The global burden of cardiovascular diseases and risk: A compass for future health

Introduction

Cardiovascular diseases (CVDs) have collectively remained the leading causes of death worldwide and substantially contribute to loss of health and excess health system costs. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study has tracked trends in death and disability since 1990 and has provided an updated perspective on the status of cardiovascular health globally, regionally, and nationally.

The GBD Study also measures the burden of disease attributable to 88 risk factors for disease. While understanding the underlying physiologic causes of death is important, rigorously evaluating upstream drivers of disease provides additional strategies to guide public policy. These “actual causes of death” reflect modifiable, nongenetic risk factors that cause these diseases. Their role can be estimated by accounting for risk factor prevalence and exposure, strength of relative risk associations with health outcomes, and cause-specific mortality.

With this awareness at the forefront, the Global Burden of Cardiovascular Diseases Collaboration, an alliance between the Institute for Health Metrics and Evaluation, the National Heart, Lung, and Blood Institute, and the Journal of the American College of Cardiology (JACC), was launched in 2020. Since then, this collaboration has delivered publications as well as a 5-part region-specific digital series, focused on East Asia, North America, South America, Sub-Saharan Africa, and Western Europe, highlighting their distinct epidemiology. Knowing that the global cardiovascular clinical and research communities desire these data with more frequency, it is our intent to publish results annually. In this update, we provide a lens on the global, regional, and national burden of CVDs and risk factors.

This 2022 dedicated issue of JACC highlights 21 global regions, each with 2 pages of data presented in a graphic-rich almanac style. In this review, we also highlight the leading global modifiable cardiovascular risk factors, their contribution to disease burden, and recent advances related to their control and prevention. Attention is paid to how these metabolic, behavioral, and environmental risks may be addressed through evidence-based clinical care and health policy.