Global, regional, and national burden of cardiovascular diseases and risk factors in 204 countries and territories, 1990-2023

Stark, Benjamin A., DeCleene, Nicole K., Desai, Emily C., Hsu, Johnathan M., Johnson, Catherine O., Lara-Castor, Laura, LeGrand, Kate E., A, Bhoomadevi, Aalipour, Mohammad Amin, Aalruz, Hasan, Abafita, Bedru J., Abaraogu, Ukachukwu O., Abavisani, Mohammad, Nasir Abbas, Sha'aban, Abubakar ORCID: https://orcid.org/0000-0002-5491-9851 and [Consortium], Global Burden of Cardiovascular Diseases and Risks 2023 Collabor 2025. Global, regional, and national burden of cardiovascular diseases and risk factors in 204 countries and territories, 1990-2023. Journal of the American College of Cardiology 86 (22) , pp. 2167-2243. 10.1016/j.jacc.2025.08.015

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Abstract

Background Cardiovascular diseases (CVDs) are the leading cause of mortality and are among the foremost causes of disability globally. CVD burden has continued to increase in most countries since 1990, with trends driven by changing exposures to harmful risk factors, population growth, and population aging. Objectives We report estimates of global, national, and subnational CVD burden, including 18 subdiseases and 12 associated modifiable risk factors. We analyzed change in CVD burden from 1990 to 2023 and identified drivers of change including population growth, population aging, and risk factor exposure. Methods The Global Burden of Disease (GBD) 2023 study, a multinational collaborative research study, quantified burden due to 375 diseases including CVD burden and identified drivers of change from 1990 to 2023 using all available data and statistical models. GBD 2023 estimated the population-level burden of diseases in 204 countries and territories from 1990 to 2023. Results CVDs were the leading cause of disability-adjusted life years (DALYs) and deaths estimated in the GBD. As of 2023, there were 437 million (95% UI: 401 to 465 million) CVD DALYs globally, a 1.4-fold increase from the number in 1990 of 320 million (292 to 344 million). Ischemic heart disease, intracerebral hemorrhage, ischemic stroke, and hypertensive heart disease were the leading cardiovascular causes of DALYs in 2023 globally. As of 2023, age-standardized CVD DALY rates were highest in low and low-middle Socio-demographic Index (SDI) settings and lowest in high SDI settings. The number of CVD deaths increased globally from 13.1 million (95% UI: 12.2 to 14.0 million) in 1990 to 19.2 million (95% UI: 17.4 to 20.4 million) in 2023. The number of prevalent cases of CVD more than doubled since 1990, with 311 million (95% UI: 294 to 333 million) prevalent cases of CVD in 1990 and 626 million (95% UI: 591 to 672 million) prevalent cases in 2023 globally. A total of 79.6% (95% UI: 75.7% to 82.5%) of CVD burden is attributable to modifiable risk factors 347 million [95% UI: 318 to 373 million] DALYs in 2023). Globally, high systolic blood pressure, dietary risks, high low-density lipoprotein cholesterol, and air pollution were the modifiable risks responsible for most attributable CVD burden in 2023. Since 1990, changes in exposure to modifiable risk factors have had mixed effects on CVD burden, with increases in high body mass index, high fasting plasma glucose, and low physical activity leading to higher burden, while reductions in tobacco usage have mitigated some of these increases. Population growth and population aging were the main drivers of the increasing burden since 1990, adding 128 million (95% UI: 115 to 139 million) and 139 million (95% UI: 126 to 151 million) CVD DALYs to the increase in CVD burden since 1990.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine
Additional Information:	Full list of authors in the consortium (Global Burden of Cardiovascular Diseases and Risks 2023 Collaborators) are available from the publication website.
Publisher:	Elsevier
ISSN:	0735-1097
Date of First Compliant Deposit:	9 December 2025
Date of Acceptance:	7 August 2025
Last Modified:	09 Dec 2025 10:15
URI:	https://orca.cardiff.ac.uk/id/eprint/183018

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