European Society of Cardiology: cardiovascular disease statistics 2021: Executive Summary

Author:

Timmis Adam1ORCID,Vardas Panos23,Townsend Nick4ORCID,Torbica Aleksandra5ORCID,Katus Hugo6ORCID,De Smedt Delphine7ORCID,Gale Chris P8ORCID,Maggioni Aldo P9,Petersen Steffen E1ORCID,Huculeci Radu3,Kazakiewicz Dzianis3,Rubio Victor de Benito3,Ignatiuk Barbara10,Raisi-Estabragh Zahra1ORCID,Pawlak Agnieszka11,Karagiannidis Efstratios12ORCID,Treskes Roderick13,Gaita Dan14,Beltrame John F15,McConnachie Alex16ORCID,Bardinet Isabel17,Graham Ian18,Flather Marcus19,Elliott Perry20ORCID,Mossialos Elias A21ORCID,Weidinger Franz22,Achenbach Stephan23

Affiliation:

1. William Harvey Research Institute, Queen Mary University London , London , UK

2. Hygeia Hospitals Group, HHG , Athens , Greece

3. European Heart Agency, European Society of Cardiology , Brussels , Belgium

4. Department for Health, University of Bath , Bath , UK

5. Centre for Research on Health and Social Care Management (CERGAS), Bocconi University , Milan , Italy

6. Department of Internal Medicine and Cardiology, University of Heidelberg , Heidelberg , Germany

7. Department of Public Health, Ghent University , Ghent , Belgium

8. Medical Research Council Bioinformatics Centre, Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds , Leeds , UK

9. Research Center of Italian Association of Hospital Cardiologists (ANMCO) , Florence , Italy

10. Division of Cardiology, Ospedali Riuniti Padova Sud , Monselice , Italy

11. Mossakowski Medical Research Centre Polish Academy of Sciences , Warsaw , Poland

12. First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece

13. Department of Cardiology, Leiden University Medical Center , Leiden , The Netherlands

14. Universitatea de Medicina si Farmacie Victor Babes, Institutul de Boli Cardiovasculare , Timisoara , Romania

15. University of Adelaide, Central Adelaide Local Health Network, Basil Hetzel Institute , Adelaide , Australia

16. Robertson Centre for Biostatistics, University of Glasgow , Glasgow , UK

17. European Society of Cardiology , Sophia Antipolis , France

18. Tallaght University Hospital , Dublin , Ireland

19. Norwich Medical School, University of East Anglia , Norwich , UK

20. Institute of Cardiovascular Science, University College London , London , UK

21. Department of Health Policy, London School of Economics , London , UK

22. Department of Internal Medicine and Cardiology, Klinik Landstrasse , Vienna , Austria

23. Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen , Germany

Abstract

Abstract Aims This report from the European Society of Cardiology (ESC) Atlas Project updates and expands upon the widely cited 2019 report in presenting cardiovascular disease (CVD) statistics for the 57 ESC member countries. Methods and results Statistics pertaining to 2019, or the latest available year, are presented. Data sources include the World Health Organization, the Institute for Health Metrics and Evaluation, the World Bank, and novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery. New material in this report includes sociodemographic and environmental determinants of CVD, rheumatic heart disease, out-of-hospital cardiac arrest, leftsided valvular heart disease, the advocacy potential of these CVD statistics, and progress towards World Health Organization (WHO) 2025 targets for non-communicable diseases. Salient observations in this report: (i) Females born in ESC member countries in 2018 are expected to live 80.8 years and males 74.8 years. Life expectancy is longer in high income (81.6 years) compared with middle-income (74.2 years) countries. (ii) In 2018, high-income countries spent, on average, four times more on healthcare than middle-income countries. (iii) The median PM2.5 concentrations in 2019 were over twice as high in middle-income ESC member countries compared with high-income countries and exceeded the EU air quality standard in 14 countries, all middle-income. (iv) In 2016, more than one in five adults across the ESC member countries were obese with similar prevalence in high and low-income countries. The prevalence of obesity has more than doubled over the past 35 years. (v) The burden of CVD falls hardest on middle-income ESC member countries where estimated incidence rates are ∼30% higher compared with high-income countries. This is reflected in disability-adjusted life years due to CVD which are nearly four times as high in middle-income compared with high-income countries. (vi) The incidence of calcific aortic valve disease has increased seven-fold during the last 30 years, with age-standardized rates four times as high in high-income compared with middle-income countries. (vii) Although the total number of CVD deaths across all countries far exceeds the number of cancer deaths for both sexes, there are 15 ESC member countries in which cancer accounts for more deaths than CVD in males and five-member countries in which cancer accounts for more deaths than CVD in females. (viii) The under-resourced status of middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, ablation procedures, device implantation, and cardiac surgical procedures. Conclusion Risk factors and unhealthy behaviours are potentially reversible, and this provides a huge opportunity to address the health inequalities across ESC member countries that are highlighted in this report. It seems clear, however, that efforts to seize this opportunity are falling short and present evidence suggests that most of the WHO NCD targets for 2025 are unlikely to be met across ESC member countries.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Health Policy

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