coggeshall, M., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31460-x · Cited by 2,163
Self-citationInterpretation of the evidence for the efficacy and safety of statin therapy
Collins, R., Reith, C., Emberson, J., Armitage, J., Baigent, C., Blackwell, L., Blumenthal, R., Danesh, J., Smith, G. D., DeMets, D., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31357-5 · Cited by 1,857
Self-citationRoger, V. L. (2013) · Circulation Research · doi:10.1161/circresaha.113.300268 · Cited by 1,728 · cited 7×
“Most of these data are from North America or Europe, with sparse data from LICs and MICs.72 Recent data from China indicate that consumption of even 1 fruit serving per day confers substantial protection from CVDrelated death, but the large effect size (a 40% relative risk reduction with consumption of just 1 serving…”
BackgroundInfluentialSugar-Sweetened Beverages, Obesity, Type 2 Diabetes Mellitus, and Cardiovascular Disease Risk
Malik, V. S., Popkin, B. M., Bray, G. A., Després, J.-P., & Hu, F. B. (2010) · Circulation · doi:10.1161/circulationaha.109.876185 · Cited by 1,641
Wang, X., Ouyang, Y., Liu, J., Zhu, M., Zhao, G., Bao, W., & Hu, F. B. (2014) · BMJ · doi:10.1136/bmj.g4490 · Cited by 1,596 · cited 6×
“Most of these data are from North America or Europe, with sparse data from LICs and MICs.72 Recent data from China indicate that consumption of even 1 fruit serving per day confers substantial protection from CVDrelated death, but the large effect size (a 40% relative risk reduction with consumption of just 1 serving…”
BackgroundInfluentialSmoking prevalence and cigarette consumption in 187 countries, 1980-2012
Ng, M., Freeman, M. K., Fleming, T. D., Robinson, M., Dwyer-Lindgren, L., Thomson, B., Wollum, A., Sanman, E., Wulf, S., Lopez, A. D., et al. (2014) · JAMA · doi:10.1001/jama.2013.284692 · Cited by 1,576
Air pollution and mortality in the Medicare population
Di, Q., Wang, Y., Zanobetti, A., Wang, Y., Koutrakis, P., Choirat, C., Dominici, F., & Schwartz, J. D. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1702747 · Cited by 1,510 · cited 1×
“Recent data from the United States in 60 million individuals observed a clear, graded increase between fine particulate matter levels and all cause mortality, although cause specific mortality was not examined.(81) In some regions of the world, the use of biomass-based fuels (eg, wood, diesel, and kerosene) for indoor…”
Backgroundde Souza, R. J., Mente, A., Maroleanu, A., Cozma, A. I., Ha, V., Kishibe, T., Uleryk, E., Budylowski, P., Schünemann, H., Beyene, J., et al. (2015) · BMJ · doi:10.1136/bmj.h3978 · Cited by 1,424
Self-citationDemographic and epidemiologic drivers of global cardiovascular mortality
Roth, G. A., Forouzanfar, M. H., Moran, A. E., Barber, R., Nguyen, G., Feigin, V. L., Naghavi, M., Mensah, G. A., & Murray, C. J. L. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1406656 · Cited by 1,188
He, J., Ogden, L. G., Bazzano, L. A., Vupputuri, S., Loria, C., & Whelton, P. K. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.7.996 · Cited by 1,172 · cited 2×
“2% of the PAR.(32) Conversely, data from African populations attribute”
BackgroundInfluentialGlycemic index, glycemic load, and chronic disease risk—a meta-analysis of observational studies
Barclay, A. W., Petocz, P., McMillan-Price, J., Flood, V. M., Prvan, T., Mitchell, P., & Brand-Miller, J. C. (2008) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/87.3.627 · Cited by 1,061
Cardiovascular risk and events in 17 low-, middle-, and high-income countries
Yusuf, S., Rangarajan, S., Teo, K., Islam, S., Li, W., Liu, L., Bo, J., Lou, Q., Lu, F., Liu, T., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1311890 · Cited by 983
Yusuf, S., Islam, S., Chow, C. K., Rangarajan, S., Dagenais, G., Diaz, R., Gupta, R., Kelishadi, R., Iqbal, R., Avezum, A., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(11)61215-4 · Cited by 964
Self-citationCardiovascular Effects of Secondhand Smoke: Nearly as Large as Smoking
Barnoya, J., & Glantz, S. A. (2005) · Circulation · doi:10.1161/circulationaha.104.492215 · Cited by 939 · cited 1×
“Smoking even 1 cigarette a day increases the risk of MI (Figure 4) as does exposure to second-hand smoke.(40,41) There”
BackgroundCholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease
Yusuf, S., Bosch, J., Dagenais, G., Zhu, J., Xavier, D., Liu, L., Pais, P., López-Jaramillo, P., Leiter, L. A., Dans, A., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1600176 · Cited by 848
Self-citationHuxley, R. R., Lopez, F. L., Folsom, A. R., Agarwal, S. K., Loehr, L. R., Soliman, E. Z., Maclehose, R., Konety, S., & Alonso, A. (2011) · Circulation · doi:10.1161/circulationaha.110.009035 · Cited by 697
Stuckler, D., McKee, M., Ebrahim, S., & Basu, S. (2012) · PLoS Medicine · doi:10.1371/journal.pmed.1001235 · Cited by 666
Self-citationAnand, S. S., Hawkes, C., de Souza, R. J., Mente, A., Dehghan, M., Nugent, R., Zulyniak, M. A., Weis, T., Bernstein, A. M., Krauss, R. M., et al. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.07.050 · Cited by 507 · cited 2×
“Given that food sources, cooking methods, and food preservation practices vary substantially across the world, it is necessary to identify which dietary patterns are protective in regions of the world outside of Europe or North America, and ideally this should be followed by well-designed large randomized trials.(79)”
BackgroundSelf-citationMicha, R., Michas, G., & Mozaffarian, D. (2012) · Current Atherosclerosis Reports · doi:10.1007/s11883-012-0282-8 · Cited by 502
Graudal, N., Jürgens, G., Baslund, B., & Alderman, M. H. (2014) · American Journal of Hypertension · doi:10.1093/ajh/hpu028 · Cited by 407 · cited 1×
“mortality when compared with moderate consumption levels.(64) The increase in risk of death and CVD with low sodium consumption may be related to the marked activation of the renin–angiotensin–aldosterone system.”
BackgroundFresh Fruit consumption and major cardiovascular disease in China
Du, H., Li, L., Bennett, D., Guo, Y., Key, T. J., Bian, Z., Sherliker, P., Gao, H., Chen, Y., Yang, L., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1501451 · Cited by 281
Smyth, A., Teo, K. K., Rangarajan, S., O'Donnell, M., Zhang, X., Rana, P., Leong, D. P., Dagenais, G., Seron, P., Rosengren, A., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)00235-4 · Cited by 230
Self-citationHuang, C., Huang, J., Tian, Y., Yang, X., & Gu, D. (2014) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2014.01.037 · Cited by 198
Leong, D. P., Smyth, A., Teo, K. K., McKee, M., Rangarajan, S., Pais, P., Liu, L., Anand, S. S., & Yusuf, S. (2014) · Circulation · doi:10.1161/circulationaha.113.007627 · Cited by 141
Self-citationWhat can global health institutions do to help strengthen health systems in low income countries?
Balabanova, D., McKee, M., Mills, A., Walt, G., & Haines, A. (2010) · Health Research Policy and Systems · doi:10.1186/1478-4505-8-22 · Cited by 130
Self-citation
Research works printed but not linked: 75
- 10.2307/3349375 · DOI · Paper page
- 10.1016/S0140-6736(16)31012-1 · DOI · Paper page
- World Health Organization. Who Global NCD Action Plan 2013–2020. Geneva, Switzerland: WHO; 2013.
- 10.1016/S0140-6736(12)61993-X · DOI
- 10.1038/495305a · DOI
- 10.1016/j.ahj.2009.04.019 · DOI · Paper page
- 10.1016/S0140-6736(14)61591-9 · DOI · Paper page
- Centers for Disease Control andPrevention. Decline in deaths from heart disease and stroke—United States, 1900–1999. MMWR Morb Mortal Wkly Rep. 1999;48:649–656.
- 10.1161/CIRCULATIONAHA.113.004046 · DOI · Paper page
- 10.1161/CIRCULATIONAHA.113.004042 · DOI · Paper page
- 10.1016/S2214-109X(13)70089-5 · DOI · Paper page
- 10.1016/j.jstrokecerebrovasdis.2009.06.002 · DOI
- 10.1002/ehf2.12005 · DOI · Paper page
- 10.1016/j.hfc.2015.07.009 · DOI
- 10.1016/S2214-109X(17)30196-1 · DOI · Paper page
- 10.1016/j.gheart.2013.08.008 · DOI · Paper page
- 10.2147/CLEP.S12977 · DOI · Paper page
- 10.1161/CIRCULATIONAHA.112.128413 · DOI · Paper page
- 10.1093/oxfordjournals.aje.a112879 · DOI
- 10.1016/S2214-109X(15)00091-1 · DOI
- 10.1186/1741-7015-12-5 · DOI
- 10.1016/j.gheart.2012.10.004 · DOI
- 10.1136/jech.2008.082743 · DOI · Paper page
- 10.1001/archinternmed.2012.3310 · DOI · Paper page
- 10.1056/NEJMoa1600175 · DOI · Paper page
- 10.1136/bmj.i717 · DOI · Paper page
- 10.1016/S0140-6736(06)69249-0 · DOI · Paper page
- 10.3109/09537104.2016.1158403 · DOI
- 10.1016/S0140-6736(02)11911-8 · DOI · Paper page
- 10.1016/S0140-6736(08)61076-4 · DOI · Paper page
- 10.1016/S0140-6736(10)62038-7 · DOI · Paper page
- 10.1016/S0140-6736(16)00618-8 · DOI · Paper page
- 10.1136/bmj.i2156 · DOI · Paper page
- Department of Health. Alcohol Guidelines Review – Report from the Guidelines Development Group to the UK Chief Medical Officers. London, United Kingdom: Department of Health; 2016.
- 10.1007/s11883-017-0647-0 · DOI
- 10.1177/014107689809100802 · DOI · Paper page
- 10.1093/acprof:oso/9780199655786.003.0013 · DOI
- 10.1056/NEJMc1612304 · DOI
- 10.1016/S0140-6736(16)30467-6 · DOI · Paper page
- 10.1093/ajh/hpt130 · DOI
- 10.1056/NEJMe1407695 · DOI
- 10.1093/eurheartj/ehw549 · DOI
- Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore H, Davey Smith G. Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev. 2011:CD002137.
- 10.1001/jama.295.6.655 · DOI · Paper page
- 10.1001/2012.jama.11374 · DOI · Paper page
- Brook RD, Rajagopalan S, Pope CA, et al.. Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation. 2014;129:562–569.
- 10.1161/CIRCULATIONAHA.115.020288 · DOI
- 10.1016/j.envres.2014.06.029 · DOI · Paper page
- Institute of Medicine (US) Committee on Preventing the Global Epidemic of Cardiovascular Disease: Meeting the Challenges in Developing Countries. A critical challenge to achieve global health. Fuster V, Kelly BB, eds. In: Promoting Cardiovascular Health in the Developing World. Washington, DC: National Academies Press; 2010.
- 10.1016/s0140-6736(1017)30818-30818 · DOI
- 10.1001/jama.2013.184182 · DOI · Paper page
- 10.1093/eurheartj/ehs219 · DOI · Paper page
- 10.1093/eurheartj/ehs481 · DOI
- 10.1371/journal.pone.0084238 · DOI · Paper page
- 10.1016/j.gheart.2015.04.006 · DOI
- 10.1016/S0140-6736(15)00469-9 · DOI · Paper page
- 10.1161/CIRCULATIONAHA.110.969022 · DOI · Paper page
- 10.1038/sj.ijo.0803531 · DOI
- 10.1016/j.amepre.2006.07.009 · DOI
- 10.1093/nutrit/nuw037 · DOI
- 10.1111/j.1467-789X.2010.00826.x · DOI · Paper page
- 10.1186/1478-4505-8-17 · DOI
- 10.1016/j.amepre.2015.10.001 · DOI
- 10.1371/journal.pmed.1001336 · DOI
- 10.1136/tobaccocontrol-2014-051919 · DOI
- 10.1371/journal.pone.0023889 · DOI
- 10.1186/1744-8603-6-21 · DOI
- 10.1136/bmjopen-2016-013817 · DOI
- 10.1016/S2214-109X(16)30186-3 · DOI · Paper page
- 10.5888/pcd10.120198 · DOI
- 10.1136/bmj.h6704 · DOI · Paper page
- 10.1007/s10198-016-0795-0 · DOI
- 10.1016/j.amepre.2009.11.005 · DOI · Paper page
- 10.1016/S0140-6736(12)62000-5 · DOI · Paper page
- Institute of Medicine. Otten JJ, Pitzi Hellwig J, Meyers LD, eds. In: Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC: The National Academies Press; 2006. https://doi.org/10.17226/11537. · DOI
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Metadata
- Authors
- Joseph, P., Leong, D., McKee, M., Anand, S. S., Schwalm, J.-D., Teo, K., Mente, A., & Yusuf, S.
- Venue
- Circulation Research
- Published
- 2017-09
- Volume
- 121
- Issue
- 6
- Pages
- 677-694
- ISSN
- 0009-7330 (ISSN-L)
- 1524-4571
- OpenAlex
- W2753813400
- Cited by
- 1,073
- References
- 40
- FWCI
- 39.32
- Type
- journal article
- Language
- en
- Open access
- closed
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