Reducing the Global Burden of Ischemic Heart Disease and Stroke

Noncommunicable diseases (NCDs), which include cardiovascular diseases (CVD), cancer, diabetes mellitus, and chronic pulmonary disease, are the leading cause of global mortality accounting for 36 million (63%) of the 57 million deaths worldwide in 2008.1 Recognizing the global pandemic and burden of NCDs in a landmark decision, the United Nations has scheduled a high-level meeting on September 19 and 20, 2011 to determine priority actions and interventions in response to this crisis. The greatest increase in NCDs is in low- and middle-income countries whose resources for surveillance, prevention, and treatment are severely limited. Among NCDs, CVD is the leading cause of death, and ischemic heart disease (IHD) and stroke are the major contributors to CVD. Worldwide, 80% of deaths from CVD now occur in low- and middle-income countries.1 Thus, there is a special and urgent need for data and treatment strategies concerning CVD in low- and middle-income countries.Article see p 314Although IHD and stroke are major contributors to global mortality, causing 7.2 and 5.7 million deaths, respectively, in 2004,2 and have 9 established risk factors in common,3,4 the relative contributions of stroke and IHD to mortality on a country-to-country basis and the relative contribution of the various risk factors are not well documented. In the current issue of Circulation , Kim and Johnston5 report an analysis of mortality and disability adjusted life year loss rates from stroke and IHD from 192 World Health Organization member countries, along with national estimates of risk factors and national income data from World Bank estimates. In …