Cardiovascular Risk: A global perspective

Ranking of 10 selected risk factors of cause of death Attributable deaths due to selected risk factors (in thousands) World Health Organization 2011

Main factors that contribute to the development of CV disease there are several metabolic factors that increase the risk of heart disease, stroke, kidney failure and other complications of hypertension, including diabetes, high cholesterol and being overwight or obese. Tobacco and hypertension interact to further raise the likelihood of cardiovascular disease. Hypertension : the basic facts | A global brief on hypertension

CVD is the leading noncommunicable disease Nearly half of the 36 million deaths due to noncommunicable diseases (NCDs) are caused by CVDs World Health Organization 2011

THE COST of noncommunicable diseases for all low and middleincome countries, by disease Lost output 2011-2025 The increasing incidence of noncommunicable diseases will lead to greater dependency and mounting costs of care for patients and their families unless public health efforts to prevent these conditions are intensified. The Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases, adopted by the United Nations General Assembly in September 2011, acknowledges the rapidly growing burden of noncommunicable diseases and its devastating impact on health, socioeconomic development and poverty alleviation. World Health Organization 2011

Comparing losses from four noncommunicable disease conditions to public health spending, 2011-2025 If no action is taken to tackle hypertension and other noncommunicable diseases, the economic losses are projected to outstrip public spending on health INCOME GROUP (% of world population) Causes of death 2008, World Health Organization,Geneva

Ischemic heart disease mortality rates (age standardized, per 100 000) Causes of death 2008, World Health Organization,Geneva

Cerebrovascular disease mortality rates World Health Organization 2011

Smoking: The totally avoidable risk factor of CVD Males Prevalence of current daily tobacco smoking (%) World Health Organization 2011

Prevalence of obesity in males Prevalence of obesity (BMI30 kg/m2). Age standardized adjusted estimates in males World Health Organization 2011

Prevalence of raised blood pressure Males, ages 25+, age standardized, SBP≥ 140 and /or DBP ≥90 Figures show the distribution of prevalence of raised blood pressure in the world in adult males. Globally, the overall prevalence of raised blood pressure in adults aged 25 and over was around 40% in 2008. The number of people with uncontrolled hypertension has risen from 600 million in 1980 to nearly one billion in 2008 (6). Undetected and uncontrolled hypertension that increases the cardiovascular risk is a major contributor to stroke worldwide (6). The prevalence of raised blood pressure was highest in the WHO African Region, where it was 46% for males and females combined. The lowest prevalence of raised blood pressure was in the WHO Region of the Americas, with 35% for both males and females. Across the income groups of countries, the prevalence of raised blood pressure was consistently high, with low-, lower-middle- and upper-middleincome countries all having rates of around 40% for males and females. The prevalence in high-income countries was lower, at 35% for both genders (6). Prevalence of raised blood pressure (%) WHO 2011

Prevalence of Diabetes In males, ages 25+, age standardized, ≥ 7 mmol/l or on medication for raised blood glucose In 2008, diabetes was responsible for 1.3 million deaths globally. The magnitude of diabetes and other abnormalities of glucose tolerance would be considerably higher than the above estimate if the categories of “impaired fasting” and “impaired glucose tolerance” were included. In 2008, the global prevalence of diabetes was estimated to be 10% (6). The estimated prevalence of diabetes is relatively consistent across the income groupings of countries. Lowincome countries showed the lowest prevalence (8% for both males and females), and the upper-middle-income countries showed the highest prevalence (10% for both males and females). The prevalence of raised blood glucose worldwide is shown. Prevalence of raised blood glucose (%) World Health Organization 2011

Prevalence of raised blood cholesterol in males (ages 25+, age standardized, ≥ 5 mmol/l or on medication for raised blood cholesterol) In 2008, the global prevalence of raised total cholesterol among adults was 39% (37% for males and 40% for females). The prevalence of raised cholesterol in males in different parts of the world is shown. Globally, mean total cholesterol changed little between 1980 and 2008, falling by less than 0.1 mmol/l per decade in males and females. The prevalence of elevated total cholesterol was highest in the WHO European Region (54% for both genders), followed by the WHO Region of the Americas (48% for both genders). TheWHO African Region and the WHO South-East Asia Region showed the lowest percentages (23% and 30%, respectively) (6). The prevalence of raised total cholesterol noticeably increases according to the income level of the country (6). In low-income countries, around 25% of adults have raised total cholesterol, while in high-income countrieS, over 50% of adults have raised total cholesterol (6, 67) Prevalence of raised blood cholesterol (%) World Health Organization 2011

Association between the proportion of population living in urban areas and physical inactivity in adults in 122 countries classified by income group World Health Organization 2011

Trends in CVD mortality rates in developed countries Over the last two decades, cardiovascular mortality rates have declined in many high-income countries (13, 14, 130, 131). A combination of population-wide primary prevention and individual health-care intervention strategies have contributed to these declining mortality trends (4–6, 13, 14). This figure shows the declining trends in CVD mortality rates in some developed countries. This decline in mortality has been attributed to reduced incidence rates and/or improved survival after cardiovascular events due to health care interventions (13). World Health Organization 2011