High Blood Pressure, Obesity to Drive Global Heart Disease Burden by 2050

A study published in JACC: Journal of the American College of Cardiology predicted that high systolic blood pressure, as well as high body mass index (BMI), will continue to be the most important contributors to the burden of cardiovascular diseases in the world up to 2050, even though age-standardized rates are expected to decline.

Owing to the aging population, the net effect of summative preventative efforts will be offset by the increases in crude DALYs,”  the authors wrote. “Understanding epidemiologic trends in the modifiable risk factors driving CVDs is essential in designing effective countermeasures.”

The researchers estimated the projection of age-standardization and raw disability-adjusted life years (DALYs) and mortality rates linked to five CVD risk factors that could be modified, including high SBP, high fasting plasma glucose (FPG), high BMI, high low-density lipoprotein (LDL) cholesterol, and tobacco use, based on Global Burden of Disease  2021 data in 204 countries and territories. Projections extend to 2050 and are stratified by sex, age, region, and sociodemographic index (SDI).

High SBP is projected to contribute the most DALYs worldwide in 2050 (325 million), with high LDL (122 million), high BMI (93 million), high FPG (91 million), and tobacco use (91 million) coming second. Despite the fact that age-standardized DALY rates will decrease in all five risk factors, the total crude number of DALYs will increase: +99 million in the case of high SBP (+44.1%), +44 million in the case of high BMI (+88.0%), +43 million in the case of high FPG (+89.7%), +31 million in the case of high LDL (+34.4%), and +15 million in the case of tobacco use (+19.3%).

The highest rates of rise in crude DALY burden are likely to be in low- and middle-SDI areas, especially South Asia, Sub-Saharan Africa, and North Africa/Middle East. High SBP will continue to be the dominant risk factor in terms of age-standardized DALY rates, which will vary from 1,270.2 to 2,185.4 per 100,000 population in terms of sex categories in 2050. High BMI is expected to take over the tobacco use in the DALY burden in the mid-century.

Gender-specific trends are still present. It is also expected that males will have a greater cumulative DALYs at all risk factors and start accumulating risk earlier than female subjects, who will exhibit more gradual increases with age, particularly after menopause.

“The projected decline in age-standardized DALYs of modifiable cardiovascular risk factors suggest improved management of CVDs, crude DALYs will continue to rise due to population growth and aging.”  authors concluded.