Cardiovascular diseases (CVD) continue to be the leading cause of death worldwide, responsible for one in three deaths, driven by population growth, ageing, and increased exposure to risk factors such as obesity and diabetes. These findings come from the latest Global Burden of Disease (GBD) Study special report, published in JACC.
Launched in 2020, the Global Burden of Cardiovascular Diseases Collaboration is a partnership between JACC, the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, and the National Heart, Lung, and Blood Institute. The 2025 report covers 204 countries and territories, highlighting key modifiable cardiovascular risk factors, their impact, and prevention progress.
This research gives countries a clear view of where progress is happening and where urgent action is needed. By addressing the most preventable risks with effective policies and cost-effective treatments, premature deaths from non-communicable diseases can be reduced. These results provide reliable evidence and actionable guidance for improving cardiovascular health.
The report highlights substantial global, regional, and national variation in CVD burden, even among countries with similar economies. Researchers analysed data on 376 diseases, including CVD, from 1990 to 2023 across 204 countries using statistical modelling to identify drivers such as population growth, ageing, and risk factor exposure.
Globally, CVD remains the leading cause of death and disability-adjusted life years (DALYs). In 2023, there were 437 million CVD DALYs, a 1.4-fold increase from 320 million in 1990, with a 16-fold variation between countries with the lowest and highest DALY rates. CVD caused 19.2 million deaths in 2023, up from 13.1 million in 1990. Leading contributors to DALYs included ischaemic heart disease, intracerebral haemorrhage, ischaemic stroke, and hypertensive heart disease.
79.6% of global CVD DALYs were linked to modifiable risk factors, an increase of 97.4 million since 1990, mainly due to population growth and ageing. Key risks include metabolic factors, high body mass index (BMI) and high fasting plasma glucose, followed by behavioural and environmental/occupational risks such as air pollution, lead exposure, and higher temperatures. Metabolic, behavioural, and environmental/occupational factors contributed 67.3%, 44.9%, and 35.8% of CVD DALYs, respectively. Reductions in tobacco use and household air pollution partially offset the rising burden.
Key Findings:
- Global CVD deaths rose from 13.1 million in 1990 to 19.2 million in 2023.
- Ischaemic heart disease affected ~240 million people in 2023; lower extremity peripheral arterial disease impacted 122 million. Stroke remains a major cause of death and disability worldwide.
- Men have higher cardiovascular mortality than women, with risk increasing sharply after age 50.
- High BMI and high fasting plasma glucose were the fastest-growing metabolic contributors from 2018 to 2023, reflecting global obesity and diabetes trends.
- In 2023, high systolic blood pressure was the leading contributor to CVD burden, followed by poor diet, environmental risks (air pollution, lead exposure, non-optimal temperatures), high LDL cholesterol, tobacco use, kidney dysfunction, low physical activity, and unsafe alcohol use.
- Ambient air pollution caused nearly 4 million CVD deaths, with the highest rates in Oceania. Lead exposure remains a significant hazard in parts of Central Asia and North Africa.
- Lifestyle factors, tobacco, diet, physical inactivity, and alcohol continue to drive ischaemic heart disease and atrial fibrillation.
The burden of CVD is substantially higher outside the most developed countries, even after accounting for population age differences. Findings show wide geographic disparities in CVD that income alone cannot explain, emphasising the need for locally tailored health policies.
Source: American College of Cardiology
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