Chronic Disease Epidemiology

Cardiovascular Disease

Cardiovascular disease (comprised mainly of heart disease and stroke) accounted for 30% (17 million) of all deaths, and 10% of disability-adjusted life-years worldwide in 2005, and thus represents the leading cause of mortality and morbidity globally. It is anticipated that the developing world will experience the greatest increases in the burden of cardiovascular disease in the decades to come. Between 1990 and 2020, the developing world is projected to have 137% and 120% increases in the number of deaths from coronary heart disease among men and women, respectively. In contrast, these increases are estimated to be 29% and 48% in developed countries. Likewise, 124% and 107% increases of stroke deaths among men and women in developing countries are expected over the same time period, with lesser respective increases of 78% and 56% in developed countries.

In Western developed nations, including the United States, Canada, and Australia, mortality rates from coronary heart disease rose until the late 1960s, after which there was a secular decline in mortality rates. A similar pattern was observed for stroke mortality rates, although the decline began as much as two decades earlier and was more pronounced than for heart disease. Presently in these countries, coronary heart disease mortality rates exceed stroke mortality rates. Despite the declines in annual rates of death for both coronary heart disease and stroke, the absolute number of deaths from each outcome has substantially increased over the past decade. This is mainly due to population aging, with mortality rates increasing successively with age. Notably, disparities in these outcomes, particularly along racial/ethnic lines, are well established. For example, in the United States, compared with whites, in both men and women, heart disease and stroke death rates are higher among blacks, yet lower among Asians/Pacific Islanders and Hispanics.

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