By AMERICAN HEART ASSOCIATION NEWS
By 2025, more than 5 million men and 2.8 million women worldwide will die prematurely each year from cardiovascular disease if nations do not intervene, says a recent report from the American Heart Association and World Heart Federation.
Forecasting the trajectory of risk factors and their effect on premature deaths on such a large scale involved huge amounts of data from more than 180 countries, complex statistical systems and hundreds of thousands of scenarios run by thousands of computers.
Cardiologist Gregory Roth, M.D., co-authored the scientific statement and designed the models used to forecast the 2025 scenarios. As an assistant professor at the Institute of Health Metrics and Evaluation at the University of Washington in Seattle, he used data from the institute’s Global Burden of Disease study to create “the biggest database of health on the planet.”
The data showed the effect of four risk factors — tobacco use, high blood pressure, diabetes and obesity — on premature deaths.
“If you can reduce them to the healthiest level, you’d have massive reductions in heart disease and stroke,” Roth said.
With no changes through 2025, premature deaths would rise 34 percent in men and 30 percent in women, according to the forecast. But if World Health Organization goals to reduce premature cardiovascular deaths by 25 percent by 2025 were met, deaths would decrease 5 percent in men and increase only 1 percent in women. Reducing smoking and obesity and lowering blood pressure had the biggest effects.
Despite these broad predictions, “you get very, very different results in different countries,” Roth said. For example, premature deaths from heart disease and stroke would drop in Australia, Canada, Japan, South Korea, the U.S and Western Europe — 19 percent in men and 16 percent in women.
In those high-income countries, Roth said, reducing deaths 25 percent by 2025 is achievable because most risk factors are already going down. In contrast, premature cardiovascular disease deaths are expected to rise by 56 percent in South Asian men and 48 percent in sub-Saharan African women, according to the statement. Population growth and aging contribute to those increases.
Calculating projections worldwide is difficult given the weak systems of collecting and monitoring data in many lower and middle-income countries, said epidemiologist Donna Arnett, Ph.D., a co-author of the statement.
However, Roth said global health leaders must use the information they have now. He works directly with governments at his university’s institute and has talked to officials from Canada and China about how they can use the projections.
“Even in countries with very little data, we know something,” he said. “It’s not completely unknown, it’s just in a very wide range.”
Nations must use the data to improve risk factors and contain the worldwide burden of heart disease and stroke, Arnett said.
“What you see that’s so dramatic and why this is so important globally, is that we’re expecting an increase in the mean number of deaths globally,” she said. “That tells us we’ve got to mobilize all resources and come together to find ways to address this challenge.”