It Is Time for Reducing Global Cardiovascular Mortality

Article, see p 715 I t has been known for many decades that cardiovascular disease (CVD) is the leading cause of death in high-income countries. However, it wasn't until the 1990 GBD (Global Burden of Disease) study that it became recognized that CVD is the leading cause of death worldwide, both in high-and low-income populations. This study estimated that ischemic heart disease and cerebrovascular disease accounted for 5.7 and 4.6 million deaths worldwide, respectively, in 1990. 2 These data corrected a perception that noncommunicable diseases were primarily diseases of affluent populations and stressed the need for addressing them in all world regions. After this first report, there have been subsequent waves of the GBD study that have continued to highlight a high, and growing, global burden of CVD. For example, the GBD study estimated that between 1990 and 2013, deaths attributable to ischemic heart disease and cerebrovascular disease increased by 42% and 41%, respectively, with approximately 70% of all CVD deaths worldwide in 2013 having occurred in low-or middle-income countries. 2 Additionally, it has been estimated that CVD will account for >23 million deaths by 2030. In the current issue of Circulation, Kontis et al 4 report on a study that estimated the number of deaths from CVD and other non-communicable diseases between 2015 and 2040 that could be delayed worldwide through the implementation of 3 population-based interventions: