Where you live may be putting your heart at risk
Insights from the ESC Atlas reveal global CVD challenges, emphasizing resource gaps and strategies to reduce mortality and improve equity.
Discover how the ESC Atlas highlights cardiovascular disparities and guides global strategies to reduce CVD mortality and enhance equitable care. (CREDIT: Apollo Sage Hospital)
Healthcare systems worldwide are grappling with the challenges posed by aging populations, the rise of non-communicable diseases, and the looming threat of future pandemics.
These evolving dynamics demand a comprehensive transformation in healthcare delivery. To meet these demands, evidence-based planning, prioritization of healthcare goals, and cost-effective investment strategies are essential.
Metrics and specific indicators play a pivotal role in guiding healthcare decisions. These tools enable performance measurement, resource allocation, and policy development while promoting accountability and equity.
The European Society of Cardiology (ESC) has taken a lead role in this effort through its Atlas of Cardiology project. This initiative provides a wealth of data and insights into cardiovascular health and healthcare systems across its member countries.
A Detailed Look at Cardiovascular Disease
Cardiovascular disease (CVD) remains the leading cause of death in Europe, with over 3 million deaths annually, accounting for 37.4% of all deaths. Although CVD mortality rates are declining, the decrease is far less pronounced in middle-income countries compared to high-income countries.
Between 1990 and 2021, age-standardized mortality rates (ASMRs) fell by more than 50% in high-income countries, while middle-income countries saw a reduction of less than 12%.
Middle-income countries face higher CVD mortality rates, with 46% of male and 53% of female deaths attributed to CVD, compared to 30% and 34%, respectively, in high-income countries. Additionally, the age-standardized potential years of life lost are three times higher in middle-income nations.
Professor Adam Timmis, lead author of the ESC Atlas report, highlighted the disparities: “The new statistics on deaths due to CVD illustrate the scale of the problem and underscore the urgent need for effective strategies in prevention and management. The inequalities between middle- and high-income countries likely reflect heterogeneous exposures to environmental, socioeconomic, and clinical risk factors.”
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Risk Factors and Resource Disparities
Risk factors like smoking, hypertension, and diabetes remain prevalent across ESC member countries. Around 25.4% of individuals aged 15 and older use tobacco products, with rates exceeding 40% among males in middle-income countries.
Hypertension affects over 40% of both sexes in middle-income nations, compared to less than 30% of females and 40% of males in high-income countries. Diabetes prevalence is also higher in middle-income countries, at 7.7% compared to 6% in high-income nations.
Obesity and overweight rates are alarmingly similar across all income levels, with 55% of individuals being overweight and 17% obese. However, disparities in healthcare resources exacerbate these issues.
Middle-income countries report significantly fewer cardiologists and lower rates of critical procedures like percutaneous coronary intervention, transcatheter aortic valve implantation, and pacemaker implantation. For instance, high-income countries have twice as many cardiologists per million inhabitants as middle-income countries (100 vs. 55), and procedure rates are similarly skewed.
Professor Timmis pointed to these resource gaps as contributors to the unequal CVD mortality rates: “Middle-income countries are substantially under-resourced in terms of specialist staffing and access to diagnostic and therapeutic procedures.”
Economic and Societal Impacts
The economic toll of CVD is staggering, with an annual cost of €282 billion across the European Union. This translates to €630 per person, ranging from €381 in Cyprus to €903 in Germany. Of these costs, 46% stem from healthcare, 9% from social care, 28% from informal care, and 17% from productivity losses.
Professor Panos Vardas, past president of the ESC and Chief Strategy Officer at the European Heart Agency, emphasized the importance of accurate data: “Informed decision-making is key to tackling the challenges posed by CVD, but this can only happen with accurate and comprehensive data.”
The ESC Atlas of Cardiology project has proven to be an invaluable tool in addressing these challenges. By analyzing trends, disparities, and associations over time, it provides actionable insights for policymakers, healthcare providers, and researchers. For example, Atlas data were recently presented to EU health ministers to aid in developing national and EU Cardiovascular Health Plans.
The ESC’s efforts go beyond publications. Its new website offers free access to over 300 CVD-related variables, complete with downloadable graphs and charts for comparative analysis. Additionally, the ESC’s “Cardiovascular Realities 2024” initiative contextualizes this data to drive policy changes aimed at improving heart health.
Professor Vardas concluded: “The ESC is committed to advancing cardiovascular health through research, education, and advocacy. The ESC Atlas is a testament to that commitment and will serve as a valuable resource for all stakeholders involved in cardiovascular health.”
The comprehensive data and insights provided by the ESC Atlas of Cardiology underscore the need for coordinated action to reduce the global burden of CVD.
By addressing disparities in healthcare resources and implementing evidence-based strategies, all countries can work towards equitable and effective cardiovascular care.
Note: Materials provided above by The Brighter Side of News. Content may be edited for style and length.
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