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J Am Coll Cardiol. 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.

Roth GA1, Johnson C2, Abajobir A3, Abd-Allah F4, Abera SF5, Abyu G5, Ahmed M6, Aksut B7, Alam T2, Alam K8, Alla F9, Alvis-Guzman N10, Amrock S11, Ansari H12, Ärnlöv J13, Asayesh H14, Atey TM5, Avila-Burgos L15, Awasthi A16, Banerjee A17, Barac A18, Bärnighausen T19, Barregard L20, Bedi N21, Belay Ketema E5, Bennett D22, Berhe G5, Bhutta Z23, Bitew S24, Carapetis J25, Carrero JJ26, Malta DC27, Castañeda-Orjuela CA28, Castillo-Rivas J29, Catalá-López F30, Choi JY31, Christensen H32, Cirillo M33, Cooper L Jr34, Criqui M35, Cundiff D36, Damasceno A37, Dandona L38, Dandona R38, Davletov K39, Dharmaratne S40, Dorairaj P41, Dubey M42, Ehrenkranz R2, El Sayed Zaki M43, Faraon EJA44, Esteghamati A45, Farid T46, Farvid M19, Feigin V47, Ding EL19, Fowkes G48, Gebrehiwot T6, Gillum R19, Gold A2, Gona P49, Gupta R50, Habtewold TD51, Hafezi-Nejad N45, Hailu T5, Hailu GB5, Hankey G25, Hassen HY52, Abate KH6, Havmoeller R26, Hay SI53, Horino M54, Hotez PJ55, Jacobsen K56, James S57, Javanbakht M58, Jeemon P41, John D59, Jonas J60, Kalkonde Y61, Karimkhani C62, Kasaeian A45, Khader Y63, Khan A46, Khang YH64, Khera S65, Khoja AT66, Khubchandani J67, Kim D68, Kolte D69, Kosen S70, Krohn KJ2, Kumar GA71, Kwan GF72, Lal DK71, Larsson A13, Linn S73, Lopez A8, Lotufo PA74, El Razek HMA43, Malekzadeh R45, Mazidi M75, Meier T76, Meles KG5, Mensah G77, Meretoja A8, Mezgebe H5, Miller T78, Mirrakhimov E79, Mohammed S80, Moran AE81, Musa KI82, Narula J83, Neal B84, Ngalesoni F85, Nguyen G2, Obermeyer CM86, Owolabi M87, Patton G8, Pedro J88, Qato D89, Qorbani M90, Rahimi K22, Rai RK91, Rawaf S92, Ribeiro A27, Safiri S93, Salomon JA19, Santos I74, Santric Milicevic M18, Sartorius B94, Schutte A95, Sepanlou S45, Shaikh MA96, Shin MJ97, Shishehbor M7, Shore H98, Silva DAS99, Sobngwi E100, Stranges S101, Swaminathan S102, Tabarés-Seisdedos R30, Tadele Atnafu N52, Tesfay F5, Thakur JS103, Thrift A104, Topor-Madry R105, Truelsen T106, Tyrovolas S107, Ukwaja KN108, Uthman O109, Vasankari T110, Vlassov V111, Vollset SE112, Wakayo T6, Watkins D2, Weintraub R113, Werdecker A114, Westerman R114, Wiysonge CS115, Wolfe C116, Workicho A6, Xu G117, Yano Y118, Yip P119, Yonemoto N120, Younis M121, Yu C122, Vos T2, Naghavi M2, Murray C2.

Author information

1
University of Washington, Seattle, Washington. Electronic address: rothg@uw.edu.
2
University of Washington, Seattle, Washington.
3
University of Queensland, Brisbane, Queensland, Australia.
4
Cairo University, Cairo, Egypt.
5
Mekelle University, Addis Ababa, Ethiopia.
6
Jimma University, Jimma, Ethiopia.
7
Cleveland Clinic, Cleveland, Ohio.
8
University of Melbourne, Melbourne, Victoria, Australia.
9
University of Lorraine, Nancy, France.
10
Universidad de Cartagena, Cartagena, Colombia.
11
Oregon Health & Science University, Portland, Oregon.
12
Zahedan University of Medical Sciences, Zahedan, Iran.
13
Uppsala University, Uppsala, Sweden.
14
Qom University of Medical Sciences, Qom, Iran.
15
National Institute of Public Health, Cuernavaca, Mexico.
16
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
17
University College London, London, United Kingdom.
18
University of Belgrade, Belgrade, Serbia.
19
Harvard University, Boston, Massachusetts.
20
University of Gothenburg, Gothenburg, Sweden.
21
College of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia.
22
University of Oxford, Oxford, United Kingdom.
23
Aga Khan University, Karachi, Pakistan.
24
Wolaita Sodo University, Wolaita Sodo, Ethiopia.
25
The University of Western Australia, Perth, Western Australia, Australia.
26
Karolinska Institutet, Stockholm, Sweden.
27
Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
28
Instituto Nacional de Salud, Bogotá, Colombia.
29
Caja Costarricense de Seguro Social, San José, Costa Rica.
30
University of València/INCLIVA Health Research Institute and CIBERSAM, València, Spain.
31
Seoul National University Hospital, Seoul, South Korea.
32
Bispebjerg University Hospital, Copenhagen, Denmark.
33
University of Salerno, Salerno, Italy.
34
Mayo Clinic, Rochester, Minnesota.
35
University of California, San Diego, California.
36
Long Beach, California.
37
Eduardo Mondlane University, Maputo, Mozambique.
38
University of Washington, Seattle, Washington; Public Health Foundation of India, New Delhi, India.
39
Republican Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan.
40
University of Peradeniya, Peradeniya, Sri Lanka.
41
Centre for Chronic Disease Control, Gurgaon, India.
42
International Institute for Population Sciences, Mumbai, India.
43
Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
44
University of Philippines Manila, Manila, Philippines.
45
Tehran University of Medical Sciences, Tehran, Iran.
46
University of Louisville, Louisville, Kentucky.
47
Auckland University of Technology, Auckland, New Zealand.
48
University of Edinburgh, Edinburgh United Kingdom.
49
University of Massachusetts Boston, Boston, Massachusetts.
50
Eternal Heart Care Center and Research Institute, Jaipur, India.
51
University of Groningen, Groningen, the Netherlands.
52
Mizan-Tepi University, Mizan Teferi, Ethiopia.
53
University of Washington, Seattle, Washington; University of Oxford, Oxford, United Kingdom.
54
Nevada Division of Public and Behavioral Health, Carson City, Nevada.
55
Baylor College of Medicine, Houston, Texas.
56
George Mason University, Fairfax, Virginia.
57
Denver Health/University of Colorado, Denver, Colorado.
58
University of Aberdeen, Aberdeen, United Kingdom.
59
International Center for Research on Women, New Delhi, India.
60
Ruprecht-Karls Universitaet Heidelberg, Heidelberg, Germany.
61
Society for Education, Action and Research in Community Health, Gadchiroli, India.
62
Case Western University Hospitals, Cleveland, Ohio.
63
Jordan University of Science and Technology, Irbid, Jordan.
64
Seoul National University, Seoul, South Korea.
65
New York Medical College, Valhalla, New York.
66
Al-Imam Muhammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia.
67
Ball State University, Muncie, Indiana.
68
Northeastern University, Boston, Massachusetts.
69
Brown University, Providence, Rhode Island.
70
Health Policy and Humanities, National Institute of Health Research and Development, Jakarta, Indonesia.
71
Public Health Foundation of India, New Delhi, India.
72
Boston University School of Medicine, Boston, Massachusetts.
73
University of Haifa, Haifa, Israel.
74
University of São Paulo, São Paulo, Brazil.
75
Chinese Academy of Sciences, Beijing, China.
76
Martin Luther University Halle-Wittenberg, Halle, Germany.
77
National Institutes of Health, Bethesda, Maryland.
78
Pacific Institute for Research & Evaluation, Beltsville, Maryland.
79
Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
80
Ahmadu Bello University, Zaria, Nigeria.
81
Columbia University, New York, New York.
82
University of Science Malaysia, Penang, Malaysia.
83
The Mount Sinai Hospital, New York, New York.
84
The George Institute for Global Health, Newtown, New South Wales, Australia.
85
Ministry of Health and Social Welfare, Dar es Salaam, Tanzania.
86
American University of Beirut, Beirut, Lebanon.
87
College of Medicine, University of Ibadan, Ibadan, Nigeria.
88
University of Porto, Porto, Portugal.
89
University of Illinois at Chicago, Chicago, Illinois.
90
Alborz University of Medical Sciences, Karaj, Iran.
91
Society for Health and Demographic Surveillance, Birbhum, India.
92
Imperial College London, London, United Kingdom.
93
Maragheh University of Medical Sciences, Maragheh, Iran.
94
University of KwaZulu-Natal, Durban, South Africa.
95
North-West University, Potchefstroom, South Africa.
96
Independent Consultant, Islamabad, Pakistan.
97
Korea University, Seoul, South Korea.
98
Haramaya University, Dire Dawa, Ethiopia.
99
Federal University of Santa Catarina, Florianópolis, Brazil.
100
University of Yaoundé, Yaoundé, Cameroon.
101
Luxembourg Institute of Health, Strassen, Luxembourg.
102
Indian Council of Medical Research, New Delhi, India.
103
Postgraduate Institute of Medical Education and Research, Chandigarh, India.
104
Monash University, Melbourne, Victoria, Australia.
105
Jagiellonian University Medical College, Kraków, Poland.
106
University of Copenhagen, Copenhagen, Denmark.
107
Universitat de Barcelona, CIBERSAM, Barcelona, Spain.
108
Federal Teaching Hospital, Abakaliki, Nigeria.
109
University of Warwick, Coventry, United Kingdom.
110
UKK Institute for Health Promotion Research, Tampere, Finland.
111
National Research University Higher School of Economics, Moscow, Russia.
112
Norwegian Institute of Public Health, Oslo, Norway.
113
Royal Children's Hospital, Melbourne, Victoria, Australia.
114
Federal Institute for Population Research, Wiesbaden, Germany.
115
Cochrane South Africa, Tygerberg, South Africa.
116
King's College London, London, United Kingdom.
117
Nanjing University School of Medicine, Nanjing, China.
118
Northwestern University, Chicago, Illinois.
119
University of Hong Kong, Pokfulam, Hong Kong.
120
Kyoto University, Kyoto, Japan.
121
Jackson State University, Jackson, Mississippi.
122
Wuhan University, Wuhan, China.

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

PMID:
28527533
PMCID:
PMC5491406
DOI:
10.1016/j.jacc.2017.04.052
[Indexed for MEDLINE]
Free PMC Article

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