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. 2024 Jul 10:49:101138.
doi: 10.1016/j.lanwpc.2024.101138. eCollection 2024 Aug.

The burden of cardiovascular disease in Asia from 2025 to 2050: a forecast analysis for East Asia, South Asia, South-East Asia, Central Asia, and high-income Asia Pacific regions

Rachel Sze Jen Goh  1 , Bryan Chong  1 , Jayanth Jayabaskaran  1 , Silingga Metta Jauhari  2   3 , Siew Pang Chan  1   2   3 , Martin Tze Wah Kueh  4   5 , Kannan Shankar  1 , Henry Li  6 , Yip Han Chin  7 , Gwyneth Kong  7 , Vickram Vijay Anand  8 , Keith Andrew Chan  3   9 , Indah Sukmawati  10 , Sue Anne Toh  1   11   12   13 , Mark Muthiah  1   14   15 , Jiong-Wei Wang  16 , Gary Tse  17   18 , Anurag Mehta  19 , Alan Fong  20   21 , Lohendran Baskaran  22   23   24 , Liang Zhong  23   24   25 , Jonathan Yap  22 , Khung Keong Yeo  22 , Derek J Hausenloy  1   26   27   28 , Jack Wei Chieh Tan  22 , Tze-Fan Chao  29   30 , Yi-Heng Li  31 , Shir Lynn Lim  1   3   32 , Koo Hui Chan  1   3 , Poay Huan Loh  1   3   33 , Ping Chai  1   3 , Tiong Cheng Yeo  1   3 , Adrian F Low  1   3 , Chi Hang Lee  1   3 , Roger Foo  1   3 , Huay Cheem Tan  1   3 , James Yip  1   3 , Sarita Rao  34 , Satoshi Honda  35 , Satoshi Yasuda  35 , Takashi Kajiya  36 , Shinya Goto  37 , Bryan P Yan  38 , Xin Zhou  39 , Gemma A Figtree  40 , Mamas A Mamas  41 , Yongcheol Kim  42 , Young-Hoon Jeong  43 , Moo Hyun Kim  44 , Duk-Woo Park  45 , Seung-Jung Park  45 , A Mark Richards  46   47 , Mark Y Chan  1   3 , Gregory Y H Lip  48   49 , Nicholas W S Chew  1   3
Affiliations

The burden of cardiovascular disease in Asia from 2025 to 2050: a forecast analysis for East Asia, South Asia, South-East Asia, Central Asia, and high-income Asia Pacific regions

Rachel Sze Jen Goh et al. Lancet Reg Health West Pac. .

Abstract

Background: Given the rapidly growing burden of cardiovascular disease (CVD) in Asia, this study forecasts the CVD burden and associated risk factors in Asia from 2025 to 2050.

Methods: Data from the Global Burden of Disease 2019 study was used to construct regression models predicting prevalence, mortality, and disability-adjusted life years (DALYs) attributed to CVD and risk factors in Asia in the coming decades.

Findings: Between 2025 and 2050, crude cardiovascular mortality is expected to rise 91.2% despite a 23.0% decrease in the age-standardised cardiovascular mortality rate (ASMR). Ischaemic heart disease (115 deaths per 100,000 population) and stroke (63 deaths per 100,000 population) will remain leading drivers of ASMR in 2050. Central Asia will have the highest ASMR (676 deaths per 100,000 population), more than three-fold that of Asia overall (186 deaths per 100,000 population), while high-income Asia sub-regions will incur an ASMR of 22 deaths per 100,000 in 2050. High systolic blood pressure will contribute the highest ASMR throughout Asia (105 deaths per 100,000 population), except in Central Asia where high fasting plasma glucose will dominate (546 deaths per 100,000 population).

Interpretation: This forecast forewarns an almost doubling in crude cardiovascular mortality by 2050 in Asia, with marked heterogeneity across sub-regions. Atherosclerotic diseases will continue to dominate, while high systolic blood pressure will be the leading risk factor.

Funding: This was supported by the NUHS Seed Fund (NUHSRO/2022/058/RO5+6/Seed-Mar/03), National Medical Research Council Research Training Fellowship (MH 095:003/008-303), National University of Singapore Yong Loo Lin School of Medicine's Junior Academic Fellowship Scheme, NUHS Clinician Scientist Program (NCSP2.0/2024/NUHS/NCWS) and the CArdiovascular DiseasE National Collaborative Enterprise (CADENCE) National Clinical Translational Program (MOH-001277-01).

Keywords: Asia; Cardiovascular disease; Disability-adjusted life years; Global burden; Mortality; Risk factors.

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Conflict of interest statement

S.T has received research grant support from Janssen, Merck, American Heart Association (USA) and the National Medical Research Council (Singapore). She has received speaker and/or consulting fees from AstraZeneca, Eli Lilly, Boehringer-Ingelheim, Merck, Novo Nordisk, Abbott, Medtronic, Dexcom, MIMS, Janssen, Novartis and Sanofi. She is also a shareholder of a health technology company (NOVI Health). D.J.H. has received consultant fees from Faraday Pharmaceuticals Inc. and Boehringer Ingelheim International GmbH, honoraria from Servier, and research funding from Astra Zeneca, Merck Sharp & Dohme Corp and Novonordisk. DJH is supported by the Duke-NUS Signature Research Programme funded by the Ministry of Health, Singapore Ministry of Health's National Medical Research Council under its Singapore Translational Research Investigator Award (MOH-STaR21jun-0003), Centre Grant scheme (NMRC CG21APR1006), and Collaborative Centre Grant scheme (NMRC/CG21APRC006). L.B. was supported by the National Medical Research Council (NMRC) of Singapore Centre Grant (Program for Transforming and Evaluating Outcomes in Cardiometabolic disease [PROTECT], Grant number: CG21APR1006), the National Medical Research Counsil (NMRC) of Singapore Transitional Award Grant (Improving Obstructive Coronary Artery Disease and Cardiovascular Risk Prediction Using Deep Learning Analysis on Coronary Artery Calcium Imaging, Grant number: TA21nov-0001), and the National Medical Research Council (NMRC) of Singapore Collaborative Centre Grant (CCG) (IMplementing a PArtnership for Cardiovacular Trials-2 [IMPACT-2] Program, Grant number: NMRC/CG2/001a/2021-NHCS). L.Z is supported by National Medical Research Council under its Clinician-Innovator Award Senior Investigator (CIASI24jan-0001) and Health Service Research Award (MOH-000358), SingHealth Duke-NUS Academic Medical Centre AM strategic fund award (07 FY2023 HTP P2 15-A2) and Industry Alignment Fund Pre-Positioning (IAFPP award) (H20c6a0035). S.L.L. is supported by the National Medical Research Council Transitional Award; she has received research grants from National University Health System, National Kidney Foundation of Singapore and Singapore Heart Foundation. She is an Associate Editor of Resuscitation and Guest Editor of Resuscitation Plus. M.Y.C. receives speaker's fees and research grants from Astra Zeneca, Abbott Technologies and Boston Scientific. N.W.S.C has received research grant support from NUHS Seed Fund (NUHSRO/2022/RO5+6/Seed-Mar/03), National Medical Research Council Research Training Fellowship (MH 095:003/008-303), National University of Singapore Yong Loo Lin School of Medicine's Junior Academic Fellowship Scheme, and the NUHS Clinician Scientist Program (NCSP2.0/2024/NUHS/NCWS).

Figures

Fig. 1
Fig. 1
The world map of the cardiovascular disease burden in 2050, depicting the age-standardised mortality rates (per 100,000 population) age-standardised DALY disability-adjusted life years (per 100,000 population) across the regions in Asia.
Fig. 2
Fig. 2
The projected trends in age-standardised mortality, disability-adjusted life years, and prevalence rates (per 100,000 population) of cardiovascular diseases in Asia from 2025 to 2050.
Fig. 3
Fig. 3
Rankings of age-standardised A) mortality and B) disability-adjusted life year rates per 100,000 population associated with cardiovascular diseases in 2050 by region.
Fig. 4
Fig. 4
Projected trends in the age-standardised A) mortality and B) disability-adjusted life years rates per 100,000 population associated with cardiovascular diseases from 2025 to 2050 stratified by sex.
Fig. 5
Fig. 5
Rankings of age-standardised A) mortality and B) disability-adjusted life year rates per 100,000 population associated with cardiovascular risk factors in 2050 by region.
Central Illustration
Central Illustration
A forecast analysis of cardiovascular diseases in Asia from 2025 to 2050. Legend: AF, atrial fibrillation and flutter; ASMR, age-standardised mortality rates; BMI, body mass index; FPG, fasting plasma glucose; HHD, hypertensive heart disease; LDL, low-density lipoprotein; IHD, ischemic heart disease; PAD, peripheral artery disease.
See this image and copyright information in PMC

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