Cardiovascular disease — a global health time bomb



Fiona Fleck




Cardiovascular diseases such as heart disease, stroke and diabetes — usually associated with wealthy, developed countries — have become far more prevalent in poorer, less developed countries than previously thought, according to a new report published by Columbia University's Earth Institute in New York on 26 April.

The report, A Race against Time: The Challenge of Cardiovascular Disease in Developing Economies, concluded that cardiovascular diseases could become a public health time bomb in developing countries if too little is done to reverse the trend.

Dr Shanthi Mendis, Coordinator of WHO's Cardiovascular Diseases unit described the report as "a compelling and cogent argument to convince policy-makers and politicians of the need for commitment, development and implementation of policies for prevention and control of the cardiovascular diseases epidemic."

The researchers, led by Australian epidemiologist Stephen Leeder, analysed mortality and disease data from four middle-income countries: Brazil, China, South Africa and the Russian Republic of Tatarstan, and one low-income country, India.

They found that even if nothing changes in the next 30 years, population growth alone will lead to major increases in cardiovascular disease in developing countries which could severely curb workforce productivity and economic progress. According to the report, the problem is often neglected by developed countries, whose chief health-care priority is infectious diseases such as AIDS, malaria and tuberculosis.

Cardiovascular mortality rates among people of working age in India, South Africa and Brazil were one-and-a-half to two times higher than those in the US, said the report. In South Africa, despite the predominance of AIDS, 12% of men aged between 35 and 44 died from cardiovascular disease while the figure for women was 17.2%. In India, 28% of the five million people who die of cardiovascular diseases every year are under 65. The authors said this was even higher than the equivalent figure for the US 50 years ago, before treatment for cardiovascular diseases became a public health priority.

Recommendations included a reduction in tobacco production and consumption, campaigns aimed at improving nutrition, including school programmes on healthy diet and physical exercise. These recommendations are also part of a global plan to prevent chronic disease through healthy diet and physical exercise to be adopted by WHO's 192 Member States during the Fifty-seventh World Health Assembly in Geneva,17–22 May.

Professor Shah Ebrahim, a cardiovascular diseases expert at Bristol University in England, said the projections were reasonable and should be enough to make policy makers take notice. He also said that cardiovascular diseases were also often neglected because of a lack of data and training.

The report is available at:

World Health Organization Genebra - Genebra - Switzerland