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. 2014 Jun 6;114(12):1959-75.
doi: 10.1161/CIRCRESAHA.114.302782.

Global perspective on acute coronary syndrome: a burden on the young and poor

Rajesh Vedanthan  1 , Benjamin Seligman  1 , Valentin Fuster  2
Affiliations

Global perspective on acute coronary syndrome: a burden on the young and poor

Rajesh Vedanthan et al. Circ Res. .

Erratum in

  • Circ Res. 2014 Aug 1;115(4):e8

Abstract

Ischemic heart disease (IHD) is the greatest single cause of mortality and loss of disability-adjusted life years worldwide, and a substantial portion of this burden falls on low- and middle-income countries (LMICs). Deaths from IHD and acute coronary syndrome (ACS) occur, on average, at younger ages in LMICs than in high-income countries, often at economically productive ages, and likewise frequently affect the poor within LMICs. Although data about ACS in LMICs are limited, there is a growing literature in this area and the research gaps are being steadily filled. In high-income countries, decades of investigation into the risk factors for ACS and development of behavioral programs, medications, interventional procedures, and guidelines have provided us with the tools to prevent and treat events. Although similar tools can be, and in fact have been, implemented in many LMICs, challenges remain in the development and implementation of cardiovascular health promotion activities across the entire life course, as well as in access to treatment for ACS and IHD. Intersectoral policy initiatives and global coordination are critical elements of ACS and IHD control strategies. Addressing the hurdles and scaling successful health promotion, clinical and policy efforts in LMICs are necessary to adequately address the global burden of ACS and IHD.

Keywords: acute coronary syndrome; coronary disease; epidemiology; world health.

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Figures

Figure 1
Figure 1
The epidemiologic transition in the United States, which was already well underway by 1900. From: JAMA. 1999;281(1):61-66.
Figure 2
Figure 2
Mortality rates from IHD per 100,000 in 2010 by country, ages 15-49, males (top) and females (bottom). Data from 2012 Global Burden of Disease.
Figure 3
Figure 3
Age-standardized mean body-mass index (BMI) by sex and region. Green: high-income countries, Black: East Asia/Pacific, Red: Eastern Europe/Central Asia, Dark Blue: Latin America/Caribbean, Light Blue: Middle East/North Africa, Purple: South Asia, Yellow: Sub-Saharan Africa.
Figure 4
Figure 4
Age-standardized mean systolic blood pressure (SBP) by sex and region. Color coding as in Figure 3.
Figure 5
Figure 5
Age-standardized mean total cholesterol by sex and region. Color coding as in Figure 3.
Figure 6
Figure 6
Age-standardized prevalence of smoking as percent of population, males (top), females (bottom). From JAMA. 2014;311(2):183-192.
Figure 7
Figure 7
Age-adjusted percent of adults who are physically inactive, males (A) and females (B). From Lancet 2012, 380(9838):247-257.
Figure 8
Figure 8
Percentage of total deaths (top) and DALYs (bottom) in LMICs for males (left) and females (right) of all ages attributable to different categories of risk factors. Data from 2012 Global Burden of Disease.
Figure 9
Figure 9
Age distribution of male (top) and female (bottom) IHD (ischemic heart disease) deaths in 2010 among countries classified as high-income versus low- and middle-income. Data from 2012 Global Burden of Disease.
See this image and copyright information in PMC

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