Cardiovascular Specialty Societies and the Emerging Global Burden of Cardiovascular Disease

Recently available data on the global burden of disease document, perhaps for the first time, that cardiovascular disease (CVD) has achieved the dubious status of the leading cause of death worldwide.1 Coronary heart disease and stroke have dominated the mortality figures for Western Europe, North America, and Australia/New Zealand for many decades, extending to Eastern Europe more recently. However, the emergence of CVD as the major cause of death in the world’s most populous regions, such as China and India, along with falling death rates from infectious and parasitic diseases in these countries are clearly the reasons for the elevation of CVD as the leading cause of death globally. Additional data from South and Central America, the Middle East and North Africa, and Southeast Asia confirm these trends. Moreover, projections of mortality based on population increases and increased life expectancy suggest that CVD will be the leading cause of mortality in all parts of the world by the year 2020, with the exception of sub-Saharan Africa.2 Some of us believe that even these estimates may be optimistic, with additional CVD occurring due to the increase in tobacco use, obesity, sedentary lifestyle, and an atherogenic diet in countries of increasing affluence; interaction of these new risk factors with presently prevalent risk factors such as hypertension; and the genetic predisposition of certain subgroups (such as South Asians) to CVD when placed in industrial societies.3 Indeed, conversations with colleagues from far-flung corners of the globe confirm the rising numbers of patients with coronary disease and stroke at relatively young ages now populating hospital wards and intensive care units. These cardiovascular specialists in lesser developed countries will likely not only be faced with increasing numbers of patients with acute and chronic manifestations of CVD but will also lack the extensive (and …