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European Society of Cardiology: Cardiovascular Disease Statistics 2019.

  • Timmis, Adam1
  • Townsend, Nick2
  • Gale, Chris P3
  • Torbica, Aleksandra4
  • Lettino, Maddalena5
  • Petersen, Steffen E1
  • Mossialos, Elias A6
  • Maggioni, Aldo P7
  • Kazakiewicz, Dzianis8
  • May, Heidi T9
  • De Smedt, Delphine10
  • Flather, Marcus11
  • Zuhlke, Liesl12
  • Beltrame, John F13
  • Huculeci, Radu8
  • Tavazzi, Luigi14
  • Hindricks, Gerhard15
  • Bax, Jeroen16
  • Casadei, Barbara17
  • Achenbach, Stephan18
  • And 2 more
  • 1 Barts Heart Centre and Queen Mary University London, London, UK.
  • 2 Department for Health, University of Bath, Bath, UK.
  • 3 Medical Research Council Bioinformatics Centre, Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
  • 4 Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy. , (Italy)
  • 5 San Gerardo Hospital, Monza, Italy. , (Italy)
  • 6 Department of Health Policy, London School of Economics, London, UK.
  • 7 Research Center of Italian Association of Hospital Cardiologists (ANMCO), Florence, Italy. , (Italy)
  • 8 European Society of Cardiology Health Policy Unit, European Heart Health Institute, European Heart Agency, Brussels, Belgium. , (Belgium)
  • 9 Intermountain Medical Center Heart Institute, Salt Lake City, UT, USA.
  • 10 Department of Public Health and Primary Care, Ghent University, Ghent, Belgium. , (Belgium)
  • 11 Norwich Medical School, University of East Anglia, Norwich, UK.
  • 12 Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa. , (South Africa)
  • 13 University of Adelaide, Central Adelaide Local Health Network, The Queen Elizabeth Hospital, Adelaide, Australia. , (Australia)
  • 14 Maria Cecilia Hospital-GVM Care&Research, Cotignola, Italy. , (Italy)
  • 15 University of Leipzig, Leipzig, Germany. , (Germany)
  • 16 Leiden University Medical Center, Leiden, The Netherlands. , (Netherlands)
  • 17 Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Level 6, West Wing, Oxford, UK.
  • 18 Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany. , (Germany)
  • 19 Nuffield Department of Population Health, University of Oxford, Headington, Oxford, UK.
Published Article
European Heart Journal
Oxford University Press
Publication Date
Jan 01, 2020
DOI: 10.1093/eurheartj/ehz859
PMID: 31820000


The 2019 report from the European Society of Cardiology (ESC) Atlas provides a contemporary analysis of cardiovascular disease (CVD) statistics across 56 member countries, with particular emphasis on international inequalities in disease burden and healthcare delivery together with estimates of progress towards meeting 2025 World Health Organization (WHO) non-communicable disease targets. In this report, contemporary CVD statistics are presented for member countries of the ESC. The statistics are drawn from the ESC Atlas which is a repository of CVD data from a variety of sources including the WHO, the Institute for Health Metrics and Evaluation, and the World Bank. The Atlas also includes novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery obtained by annual survey of the national societies of ESC member countries. Across ESC member countries, the prevalence of obesity (body mass index ≥30 kg/m2) and diabetes has increased two- to three-fold during the last 30 years making the WHO 2025 target to halt rises in these risk factors unlikely to be achieved. More encouraging have been variable declines in hypertension, smoking, and alcohol consumption but on current trends only the reduction in smoking from 28% to 21% during the last 20 years appears sufficient for the WHO target to be achieved. The median age-standardized prevalence of major risk factors was higher in middle-income compared with high-income ESC member countries for hypertension {23.8% [interquartile range (IQR) 22.5-23.1%] vs. 15.7% (IQR 14.5-21.1%)}, diabetes [7.7% (IQR 7.1-10.1%) vs. 5.6% (IQR 4.8-7.0%)], and among males smoking [43.8% (IQR 37.4-48.0%) vs. 26.0% (IQR 20.9-31.7%)] although among females smoking was less common in middle-income countries [8.7% (IQR 3.0-10.8) vs. 16.7% (IQR 13.9-19.7%)]. There were associated inequalities in disease burden with disability-adjusted life years per 100 000 people due to CVD over three times as high in middle-income [7160 (IQR 5655-8115)] compared with high-income [2235 (IQR 1896-3602)] countries. Cardiovascular disease mortality was also higher in middle-income countries where it accounted for a greater proportion of potential years of life lost compared with high-income countries in both females (43% vs. 28%) and males (39% vs. 28%). Despite the inequalities in disease burden across ESC member countries, survey data from the National Cardiac Societies of the ESC showed that middle-income member countries remain severely under-resourced compared with high-income countries in terms of cardiological person-power and technological infrastructure. Under-resourcing in middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, device implantation and cardiac surgical procedures. A seemingly inexorable rise in the prevalence of obesity and diabetes currently provides the greatest challenge to achieving further reductions in CVD burden across ESC member countries. Additional challenges are provided by inequalities in disease burden that now require intensification of policy initiatives in order to reduce population risk and prioritize cardiovascular healthcare delivery, particularly in the middle-income countries of the ESC where need is greatest. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: [email protected]

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