Global Correlates of Cardiovascular Risk: A Comparison of 158 Countries

Nutrients. 2018 Mar 26;10(4):411. doi: 10.3390/nu10040411.


The aim of this study was a large-scale ecological analysis of nutritional and other environmental factors potentially associated with the incidence of cardiovascular diseases (CVDs) in the global context. Indicators of CVDs from 158 countries were compared with the statistics of mean intake (supply) of 60 food items between 1993 and 2011, obesity rates, health expenditure and life expectancy. This comparison shows that the relationship between CVD indicators (raised blood pressure, CVD mortality, raised blood glucose) and independent variables in the global context is influenced by various factors, such as short life expectancy, religiously conditioned dietary customs, the imprecision of some statistics and undernutrition. However, regardless of the statistical method used, the results always show very similar trends and identify high carbohydrate consumption (mainly in the form of cereals and wheat, in particular) as the dietary factor most consistently associated with the risk of CVDs. These findings are in line with the changing view of the causes of CVDs. Because the statistics of raised blood glucose only include people using medications and do not reflect true prevalence that is independent of healthcare, more objective data on the prevalence of CVDs are needed to confirm these observed trends.

Keywords: cardiovascular diseases; ecological study; nutrition; risk factors.

MeSH terms

  • Age Factors
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / economics
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / mortality
  • Comorbidity
  • Dietary Carbohydrates / administration & dosage
  • Dietary Carbohydrates / adverse effects*
  • Eating*
  • Feeding Behavior
  • Female
  • Global Health*
  • Health Expenditures
  • Humans
  • Hyperglycemia / epidemiology
  • Hypertension / epidemiology
  • Incidence
  • Life Expectancy
  • Male
  • Nutritional Status
  • Nutritive Value
  • Obesity / epidemiology
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Time Factors


  • Dietary Carbohydrates