Burden and Risk Factors of Cardiovascular Diseases in Asia, 1990–2021

BACKGROUND: Despite ongoing prevention efforts, the burden of cardiovascular disease (CVD) continues to rise with rapidly aging population and lifestyle changes. Comprehensive reports on CVD burden for Asia remain limited. OBJECTIVES: The aims of this study were to quantify the CVD burden in Asia from 1990 to 2021 and to investigate associated risk factors and their temporal rank changes. METHODS: Data from the Global Burden of Disease (GBD) 2021 study were used to estimate the prevalence, disability-adjusted life years (DALYs), and mortality of CVD from 1990 to 2021 across 6 Asian regions, age groups, and sex. Twenty-seven behavioral, environmental, and metabolic risk factors were analyzed. RESULTS: In 2021, Asia accounted for 270.4 million DALYs and 11.8 million deaths of CVD, representing 61.3% of global CVD mortality. The age-standardized DALYs rate (ASDR) in Asia exceeded the global average by 8.3%. The ASDR was highest in Central Asia but lowest in the high-income Asia Pacific region among the 6 Asian regions. From 1990 to 2021, ASDR and age-standardized mortality rate declined by 27.5% and 25.4%, respectively, whereas age-standardized prevalence increased by 71.7%. Ischemic heart disease and stroke collectively contributed to more than 80% of CVD deaths. High systolic blood pressure persisted as the leading risk factor, while particulate matter pollution emerged as a leading contributor to CVD burden in Asia. CONCLUSIONS: Despite declines in ASDR and age-standardized mortality rate, the absolute CVD burden in Asia has increased sharply. Regional disparities in CVD burden and risk factors profiles highlight the necessity for targeted interventions.