Cardiovascular disease (CVD) remains the leading cause of mortality and disability worldwide, with its absolute burden continuing to increase, according to the latest findings from the Global Burden of Disease (GBD) 2023 study.¹ The analysis highlights that while some risk factors have seen improvement, population growth, aging, and rising metabolic risks are driving an overall increase in CVD cases and deaths.
The GBD 2023 study is a multinational collaborative research project that quantified the burden of 375 diseases, including 18 cardiovascular sub-diseases, across 204 countries and territories from 1990 to 2023. The researchers analysed trends in mortality, prevalence, and disability-adjusted life years (DALYs), a metric combining years of life lost to premature death and years lived with disability. The study also identified the contribution of 12 associated modifiable risk factors to the overall CVD burden.
Globally, CVDs were responsible for 437 million DALYs in 2023, a 1.4-fold increase from 320 million in 1990. The number of CVD deaths rose from 13.1 million to 19.2 million over the same period. Furthermore, the number of prevalent CVD cases more than doubled, from 311 million in 1990 to 626 million in 2023.¹
The leading cardiovascular causes of DALYs in 2023 were ischaemic heart disease, intracerebral haemorrhage, ischaemic stroke, and hypertensive heart disease. The burden was not evenly distributed, with the highest age-standardised DALY rates found in low and low-middle Socio-demographic Index (SDI) regions.
Modifiable risk factors were responsible for 79.6% of the total CVD burden. The four largest contributors were high systolic blood pressure, dietary risks, high LDL-cholesterol, and air pollution. The study identified population growth and aging as the primary drivers of the increased burden since 1990. While reductions in tobacco use have helped mitigate some of this increase, rising levels of high body mass index, high fasting plasma glucose, and low physical activity have contributed to a higher burden.
The findings underscore the persistent and growing challenge of CVD globally. The study collaborators concluded, “CVD remains the leading cause of disease burden and death worldwide with the greatest burden in low, low-middle, and middle SDI regions.”¹ They also noted that the “large variation exists in CVD burden even for countries at similar levels of development, a gap explained substantially by known, modifiable risk factors that are inadequately controlled.” This highlights the urgent need for effective health system and public health strategies to address these risk factors and curb the rising tide of CVD, particularly in resource-limited settings, to meet global health targets such as the Sustainable Development Goals.²
This study was funded by the Bill and Melinda Gates Foundation and the American College of Cardiology Foundation.
References
1. Global Burden of Cardiovascular Diseases and Risks 2023 Collaborators. Global, Regional, and National Burden of Cardiovascular Diseases and Risk Factors in 204 Countries and Territories, 1990-2023. J Am Coll Cardiol. 2025;86(22):2167-2243. https://doi.org/10.1016/j.jacc.2025.08.015
2. World Health Organization. SDG Target 3.4 Noncommunicable diseases and mental health. Accessed 3 January 2025. https://www.who.int/data/gho/data/themes/topics/sdg-target-3_4-noncommunicable-diseases-and-mental-health
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