Physicians' Academy for Cardiovascular Education

An overview of the global burden of CVD and risk factors from 1990 to 2019

Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study

Literature - Roth GA, Mensah GA, Johnson CA, et al. - J Am Coll Cardiol. 2020;76:2982-3021. doi: 10.1016/j.jacc.2020.11.010.

Introduction and methods

Cardiovascular diseases (CVDs), predominately ischemic heart disease (IHD) and stroke, remain a leading cause of mortality and rising health care costs [1,2].

This article reviews the magnitude of total CV burden and addresses underlying causes of CV death and related risk factors at global, regional, and national levels from 1990 to 2019 using estimates from the Global Burden of Disease (GBD) Study 2019.

The GBD is an annually updated multinational collaborative research study that estimates population health over time and is designed to make consistent comparative analyses by age and sex, and across regions. The research study uses standard epidemiological data on incidence, prevalence, mortality and health risk to produce estimates for 204 countries and territories from 1990 to 2019 [3].

Main results


Total CVDs

Ischemic Heart Disease (IHD)


Hypertensive Heart Disease (HHD)

Atrial fibrillation (AF) and atrial flutter (AFL)


Systolic Blood pressure (SBP)

Theoretical minimum risk exposure level TTMREL) is defined by the GBP 2019 as the level of exposure that minimizes risk at the population level. For SBP, this value is set at ≥110 to 115 mm Hg.

Fasting plasma glucose

High fasting plasma glucose is defined as plasma glucose concentration above a TMREL of 4.8-5.4 mmol/L.

Low-density lipoprotein cholesterol (LDL-c)

High LDL-c is defined by a TMREL of LDL-c above 0.7-1.3 mmol/L.

Body Mass Index (BMI)

High BMI is defined by a TMREL as above 20-25 kg/m² for adults and an above normal weight for children.


The global CVD burden has increased in almost all regions outside high-income countries. The increase was largely attributed to aging of the population and population growth. CVD burden attributable to several risk factors such as SBP, BMI and dietary risk was also increased worldwide.


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