Burden of cardiovascular diseases in the Arab region, 1990–2023: a systematic analysis of mortality, morbidity, and risk factors from the Global Burden of Disease study 2023

Background The Arab region has undergone substantial demographic and epidemiological changes, alongside conflict, displacement, and health-system disruption in some countries. We assessed cardiovascular disease burden and trends across Arab countries from 1990 to 2023. Methods As part of the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2023, we estimated the prevalence, mortality, and disability-adjusted life-years (DALYs) for cardiovascular diseases in the Arab region from 1990 to 2023. Estimates were stratified by age, sex, country, and cause. We examined temporal trends in age-standardised rates and absolute numbers, assessed variation across countries, and quantified the contribution of major risk factors. Findings In 2023, there were 28.9 million (95% UI 27.1–31.0 million) prevalent cases of cardiovascular disease and approximately 1.05 million deaths (0.94–1.15 million) in the Arab region. Total DALYs reached 27.0 million (24.3–29.9 million), with YLLs accounting for the majority of burden, indicating that cardiovascular disease remains predominantly driven by premature mortality, although the contribution of non-fatal burden is increasing in some settings. Between 1990 and 2023, absolute numbers increased substantially, with prevalent cases rising by 158.1% (149.8–166.5), deaths by 98.4% (75.4–123.2), and DALYs by 73.0% (46.8–102.7), despite declines in age-standardised mortality (−28.1% [−35.4 to −19.1]), DALYs (−32.4% [−40.1 to −24.0]), and YLLs (−33.5% [−41.8 to −24.8]) rates. Age-standardised burden varied markedly across countries, with persistently high or increasing rates in countries such as Egypt, Sudan, Morocco, and Yemen, and substantially lower rates in Gulf countries including Qatar and the United Arab Emirates. However, declines in several higher-income countries have slowed in recent years. Ischaemic heart disease and stroke remained the leading causes of burden, while chronic conditions such as atrial fibrillation, peripheral arterial disease, and aortic aneurysm increased in relative importance. Most burden was attributable to high systolic blood pressure, dietary risks, high low-density lipoprotein cholesterol, air pollution, and high body-mass index, with high fasting plasma glucose also contributing substantially. Interpretation Cardiovascular disease remains a major and unequal cause of mortality and morbidity in the Arab region, with the burden still largely driven by premature mortality. Rising absolute burden despite declining age-standardised rates underscores the need for stronger prevention of metabolic and environmental risks and health-system responses tailored to national contexts. Funding Khalifa University of Science and Technology.