Global Burden of Cardiovascular Diseases and its Risk Factors, 1990–2021: A Systematic Analysis for the Global Burden of Disease Study 2021

Abstract Background Cardiovascular diseases (CVDs) represent a major global health challenge, necessitating up-to-date data on their burden for effective care planning and resource allocation. Aim To evaluate the trends and disparities in CVD burden and associated risk factors from 1990 to 2021. Design A population-based secondary analysis of global, regional, and national CVD burden using data from the Global Burden of Disease (GBD) 2021 study. Methods We analyzed CVD burden and its risk factors using estimates from the GBD 2021 study. Results In 2021, there were 612 million cases of CVD globally, accounting for 26.8% of all deaths. From 1990 to 2021, the global age-standardized prevalence rate of CVD rose by 0.88% to 7179 cases per 100 000 individuals, while mortality and DALY rates fell by 34.3% and 33.0% to 235 and 5056 cases per 100 000 individuals, respectively. The highest CVD burden is seen in low-middle SDI levels. Regional disparities, differences in health system outcomes and SDI-related inequalities persist. Ischemic heart disease (IHD) and stroke are significant contributors among CVD subtypes. The burden is more pronounced in older age groups and men. Notably, 79.5% of total CVD disability-adjusted life years (DALYs) were attributable to 11 risk factors, with high body mass index (BMI) showing the most significant increase. Conclusion Despite advancements, CVD remains a significant global burden, especially in low and lower-middle SDI regions. Rising prevalence and the impact of COVID-19 underscore ongoing challenges. The diverse burden across health systems highlights the need for sustained investment in healthcare infrastructure and targeted interventions. Addressing modifiable risk factors and socioeconomic inequalities is essential.