Q&A: Cardiovascular diseases caused 1 in 3 global deaths in 2023
Published September 24, 2025
A major paper was just published on the global burden of cardiovascular disease (CVD). According to this new research, CVD caused 1 in 3 deaths globally in 2023, with population growth, population aging, and increased exposure to modifiable metabolic risks driving burden around the world.
Learn more from lead author, Dr. Greg Roth. Dr. Roth is a professor in the Division of Cardiology and Adjunct Professor of Health Metrics Sciences at IHME at the University of Washington School of Medicine. He is the Director for the Program in Cardiovascular Health Metrics at IHME.
Video transcript
This transcript has been lightly edited for clarity
What is the scope of your global study into cardiovascular diseases and risk factors?
We are publishing a major paper on the global burden of cardiovascular disease. It’s going to cover 18 different specific cardiovascular diseases, a dozen cardiovascular risk factors, for every country in the world. We use the word estimates to describe what we’re producing because we’re combining different sources of data.
Our paper reports not just where we are in the most recent year that we’ve done this, which is 2023, but the long-term trend starting in 1990, and showing how it’s changed in every country in the world over time.
This figure shows the number of cardiovascular disease disability-adjusted life years from 1990 through 2023, separately for males and females. You can see on the y-axis the number of disability-adjusted life years in millions, and time on the x-axis. And without a doubt, cardiovascular disease burden is larger for males than females. It is an important feature to recognize as we think about what kind of interventions will most benefit the patients who most need those interventions. The second point to make is that rates have been rising and they’ve been rising relatively steadily, but faster in males.
What were the key findings of the study?
One of the things we’ve added to this study is a new method in which we identify what’s actually driving those changes in cardiovascular disease in each country. And the answer, as you can imagine, is complicated. Cardiovascular disease is not one thing; it’s many different conditions, and different risk factors drive it in complex ways. And that’s actually one of our findings, that it matters a lot which country you’re in, because the composition of risk factors are almost like a fingerprint. They’re unique in each country.
This figure shows the drivers of cardiovascular disease around the world. We’ve decomposed the rates of cardiovascular disease into four categories. On the right you see mostly light and dark blue. These are the driving forces of population aging and population growth. And they’re forcing cardiovascular disease rates up. In fact, the cardiovascular disease rate overall is the black dot in each bar.
The yellow is the contribution of the risk factors we can measure. Metabolic risks include high blood pressure, high cholesterol, obesity, diabetes, and kidney disease. Behavioral
risks include diet, tobacco smoking, physical activity; and environmental exposures include air pollution, both indoor and outdoor, as well as lead exposure, which drives up blood pressure and heart disease.
And what you can see here is that metabolic risks are increasing. The others, despite having come down – contributing to the leftward direction on these figures – they haven’t done it enough. And so population growth and population aging are continuing to outpace everything we can do in terms of lowering the risk exposure. And then, in green, are all of the unmeasured components that are balancing out this equation we have here. In the end, what this means is we are running a race against population growth and population aging, and we’re losing.
How do cardiovascular disease-related DALYs and deaths vary across regions of the world?
It’s very clear from our study that there’s immense variation in cardiovascular burden, which we measure as a DALY, a disability-adjusted life year, between different locations. We found almost a 16-fold variation from countries that have the healthiest levels of heart disease, to the highest. We see the highest levels of heart and vascular disease, sort of in a diagonal stripe across Asia and sub-Saharan Africa – very high levels of cardiovascular disease in Eastern Europe, parts of Central Europe, North Africa, and parts of Africa. And this is, actually, a little bit counterintuitive to people who may assume that cardiovascular diseases are to be found in the wealthiest countries, that they’re diseases that only occur in economies that have advanced to the highest level that we see.
What it actually turns out to be is that health care is very effective. We know how to lower blood pressure. We know how to lower cholesterol. We know how to treat heart attacks. We know how to treat strokes. And if you’re in a place where you have access to that care, you do a little bit better. And if you have places where the health systems are still evolving, where the interventions are not readily available, the disease burden is going to be higher.
We also see countries that have particular risk factors that are driving disease. So countries where alcohol intake is very high. Countries that have high levels of indoor air pollution. And then finally we see that just the age structure of a population matters a lot.
What needs to be done to address the growing burden of cardiovascular diseases?
I think there are two main takeaway messages that anyone who’s interested in improving cardiovascular health can take away from our study. The first is that high blood pressure, without a doubt, is the largest cause of cardiovascular disease. It doesn’t cause every cardiovascular disease, but it causes the major ones, ischemic heart disease, ischemic stroke, atrial fibrillation, aortic aneurysmal diseases, hypertensive heart diseases, and heart failure.
And so, we now know how to deliver inexpensive combination tablets that do a lot better than our traditional approach to lowering blood pressure. And so we really need to redouble our effort to build systems. And this often goes beyond a doctor’s office, to community health workers who can deliver blood pressure–lowering medications and support people to take them. That’s one.
Number two is the rising rates of obesity and diabetes that are really dramatically increasing the amount of cardiovascular disease that we see year on year. And so, while high blood pressure is the dominant cause, it’s not going up in the way that we see obesity and diabetes rates going up. And those are going to be dangerous components of the future of cardiovascular risk. Anything we can do to flatten the curve of rising obesity and diabetes rates is going to reduce the amount of cardiovascular disease in the future.