Journal
CURRENT DIABETES REPORTS
Volume 19, Issue 7, Pages -Publisher
CURRENT MEDICINE GROUP
DOI: 10.1007/s11892-019-1161-2
Keywords
Global burden of diseases; Non-communicable diseases; Cardiovascular diseases; Risk factors; The epidemiological transition; Disparities; Body mass index; Type 2 diabetes; Hypertension; Evidence-based medicine
Categories
Funding
- National Heart, Lung, And Blood Institute of the National Institutes of Health [R01HL125442, U01HL138635]
- National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health [P30DK111024]
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Purpose of ReviewThe last 2-3 decades have witnessed a decline in age-standardized cardiovascular mortality rates in high-income regions, whereas this has only slightly decreased or even increased in most of the low- and middle-income countries. A systematic comparison of global CVD mortality by regions attributable to various modifiable risk factors such as diabetes, obesity, hypertension, poor diet, and physical inactivity is not available.Recent FindingsWe present a summary of time trends and heterogeneity in the distribution of global CVD mortality and the attribution of risk factors between 1990 and 2017 using the Global Burden of Disease (GBD) 2017 study. Globally, an estimated 17.8 million (233.1 per 100,000) people died of CVD in 2017. The rate of CVD death was decreased in high-income countries (1990: 271.8 (95% UI (uncertainty interval), 270.9-273.5); 2017: 128.5 (95% UI, 126.4-130.7) per 100,000)) whereas it remained the same in lower- and middle-income countries (1990: 368.2 (95% UI, 335.6-383.3); 2017: 316.9 (95% UI, 307.0-325.5) per 100,000). Among the various traditional risk factors, high systolic blood pressure, unhealthy diet, high fasting plasma glucose, and high low-density lipoprotein levels were attributed to most of the CVD death and disability-adjusted life year lost. We also observed gender variations in tobacco and increased alcohol consumption. In addition to the traditional risk factors, poor air quality is associated with increased CVD burden in developing countries.SummarySurveillance, country-specific guidelines, evidence-based policies, reinforcement of multisectoral health systems, and innovative solutions are urgently needed in resource-challenged settings to curb CVD risk factors and overall burden.
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