Global Trends and Regional Differences in Incidence and Mortality of Cardiovascular Disease, 1990-2019: Findings from 2019 Global Burden of Disease Study.

AIMS
Cardiovascular disease (CVD) is the main cause of morbidity and mortality worldwide and is linked with a regional economic burden. We analyzed and compared global trends as well as regional and sociodemographic differences in CVD incidence and mortality.


METHODS AND RESULTS
We obtained data to annual incident cases, deaths, age-standardized incidence rates (ASIRs), and age-standardized mortality rates (ASMRs) of CVD during 1990-2019 from the 2019 Global Burden of Disease Study. To quantify the temporal trends, we calculated changes in the incident cases and deaths as well as the estimated annual percentage changes (EAPCs) of age-standardized rates. Globally, CVD incident cases increased by 77.12% from 31.31 million in 1990 to 55.45 million in 2019; deaths rose by 53.81% from 12.07 million in 1990 to 18.56 million in 2019. The overall ASIR (EAPC, -0.56; 95% confidence interval [CI], -0.59 to -0.53) and ASMR (EAPC, -1.46; 95%CI, -1.51 to -1.40) decreased in this period. Against the global trend of ASIR falling, an increasing trend was found in Uzbekistan (EAPC, 1.24; 95%CI, 0.97-1.50), Tajikistan (EAPC, 0.49; 95%CI, 0.47-0.52), and Zimbabwe (EAPC, 0.42; 95%CI, 0.33-0.50). The number of CVD incident cases increased remarkably in low (108.3%), low-middle (114.81%) and middle (117.85%) Socio-Demographic Index regions in 1990-2019.


CONCLUSION
Despite the increased number of CVD cases and deaths after adjusting for changes in population age, we observed a consistent decrease in age-standardized incidence and mortality in most countries. However, specific regions-especially low to middle SDI regions-present worrying increases in CVD cases and deaths.