Researchers Call for New Solutions to Tackle Global CVD Increase

18 May 2017 --- A new study has found that cardiovascular diseases (CVD), including heart diseases and stroke, account for one-third of deaths throughout the world. Analyzing data from every country over the past 25 years, the study’s authors concluded that trends in CVD mortality are no longer declining for high-income regions and that low- and middle-income countries are also experiencing an increase in CVD-related deaths. The study's authors note that the findings present opportunities for the global health community to share successful strategies for addressing these risk factors.

“It is an alarming threat to global health,” says lead author Dr. Gregory Roth, Assistant Professor at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and in the Division of Cardiology at the University of Washington School of Medicine.

“The population health community realizes that CVD is a global problem,” he says. “Now we need to find innovative ways to deliver our low-cost, effective treatments to the hundreds of millions of people who can’t access them.”

The study also found that the steep declines experienced by the US, Canada, Australia, New Zealand, Japan, South Korea and countries in Western Europe over the past two decades have begun to taper off and plateau.

Companies are already responding to demand for heart health solutions with a number of new products. According to Innova Market Insights data on European product launches, 19% of supplement launches in 2016 had a heart health positioning, albeit sometimes in conjunction with other health positionings. This number is a dramatic increase from the 11% recorded in 2015. Moreover, NPD grew by +57% from 2015 to 2016. Although the number of launches aimed at heart health in food and beverages is still small, at just 0.5% of total launches tracked, there has been growth in these areas, with an increase of +24% from 2015 to 2016.

Yesterday NutritionInsight reported that BASF has partnered with Aenova and Kappa Bioscience to release new food and dietary supplement applications with Vegapure, the only plant sterol ester officially approved for use in food supplements within the EU. Supplementing dietary phytosterols can particularly benefit individuals with an elevated blood cholesterol and cardiovascular disease risk, as phytosterols lower levels of blood total cholesterol and LDL cholesterol through competition with cholesterol absorption in the intestinal tract.

Last week, a report indicated that addressing cases of CVD linked to hypercholesterolemia among adults aged 55 and over is set to cost EU healthcare systems and providers €1.328 trillion between 2016 and 2020 – €266 billion a year, and equivalent to €34,637 per event. Following an analysis of the available science, research team at Frost & Sullivan concluded that consumption of just 1.7g of phytosterols a day by EU adults aged 55+ with severe hypercholesterolemia would cut their risk of experiencing a CVD-attributed hospital event associated with their condition by 2.3% basis points. In turn, this would result in cost savings of €26.5 billion over five years, or €5.3 billion a year.

In 2015, there were more than 400 million individuals living with CVD and nearly 18 million CVD deaths worldwide. From 1990 to 2010, the age-standardized death rate from CVD dropped globally, driven by improvements in high-income countries, but that progress has slowed over the last five years. In 1990, there were about 393 deaths for every 100,000 people from CVD globally. That fell to 307 deaths per 100,000 in 2010, and, over the next five years, decreased only slightly, to 286 deaths per 100,000.

Roth's study, titled “Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990–2015,” was published in the Journal of the American College of Cardiology (JACC).

“This paper is the manifestation of two paradoxes,” says JACC Editor-in-Chief Valentin Fuster, MD, PhD. “First, we keep discussing how much we have progressed among our subspecialty, yet the paradox is that the disease state remains the no. 1 killer in the world. The second paradox is that medicine remains very expensive, yet we don’t put efforts into promoting health at younger ages, which could be a cost-effective method to preventing the onset of the disease. Instead, we continue to only invest in treating advanced manifestations of cardiovascular disease.”

The paper is based on the most recent Global Burden of Disease (GBD) study, an international consortium of more than 2,300 researchers in 133 nations, convened by IHME.

Dr. Paulo Lotufo with the University of São Paulo in Brazil, one of the paper’s co-authors, notes: “High levels of cardiovascular disease can be especially problematic for low-resource countries with limited access to or availability of effective treatments. Many nations are now dealing with a ‘double burden’ of chronic and infectious disease, which puts additional strain on health systems.”

Prevalence rates of CVD, including coronary artery disease, atrial fibrillation, heart failure, stroke and peripheral arterial disease, were highest across sub-Saharan Africa, Eastern and Central Europe and Central Asia. Some of the lowest rates occurred in high-income Asian countries such as Singapore, Japan and South Korea, and southern South American countries, including Chile and Argentina.

The highest CVD death rates occurred throughout Central Asia and Eastern Europe, but also in countries such as Iraq, Afghanistan and many South Pacific island nations. The lowest rates were in Japan, Andorra, Peru, France, Israel and Spain.

Using a measure of development status that combines levels of education, fertility and income – the Socio-demographic Index (SDI) – Dr. Roth and other researchers discovered that, on average, CVD mortality first increased, then declined steeply with increasing SDI, only to plateau in the last few years.

Of the cardiovascular conditions studied, ischemic heart disease, also known as coronary artery or heart artery disease, was the leading cause of health loss in every region of the world except sub-Saharan Africa. In 2015, there were an estimated 7.3 million heart attacks and 110.6 million people living with heart artery disease.

The highest prevalence rates for heart artery disease were found in Eastern Europe, followed by Central Asia and Central Europe, but high rates were also found in some parts of sub-Saharan Africa, the Middle East/North Africa region and South Asia. Peripheral artery disease was the most prevalent CVD cardiovascular disease worldwide, even though much of it is estimated to be without symptoms.