Report shows 60% rise in global heart and circulatory deaths

The first World Heart Federation Report, co-authored by Essex public health experts, has revealed a 60% rise in global deaths caused by cardiovascular disease (CVD) in the last 30 years.

The World Heart Report, launched at the 2023 World Heart Summit, shows that CVD deaths jumped globally from 12.1 million in 1990 to 20.5 million in 2021, with four in five of those deaths occurring in low and middle-income countries.

The report, which uses data collated and analysed by researchers at the Essex Institute of Public Health and Wellbeing (IPHW) in partnership with the World Heart Federation, presents an in-depth analysis of CVD risk and mortality.

It uses data from major global monitoring projects such as the WHO Global Health Observatory, Global Burden of Disease, and the NCD-RisC, to show how cardiovascular health is progressing globally and across countries, and to highlight actions needed to benefit everyone, no matter where they live.

Lead author, Professor Mariachiara Di Cesare, Director of the IPHW, has called for better funding to save lives.

The report shows that the highest CVD death rates occur in Central Europe, Eastern Europe, and Central Asia.

Though the overall number of CVD deaths increased in the last three decades, largely driven by an ageing and growing population, the CVD death rate fell globally from 354.5 deaths per 100,000 people in 1990 to 239.9 deaths per 100,000 people in 2019.

However, the report shows that this decline was uneven across regions with the fastest decline in mortality experienced in high-income countries.

It highlights that high blood pressure, air pollution, tobacco use, and elevated low-density lipoprotein (so-called ‘bad’) cholesterol were among the leading contributors to CVD deaths.

Professor Di Cesare said: “The data shows that risk factors vary across regions, making it vital that countries be aware of their population profile. We also see lower CVD mortality in countries that invest more in healthcare as a percentage of gross domestic product (GDP), while CVD death rates are higher in countries where people pay more out-of-pocket for healthcare. Why cannot we do better than this?”

“Investing in healthcare saves lives. This evidence is indisputable. In line with WHO recommendations, countries must invest at least five per cent of their GDP to help bring down CVD death rates and morbidity,” Professor Di Cesare added.

The report, whose Essex authors also include Dr Honor Bixby and Dr Chodziwadziwa Kabudula from the IPHW, is the first major study from Essex’s partnership with the World Heart Federation and will feed in to the larger World Heart Observatory.

In its analysis of country-level policies to improve CVD health, WHF found that 64 per cent of countries have implemented at least seven of eight recommended policies, including national tobacco control programmes, availability of CVD drug treatments, and operational units within Ministries of Health. The lowest level of policy implementation was found in Sub-Saharan Africa, where over 50 per cent of countries do not have availability of CVD drugs in primary care facilities, a CVD National Plan, or a non-communicable diseases Unit.

The report includes five recommendations to get progress on CVD health back on track including implementing all key policies to combat CVD, ensuring CVD health interventions are adequately funded, and continuing efforts to improve data on CVDs and their risk factors, particularly in low and middle-income countries.