Middle-income countries shoulder the bulk of Europe’s CVD burden
A report published in the European Heart Journal Dec. 10 suggests middle-income countries in Europe suffer most heavily from CVD morbidity and mortality.
The report, authored by Panos Vardas, a former European Society of Cardiology president, and colleagues details a “modest” decline in CVD in Europe over the past three or so decades and notes that 11 countries saw no reduction in heart disease at all over the course of 27 years. They detailed the burden of CVD in 57 ESC member countries—including all European countries except Andorra, Liechtenstein, Monaco and the Vatican City, and a handful of countries in Asia, North Africa and the East Mediterranean.
Vardas et al.’s review found that, compared to high-income countries in Europe, middle-income countries had more premature death due to CVD, a greater proportion of potential years of life lost due to CVD and three times more years lost to CVDs, related disabilities or early death. Middle-income countries also saw higher age-standardized incidence and prevalence of coronary artery disease and stroke, two major components of heart disease.
“The statistics emphasize the need for concerted application of CVD prevention policies, particularly in middle-income countries where the need is greatest,” Vardas said in a release. “Middle-income countries are less able to meet the costs of contemporary healthcare than high-income countries, leaving patients with no access to modern cardiovascular facilities.”
Vardas said access to transcatheter valve implantations, atherosclerotic coronary heart disease therapies and heart transplants greatly limit CV care in some middle-income countries.
Sex analyses revealed higher age-standardized CVD mortality rates per 100,000 people for men in both high-income and middle-income countries (283 for women vs. 410 for men and 790 for women vs. 1,022 for men, respectively). Men also demonstrated higher rates of age-standardized coronary heart disease and stroke per 100,000 inhabitants (132 for women vs. 235.9 for men and 130.3 for women vs. 159.9 for men, respectively).
Further, men saw nearly twice as many years lost to CVD ill-health, disability or early death than women (3,219 per 100,000 people in women vs. 5,925 per 100,000 people in men).
Professor Adam Timmis, head of the report writing team, said in the release that while middle-income countries seem to shoulder the majority of the CVD burden in Europe, just two reported an increase in age-standardized years lost to CVD over the past 27 years.
“The potential reversibility of risk factors, including high blood pressure and elevated cholesterol, and unhealthy behaviors such as sedentary lifestyles and poor diets, provide a huge opportunity to address the health inequities documented in this report,” Timmis said. “The WHO’s target for a 25% relative reduction in mortality from CVD, cancer, diabetes and chronic respiratory disease by 2025 is unlikely to be achieved, with the modest downward CVD trends documented in this report concealing alarming increases in mortality in some member countries.”
After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.