Roth · Journal of the American College of Cardiology 2020 · Global epidemiological modeling study · n=204 countries and territories

Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study.

Cited 11521 times in the scientific literature.

Level 3 - non-randomized controlled study

Level 3 by design analogy (multinational population-level descriptive and modeling study across longitudinal data sources).

PubMed 33309175 · doi:10.1016/j.jacc.2020.11.010 · record verified 2026-08-28

What was done

Using data from the Global Burden of Disease (GBD) Study 2019, researchers modeled global trends in cardiovascular disease (CVD) burden across 204 countries and territories from 1990 to 2019. The analysis utilized available population-level data on incidence, prevalence, case fatality, mortality, and health risks to assess 13 underlying causes of cardiovascular death and 9 associated risk factors.

What was found

Between 1990 and 2019: - Total prevalent cases of CVD increased from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019. - Annual CVD deaths rose from 12.1 million (95% UI: 11.4 to 12.6 million) in 1990 to 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. - Years lived with disability nearly doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI: 24.9 to 43.6 million). - In 2019, ischemic heart disease accounted for 197 million (95% UI: 178 to 220 million) prevalent cases, 9.14 million (95% UI: 8.40 to 9.74 million) deaths, and 182 million (95% UI: 170 to 194 million) DALYs. - In 2019, stroke accounted for 101 million (95% UI: 93.2 to 111 million) prevalent cases, 6.55 million (95% UI: 6.00 to 7.02 million) deaths, and 143 million (95% UI: 133 to 153 million) DALYs. - CVD burden continued rising in nearly all non-high-income countries, and age-standardized rates began increasing in some high-income locations.

Why it matters

This study provides benchmark global metrics demonstrating that absolute CVD prevalence, mortality, and disability continue to escalate worldwide, underscoring that current prevention and treatment strategies are failing to keep pace with population growth and aging.

Limits

The estimates depend heavily on mathematical modeling and imputation in regions where primary vital registration and disease surveillance systems are sparse. The abstract does not provide specific quantitative values for all 13 underlying causes, the 9 risk factors evaluated, or individual country-level rates.

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