Cardiovascular Disease
Cardiovascular disease causes 17.9 million deaths a year — about 32% of all global deaths. Ischaemic heart disease (heart attacks) and stroke are the top two single causes of death worldwide. Age-standardised CVD mortality has fallen by half since 1970 in high-income countries (smoking cessation, statins, blood pressure control, treatments) but absolute deaths continue to rise as populations age.
Key insights
CVD is the #1 killer worldwide
Ischaemic heart disease alone kills 8.9 million people per year — more than any other single condition. Stroke adds 7 million. Hypertensive heart disease 1.2 million. Cardiomyopathy and rheumatic heart disease contribute additional millions. Combined CVD has been the leading cause of death globally since the 1970s and shows no signs of being displaced.
Age-standardised rates have fallen substantially
Per-capita age-standardised CVD mortality in OECD countries fell by 50-65% between 1970 and 2020. Drivers: reduced smoking (the biggest single contributor), antihypertensive treatment scale-up, statins (1987-onward) for cholesterol, percutaneous coronary intervention, faster stroke response. The absolute numbers continue to rise because populations are aging and growing — but the per-person risk at any given age has fallen substantially.
Mortality patterns shifting south
High-income country CVD mortality continues to decline. Low- and middle-income country mortality has begun to rise as populations urbanize, smoke, gain weight, and live longer. Roughly 75% of CVD deaths now occur in low- and middle-income countries — and the share is rising. Sub-Saharan African CVD deaths are projected to double by 2040. Most LMIC health systems are inadequately equipped to handle this transition.
Age-standardised CVD mortality — selected countries (2024)
Deaths per 100,000, both sexes, age-standardised to WHO population
Key Finding: Russia and Eastern Europe have CVD rates 2-3× the OECD average; Mediterranean countries lowest in Europe.
US CVD mortality 1950–2020
Age-adjusted deaths per 100,000
Key Finding: ~65% decline over 70 years — one of public health's clearest success stories.
Methodology & caveats
Risk factor decomposition
Leading CVD risk factors globally: high blood pressure (responsible for ~10.8 million CVD deaths/year), tobacco use (~3.0M), high LDL cholesterol (~4.4M), elevated BMI (~3.4M), high sodium intake (~1.9M), air pollution (~3.0M), diabetes (~2.8M), physical inactivity. Many risk factors overlap; INTERHEART (2004) found 9 modifiable factors explained 90% of first heart attacks across diverse populations.
Treatment cascade matters
For hypertension: ~50% of people with high blood pressure globally know they have it; ~40% are on treatment; ~20% have it controlled. The cascade gaps are larger in LMICs but exist everywhere. Closing the diagnosis-treatment-control cascade is the highest-leverage CVD intervention available — and far more cost-effective than expensive procedural treatments after the disease has progressed.
South Asians at higher risk
South Asian populations develop CVD at lower BMI and at younger ages than European populations — partly genetic (different adipose tissue distribution, lower insulin sensitivity), partly environmental (high carbohydrate diets, low physical activity). The implication: BMI and risk thresholds calibrated for European populations may under-detect risk in South Asians; ethnicity-adjusted thresholds are increasingly used.