What are the most prevalent global medical concerns?

Most Prevalent Global Medical Concerns

Hypertension and cardiovascular diseases are the most prevalent global medical concerns, with hypertension affecting more people in low-income and middle-income countries than in high-income countries, and cardiovascular diseases remaining the leading cause of disease burden worldwide. 1, 2

Hypertension

Hypertension is one of the most important risk factors for several serious conditions:

• High blood pressure is a leading risk factor for ischemic heart disease, stroke, other cardiovascular diseases, chronic kidney disease, and dementia 1
• The prevalence of hypertension is now higher in low-income and middle-income countries than in high-income countries 1
• In 2015, an estimated 8.5 million deaths were attributable to systolic blood pressure >115 mmHg, with 88% of these deaths occurring in low-income and middle-income countries 1
• Mean blood pressure and prevalence of raised blood pressure have declined in high-income regions since the 1970s, but have risen in East, South and Southeast Asia, Oceania, and sub-Saharan Africa 1

Heart Failure

Heart failure represents another significant global health concern:

• Heart failure affects more than 64.3 million people worldwide as of 2017 1
• The prevalence of heart failure is expected to rise due to improved survival following diagnosis, availability of life-saving treatments, and longer life expectancy of the general population 1
• The total cost for heart failure was estimated to be $30.7 billion in the USA in 2012, with projections suggesting an increase to $69.8 billion by 2030 1
• Annual healthcare costs per heart failure patient amount to up to €25,000 in Western countries 1

Stroke

Stroke represents a major component of the global disease burden:

• Stroke is the second-leading cause of death in the world, though it has dropped to fourth in the United States 1
• The World Health Organization suggests there were 5.5 million deaths from stroke in 2002 (one every 6 seconds) 1
• Among stroke survivors, 5 million are left permanently disabled 1
• The burden of stroke is projected to grow from 38 million disability-adjusted life years (DALYs) in 1990 to 61 million in 2020 1
• In the Asia-Pacific region, stroke risk due to hypertension is a serious and growing problem with devastating consequences 1

Overall Cardiovascular Disease Burden

Cardiovascular diseases collectively represent the greatest global health burden:

• Prevalent cases of total cardiovascular disease nearly doubled from 271 million in 1990 to 523 million in 2019 2
• The number of cardiovascular disease deaths steadily increased from 12.1 million in 1990 to 18.6 million in 2019 2
• Ischemic heart disease caused 9.14 million deaths and 182 million DALYs in 2019 2
• Stroke caused 6.55 million deaths and 143 million DALYs in 2019 2
• Despite decreases in age-standardized rates in most countries, the absolute number of cardiovascular disease cases increased remarkably in low (108.3%), low-middle (114.81%), and middle (117.85%) sociodemographic index regions between 1990-2019 3

Regional Differences

There are significant regional variations in the burden of these conditions:

• The Western Pacific region accounted for 39% of cerebrovascular deaths in 2002, followed by Europe (29%) and South East Asia (21%) 1
• In China, hypertension accounts for as much as half of total stroke mortality 1
• A 10 mmHg increase in systolic blood pressure increased risk of hemorrhagic stroke by 72% in Asians compared with 49% in Australians and New Zealanders 1
• Cardiovascular disease burden continues its decades-long rise for almost all countries outside high-income countries 2

Other Significant Concerns

Beyond cardiovascular diseases, other important global health concerns include:

• Rheumatic heart disease, which affects populations in regions where the disease is highly endemic 1
• Chronic kidney disease, which is closely associated with hypertension 1
• Chronic obstructive pulmonary disease (COPD), which frequently co-occurs with hypertension 1
• Diabetes, which contributes to cardiovascular risk and requires management alongside hypertension 1

Prevention Strategies

Given these prevalent concerns, key prevention strategies include:

• Increasing availability and affordability of fresh fruits and vegetables 1
• Lowering sodium content of packaged and prepared food 1
• Improving availability of dietary salt substitutes 1
• Scaling up treatment coverage for hypertension 1
• Implementing lifestyle modifications including smoking cessation, physical activity, and weight management 1
• Educating patients about stroke as the most severe consequence of hypertension to motivate people at risk to seek appropriate treatment 1