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

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.