Global, Regional, and National Burden of Cardiovascular Diseases and Risk Factors in 204 Countries and Territories, 1990-2023
Nermeen Abu-Elala
Rana Kamal Abu Farha
Madineh Abbasi
Abdallah H.A. Abd Al Magied
Eman Abu-Gharbieh
Kamoru Ademola Adedokun
Nurudeen A. Adegoke
Lisa C. Adams
Armita Abedi
Mesfin Abebe
A. Bhoomadevi
Mohammad Amin Aalipour
Bedru J. Abafita
Ukachukwu O. Abaraogu
Dariush Abtahi
Ripon Kumar Adhikary
Mohd Adnan
E. S. Abhilash
Hasan Aalruz
Muhammad Sohail Afzal
Hana J. Abukhadijah
Bedru J. Abafita
Nasir Abbas
Tanin Adl Parvar
César Agostinis Sobrinho
Saira Afzal
Samar Abd ElHafeez
Olorunsola Israel Adeyomoye
Navidha Aggarwal
Johnathan M. Hsu
Catherine O. Johnson
Laura Lara-Castor
Nermeen Abu-Elala
Kate E. LeGrand
Prof Bhoomadevi A
Benjamin A. Stark
Nicole K. DeCleene
Emily C. Desai
Mohammad Abavisani
Mohammadreza Abbasian
Prerna Agarwal
Temesgen Anjulo Ageru
Oladimeji Muritala Adebayo
Suneth Buddhika Agampodi
Sepehr Aghajanian
Salahdein Aburuz
Prof Ahmed Abdelalim
Omar M. Abdelfattah
Prof Reda Abdel-Hameed
Prof Wael M Abdel-Rahman
Daba Abdissa
Mahmoud Abdelnabi
Prof Olumide Abiodun
Lucas Guimarães Abreu
Rui Adão
Aminu Kende Kende Abubakar
Apurba Acharya
Mujahid Abdullah
Ibrahim Jatau Abubakar
Swetha Acharya
Charles Oluwaseun Adetunji
Rishan Adha
Wirawan Adikusuma
Lawan Hassan Adamu
Qorinah Estiningtyas Sakilah Adnani
Gina Agarwal
Ahmed M. Afifi
Fatemeh Afrashteh
Hedayat Abbastabar
Samar Abd ElHafeez
Kulmira Abdykerimova
Rahim Abo Kasem
Asrat Agalu Abejew
Dmitry Abramov
Ousman Adal
Meshack Achore
Aidin Abedi
Olugbenga Olusola Abiodun
Shady Abohashem
Nagah M. Abourashed
David Adedia
Oyelola A. Adegboye
Habeeb Abiodun Afolabi
Anirudh Balakrishna Acharya
Isaac Yeboah Addo
Arman Abdous
Auwal Abdullahi
David Adzrago
Hasan Aalruz
Kishor Adhikari
Dhiraj Motilal Agarwal
Abdullahi Tunde Aborode
Richard Gyan Aboagye
Hassan Abolhassani
Ulric Sena Abonie
Wakgari Mosisa Abdisa
Parsa Abdi
Prince Owusu Adoma
Leticia Akua Adzigbli
Victor Adekanmbi
Arya Afrooghe
Dina Abushanab
Tajudeen Adesanmi Adebisi
Oluwatobi E. Adegbile
Olumide Thomas Adeleke
Nasir Abbas
Salahdein Aburuz
Publication Name: Journal of the American College of Cardiology
Publication Date: 2025-12-02
Volume: 86
Issue: 22
Page Range: 2167-2243
Description:
Background: Cardiovascular diseases (CVDs) are the leading cause of mortality and are among the foremost causes of disability globally. CVD burden has continued to increase in most countries since 1990, with trends driven by changing exposures to harmful risk factors, population growth, and population aging. Objectives: We report estimates of global, national, and subnational CVD burden, including 18 subdiseases and 12 associated modifiable risk factors. We analyzed change in CVD burden from 1990 to 2023 and identified drivers of change including population growth, population aging, and risk factor exposure. Methods: The Global Burden of Disease (GBD) 2023 study, a multinational collaborative research study, quantified burden due to 375 diseases including CVD burden and identified drivers of change from 1990 to 2023 using all available data and statistical models. GBD 2023 estimated the population-level burden of diseases in 204 countries and territories from 1990 to 2023. Results: CVDs were the leading cause of disability-adjusted life years (DALYs) and deaths estimated in the GBD. As of 2023, there were 437 million (95% UI: 401 to 465 million) CVD DALYs globally, a 1.4-fold increase from the number in 1990 of 320 million (292 to 344 million). Ischemic heart disease, intracerebral hemorrhage, ischemic stroke, and hypertensive heart disease were the leading cardiovascular causes of DALYs in 2023 globally. As of 2023, age-standardized CVD DALY rates were highest in low and low-middle Socio-demographic Index (SDI) settings and lowest in high SDI settings. The number of CVD deaths increased globally from 13.1 million (95% UI: 12.2 to 14.0 million) in 1990 to 19.2 million (95% UI: 17.4 to 20.4 million) in 2023. The number of prevalent cases of CVD more than doubled since 1990, with 311 million (95% UI: 294 to 333 million) prevalent cases of CVD in 1990 and 626 million (95% UI: 591 to 672 million) prevalent cases in 2023 globally. A total of 79.6% (95% UI: 75.7% to 82.5%) of CVD burden is attributable to modifiable risk factors 347 million [95% UI: 318 to 373 million] DALYs in 2023). Globally, high systolic blood pressure, dietary risks, high low-density lipoprotein cholesterol, and air pollution were the modifiable risks responsible for most attributable CVD burden in 2023. Since 1990, changes in exposure to modifiable risk factors have had mixed effects on CVD burden, with increases in high body mass index, high fasting plasma glucose, and low physical activity leading to higher burden, while reductions in tobacco usage have mitigated some of these increases. Population growth and population aging were the main drivers of the increasing burden since 1990, adding 128 million (95% UI: 115 to 139 million) and 139 million (95% UI: 126 to 151 million) CVD DALYs to the increase in CVD burden since 1990. Conclusions: CVD remains the leading cause of disease burden and death worldwide with the greatest burden in low, low-middle, and middle SDI regions. Large variation exists in CVD burden even for countries at similar levels of development, a gap explained substantially by known, modifiable risk factors that are inadequately controlled. The decades-long increase in CVD burden was the result of population growth, population aging, and increased exposure to a subset of risk factors led by metabolic risks. Countries will need to adopt effective health system and public health strategies if they are to progress in achieving global goals to reduce the burden of CVD.
Open Access: Yes
Authors - 107
Nermeen Abu-Elala
56073088900
Rana Kamal Abu Farha
56283149600
Madineh Abbasi
57193923353
Abdallah H.A. Abd Al Magied
59128864400
Eman Abu-Gharbieh
24586714800
Kamoru Ademola Adedokun
57207983240
Nurudeen A. Adegoke
57196007299
Lisa C. Adams
57192991712
Armita Abedi
57204607249
Mesfin Abebe
57223854886
A. Bhoomadevi
57208576447
Mohammad Amin Aalipour
57221831253
Bedru J. Abafita
59747304100
Ukachukwu O. Abaraogu
56119041500
Dariush Abtahi
18036750600
Ripon Kumar Adhikary
55847469100
Mohd Adnan
36022136700
E. S. Abhilash
57226827662
Hasan Aalruz
60211219100
Muhammad Sohail Afzal
56009310800
Hana J. Abukhadijah
57865346000
Bedru J. Abafita
57208648443
Nasir Abbas
59847373500
Tanin Adl Parvar
59905754300
César Agostinis Sobrinho
58962500300
Saira Afzal
7004381116
Samar Abd ElHafeez
55551273300
Olorunsola Israel Adeyomoye
57221313577
Navidha Aggarwal
57224993442
Johnathan M. Hsu
59072867100
Catherine O. Johnson
57212301236
Laura Lara-Castor
57211910875
Nermeen Abu-Elala
59016479000
Kate E. LeGrand
57216789066
Prof Bhoomadevi A
60215218600
Benjamin A. Stark
57219860666
Nicole K. DeCleene
57219860801
Emily C. Desai
59098044300
Mohammad Abavisani
57212216899
Mohammadreza Abbasian
9846109700
Prerna Agarwal
59561110400
Temesgen Anjulo Ageru
57757954600
Oladimeji Muritala Adebayo
57194329853
Suneth Buddhika Agampodi
23017863100
Sepehr Aghajanian
57221371799
Salahdein Aburuz
59755057900
Prof Ahmed Abdelalim
60215384300
Omar M. Abdelfattah
57216924676
Prof Reda Abdel-Hameed
60215262000
Prof Wael M Abdel-Rahman
60215384400
Daba Abdissa
57216254713
Mahmoud Abdelnabi
57205711287
Prof Olumide Abiodun
60215302800
Lucas Guimarães Abreu
55937631400
Rui Adão
56123651900
Aminu Kende Kende Abubakar
60215423500
Apurba Acharya
57871487800
Mujahid Abdullah
57745448700
Ibrahim Jatau Abubakar
57193384550
Swetha Acharya
57190209243
Charles Oluwaseun Adetunji
57248969000
Rishan Adha
57216878096
Wirawan Adikusuma
57194502515
Lawan Hassan Adamu
56926568700
Qorinah Estiningtyas Sakilah Adnani
58627736900
Gina Agarwal
57220151944
Ahmed M. Afifi
57196175428
Fatemeh Afrashteh
57254714200
Hedayat Abbastabar
57212441848
Samar Abd ElHafeez
59158131500
Kulmira Abdykerimova
59998147700
Rahim Abo Kasem
57221750031
Asrat Agalu Abejew
55204820500
Dmitry Abramov
25623078100
Ousman Adal
57766218500
Meshack Achore
57204045088
Aidin Abedi
56673854800
Olugbenga Olusola Abiodun
54386552600
Shady Abohashem
57194703660
Nagah M. Abourashed
57450956800
David Adedia
57207309355
Oyelola A. Adegboye
55270465600
Habeeb Abiodun Afolabi
58174110900
Anirudh Balakrishna Acharya
35751874500
Isaac Yeboah Addo
56305995900
Arman Abdous
57263159900
Auwal Abdullahi
56102934500
David Adzrago
57327792200
Hasan Aalruz
57216547615
Kishor Adhikari
57852466400
Dhiraj Motilal Agarwal
54398213500
Abdullahi Tunde Aborode
57916532700
Richard Gyan Aboagye
57221438826
Hassan Abolhassani
58597704600
Ulric Sena Abonie
57214797230
Wakgari Mosisa Abdisa
59998578600
Parsa Abdi
58143779200
Prince Owusu Adoma
57777244400
Leticia Akua Adzigbli
57899326600
Victor Adekanmbi
53463192900
Arya Afrooghe
57431758400
Dina Abushanab
57205329983
Tajudeen Adesanmi Adebisi
59997997500
Oluwatobi E. Adegbile
58998875200
Olumide Thomas Adeleke
57204237787
Nasir Abbas
56940204900
Salahdein Aburuz
55886382800
