title: Global Overview of the Epidemiology of Atherosclerotic Cardiovascular Disease.
abstract: Atherosclerotic cardiovascular disease (ACD) is the leading cause of mortality worldwide. The objective of this paper is to provide an overview of the global burden of ACD and its risk factors and to discuss the main challenges and opportunities for prevention. Publicly available data from the Global Burden of Disease Study were analyzed for ischemic heart disease (IHD), ischemic stroke and ACD risk factors. Data from the WHO Global Health Observatory were used to describe prevalence of diverse cardiometabolic risk factors. World Bank Gross Domestic Product per capita (GDPc) information was used to categorize countries according to income level. Cardiovascular mortality decreased globally from 1990-2010 with important differences by GDPc; during 1990 there was a positive association between IHD mortality and GDPc. Higher-income countries had higher rates compared to those of lower-income countries. High levels of body mass index (BMI), blood pressure, glucose and cholesterol have a differential contribution to mortality by income group over time; high-income countries have been able to reduce the contribution from these risk factors in the last 20 years, whereas lower/middle income countries show an increasing trend in mortality attributable to high BMI and glucose. Although age-adjusted ACD mortality rate trends decreased globally, the absolute number of ACD deaths is increasing in part due to the growth of the population and aging, as well as to important lifestyle and food-system changes that likely attenuate gains in prevention. Population and individual level preventable causes of ACD must be aggressively and efficiently targeted in countries of lower economic development in order to reduce the growing burden of disease due to ACD.
authors.affiliation: Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Electronic address: sbarquera@insp.mx.
authors.forename: Simon
authors.initials: S
authors.lastname: Barquera
authors.affiliation: Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pedroza-Tobías
authors.affiliation: Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
authors.forename: Catalina
authors.initials: C
authors.lastname: Medina
authors.affiliation: Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
authors.forename: Lucía
authors.initials: L
authors.lastname: Hernández-Barrera
authors.affiliation: Division of General Medicine, University of California at San Francisco, San Francisco, California, USA.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Bibbins-Domingo
authors.affiliation: Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
authors.forename: Rafael
authors.initials: R
authors.lastname: Lozano
authors.affiliation: Division of General Medicine, Columbia University, Presbyterian Hospital, New York, New York, USA.
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Moran
mesh_terms: D050197:Atherosclerosis / Q000453:epidemiology* / Q000517:prevention & control; D002545:Brain Ischemia / Q000453:epidemiology; D017281:Cost of Illness; D019049:Developed Countries / Q000706:statistics & numerical data; D003906:Developing Countries / Q000706:statistics & numerical data; D014943:Global Health / Q000706:statistics & numerical data*; D006801:Humans; D017202:Myocardial Ischemia / Q000453:epidemiology*; D015995:Prevalence; D011634:Public Health / Q000706:statistics & numerical data; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*
keywords: Cerebrovascular disease; DALYs; Epidemiologic transition; Ischemic heart disease