Burden of cardiovascular diseases in the Asia-Pacific region from 1990 to 2023, with forecasts to 2050: a secondary analysis of the Global Burden of disease study 2023.

BACKGROUND

Cardiovascular disease (CVD) is the leading cause of death globally, with the Asia-Pacific region home to over two-thirds of the world's population, bearing over half of this burden. This study aims to characterise historical trends and forecast CVD burden in the Asia-Pacific from 1990 to 2050, identifying disparities by geographic subregions, sociodemographic index (SDI), and age-sex strata.

METHODS

Historical (1990-2023) and forecasted (2025-2050) trends in CVD disability-adjusted life years (DALYs) and mortality across 39 Asia-Pacific countries were examined using Global Burden of Disease Study 2023.

FINDINGS: In the Asia-Pacific, CVD accounted for 241.2 million DALYs (55.3% of global) in 2023. Crude DALYs rose by 51.3% from 1990 to 2023, despite 36.2% reduction in age-standardised DALYs. Crude DALYs will rise further by 10.7% from 2025 to 2050. Atherosclerotic CVD is the key driver of morbidity, with stroke (1255.0 DALYs per 100,000 population) projected to plausibly surpass ischaemic heart disease (1148.7 DALYs per 100,000 population) by 2050. Disparities in CVD burden exist across SDI (low and low-middle SDI bearing the highest burden), geography (Oceania bearing the highest burden), and age-sex categories (DALYs peaking earlier in males by at least 5 years).

INTERPRETATION: The net effect of gains in CVD prevention is offset by the rising crude CVD burden owing to the growing and ageing population. The heterogeneity in CVD burden across countries of different socioeconomic development poses unique challenges in tackling CVD in the Asia-Pacific.

FUNDING: SingHealth Duke-National University of Singapore Cardiovascular Sciences Academic Clinical Programme, the National Medical Research Council of Singapore, and the Stafford Fox Foundation.