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Multicenter Study
. 2017 Jul 4;70(1):1-25.
doi: 10.1016/j.jacc.2017.04.052. Epub 2017 May 17.

Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015

Gregory A Roth  1 Catherine Johnson  2 Amanuel Abajobir  3 Foad Abd-Allah  4 Semaw Ferede Abera  5 Gebre Abyu  5 Muktar Ahmed  6 Baran Aksut  7 Tahiya Alam  2 Khurshid Alam  8 François Alla  9 Nelson Alvis-Guzman  10 Stephen Amrock  11 Hossein Ansari  12 Johan Ärnlöv  13 Hamid Asayesh  14 Tesfay Mehari Atey  5 Leticia Avila-Burgos  15 Ashish Awasthi  16 Amitava Banerjee  17 Aleksandra Barac  18 Till Bärnighausen  19 Lars Barregard  20 Neeraj Bedi  21 Ezra Belay Ketema  5 Derrick Bennett  22 Gebremedhin Berhe  5 Zulfiqar Bhutta  23 Shimelash Bitew  24 Jonathan Carapetis  25 Juan Jesus Carrero  26 Deborah Carvalho Malta  27 Carlos Andres Castañeda-Orjuela  28 Jacqueline Castillo-Rivas  29 Ferrán Catalá-López  30 Jee-Young Choi  31 Hanne Christensen  32 Massimo Cirillo  33 Leslie Cooper Jr  34 Michael Criqui  35 David Cundiff  36 Albertino Damasceno  37 Lalit Dandona  38 Rakhi Dandona  38 Kairat Davletov  39 Samath Dharmaratne  40 Prabhakaran Dorairaj  41 Manisha Dubey  42 Rebecca Ehrenkranz  2 Maysaa El Sayed Zaki  43 Emerito Jose A Faraon  44 Alireza Esteghamati  45 Talha Farid  46 Maryam Farvid  19 Valery Feigin  47 Eric L Ding  19 Gerry Fowkes  48 Tsegaye Gebrehiwot  6 Richard Gillum  19 Audra Gold  2 Philimon Gona  49 Rajeev Gupta  50 Tesfa Dejenie Habtewold  51 Nima Hafezi-Nejad  45 Tesfaye Hailu  5 Gessessew Bugssa Hailu  5 Graeme Hankey  25 Hamid Yimam Hassen  52 Kalkidan Hassen Abate  6 Rasmus Havmoeller  26 Simon I Hay  53 Masako Horino  54 Peter J Hotez  55 Kathryn Jacobsen  56 Spencer James  57 Mehdi Javanbakht  58 Panniyammakal Jeemon  41 Denny John  59 Jost Jonas  60 Yogeshwar Kalkonde  61 Chante Karimkhani  62 Amir Kasaeian  45 Yousef Khader  63 Abdur Khan  46 Young-Ho Khang  64 Sahil Khera  65 Abdullah T Khoja  66 Jagdish Khubchandani  67 Daniel Kim  68 Dhaval Kolte  69 Soewarta Kosen  70 Kristopher J Krohn  2 G Anil Kumar  71 Gene F Kwan  72 Dharmesh Kumar Lal  71 Anders Larsson  13 Shai Linn  73 Alan Lopez  8 Paulo A Lotufo  74 Hassan Magdy Abd El Razek  43 Reza Malekzadeh  45 Mohsen Mazidi  75 Toni Meier  76 Kidanu Gebremariam Meles  5 George Mensah  77 Atte Meretoja  8 Haftay Mezgebe  5 Ted Miller  78 Erkin Mirrakhimov  79 Shafiu Mohammed  80 Andrew E Moran  81 Kamarul Imran Musa  82 Jagat Narula  83 Bruce Neal  84 Frida Ngalesoni  85 Grant Nguyen  2 Carla Makhlouf Obermeyer  86 Mayowa Owolabi  87 George Patton  8 João Pedro  88 Dima Qato  89 Mostafa Qorbani  90 Kazem Rahimi  22 Rajesh Kumar Rai  91 Salman Rawaf  92 Antônio Ribeiro  27 Saeid Safiri  93 Joshua A Salomon  19 Itamar Santos  74 Milena Santric Milicevic  18 Benn Sartorius  94 Aletta Schutte  95 Sadaf Sepanlou  45 Masood Ali Shaikh  96 Min-Jeong Shin  97 Mehdi Shishehbor  7 Hirbo Shore  98 Diego Augusto Santos Silva  99 Eugene Sobngwi  100 Saverio Stranges  101 Soumya Swaminathan  102 Rafael Tabarés-Seisdedos  30 Niguse Tadele Atnafu  52 Fisaha Tesfay  5 J S Thakur  103 Amanda Thrift  104 Roman Topor-Madry  105 Thomas Truelsen  106 Stefanos Tyrovolas  107 Kingsley Nnanna Ukwaja  108 Olalekan Uthman  109 Tommi Vasankari  110 Vasiliy Vlassov  111 Stein Emil Vollset  112 Tolassa Wakayo  6 David Watkins  2 Robert Weintraub  113 Andrea Werdecker  114 Ronny Westerman  114 Charles Shey Wiysonge  115 Charles Wolfe  116 Abdulhalik Workicho  6 Gelin Xu  117 Yuichiro Yano  118 Paul Yip  119 Naohiro Yonemoto  120 Mustafa Younis  121 Chuanhua Yu  122 Theo Vos  2 Mohsen Naghavi  2 Christopher Murray  2
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Free PMC article
Multicenter Study

Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015

Gregory A Roth et al. J Am Coll Cardiol. .
Free PMC article

Abstract

Background: The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world.

Objectives: The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden.

Methods: CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility.

Results: In 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75.

Conclusions: CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD.

Keywords: cause of death; epidemiology; global health.

Figures

None
Figure 1
Figure 1
Global Map, Age-Standardized Prevalence of CVD in 2015 Choropleth map showing the estimated age-standardized prevalence of total CVD in 2015 for each country. ATG = Antigua and Barbuda; BRB = Barbados; COM = Comoros; CVD = cardiovascular diseases; DMA = Dominica; E Med = Eastern Mediterranean; FJI = Fiji; FSM = Federated States of Micronesia; GRD = Grenada; KIR = Kiribati; KS = Kaposi sarcoma; LCA = Saint Lucia; MDV = Maldives; MHL = Marshall Islands; MLT = Malta; MUS = Mauritius; NMSC = nonmelanoma skin cancer; SGP = Singapore; SLB = Solomon Islands; SYC = Seychelles; TLS = Timor-Leste; TON = Tonga; TTO = Trinidad and Tobago; VCT = Saint Vincent and the Grenadines; VUT = Vanuatu; W Africa = West Africa; WSM = Samoa.
Central Illustration
Central Illustration
Global Map, Age-Standardized Death Rate of CVD in 2015 Choropleth map showing the estimated age-standardized mortality rate of total CVD in 2015 for each country. ATG = Antigua and Barbuda; BRB = Barbados; COM = Comoros; CVD = cardiovascular diseases; DMA = Dominica; E Med = Eastern Mediterranean; FJI = Fiji; FSM = Federated States of Micronesia; GRD = Grenada; KIR = Kiribati; KS = Kaposi sarcoma; LCA = Saint Lucia; MDV = Maldives; MHL = Marshall Islands; MLT = Malta; MUS = Mauritius; NMSC = nonmelanoma skin cancer; SGP = Singapore; SLB = Solomon Islands; SYC = Seychelles; TLS = Timor-Leste; TON = Tonga; TTO = Trinidad and Tobago; VCT = Saint Vincent and the Grenadines; VUT = Vanuatu; W Africa = West Africa; WSM = Samoa.
Figure 2
Figure 2
Age-Standardized CVD Mortality Rate, From 1990 to 2015, of 21 GBD World Regions by SDI Relationship between age-standardized mortality rate for CVD and SDI over time. Each colored line represents a time trend of the relationship for the specified region. Each point represents a specific year for that region. The black line represents the overall global trend for age-standardized death rate of CVD in relation to SDI. CVD = cardiovascular diseases; GBD = Global Burden of Disease; SDI = sociodemographic index.
Figure 3
Figure 3
Relationship Between Age-Standardized Mortality Rate, CVD Cause, and SDI, by Sex This figure displays the distribution of age-standardized death rate by causes of CVD mortality by SDI. Abbreviations as in Figure 1.
Figure 4
Figure 4
Percent of Age-Standardized Prevalent Cases per 100,000 for CVD Causes, 2015 This figure displays the relative distribution of age-standardized prevalence by CVD cause for 21 GBD world regions. Abbreviations as in Figure 1.
Figure 5
Figure 5
Percent of Age-Standardized Deaths per 100,000 for CVD Causes, 2015 This figure displays the relative distribution of age-standardized prevalence by CVD cause for 21 GBD world regions. Abbreviations as in Figure 1.

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