Cardiovascular diseases are the most common cause of death in the 55 countries that are part of the ESC (European Society of Cardiology). But we are not seeing a similar trend everywhere. While it is true that mortality rates for these pathological conditions are substantially decreasing, economic well-being makes the difference. And it creates a dichotomy. The decline in deaths appears lower in countries with a medium per capita income, compared to those with a high income. This is what the ESC Atlas of Cardiology, which collects data from the European Society of Cardiology (ESC) published in the European Heart Journal, reminds us.
How much do cardiovascular diseases weigh?
According to the publication, in the 55 ESC member countries studied there would be over 3 million deaths due to these pathologies every year. More or less we are talking about 8,500 deaths per day. Which means that on average 37.4% of people die from these causes.
But be careful, social and health differences weigh heavily. Age-standardized mortality rates (ASMRs) were at least 2.5 times higher in middle-income countries than in high-income countries. And importantly, the declining trend appears less significant in the former. In particular, according to the latest data from ESC member countries, mortality from cardiovascular diseases is higher in middle-income countries (46% of all deaths in men; 53% of all deaths in women) compared to high-income countries (30% of all deaths in men; 34% of all deaths in women).
The estimated age-standardized potential life years lost were more than 3 times higher in middle-income countries than in high-income countries. What does this mean? According to Adam Timmis, lead author of the report, “the new statistics on CVD deaths illustrate the scale of the problem and underscore theurgent need for effective strategies in prevention and management. Inequalities between middle- and high-income ESC member countries likely reflect heterogeneous exposures to a range of environmental, socioeconomic and clinical risk factors.”
Treatment and prevention are not the same everywhere
The risk factor controlwith a clear impact on the well-being of citizens, appears essential to improve the management and especially the impact of heart attacks, strokes, heart failure and more. And it makes a difference.
Unfortunately, however, it does not seem that there is the same attention on this front everywhere. Here are the figures: it is estimated that about a quarter of people over 15 consume tobacco products (25.4%), with rates of 40.9% among males in middle-income countries.
Chapter high blood pressure. Hypertension affected more than 4 in 10 people of both sexes in middle-income countries compared with less than 30% of females and 40% of males in high-income countries. The prevalence of diabetes is 7.7% in middle-income countries compared to 6% in high-income countries. For the overweight more than one in two people are overweight and 17% are obese. These percentages are similar for middle- and high-income countries.
The Importance of Healthcare Financing
As reported in a note from the ESC, Timmis also highlighted new data suggesting that treatment factors may contribute to inequalities in cardiovascular disease mortality, with substantially under-financed middle-income countries in terms of specialized personnel and rates of diagnostic and therapeutic procedures compared to high-income countries.
Let’s start with the availability of specialists. In ESC member countries, there would be double the number of cardiologistsper million population in high-income countries compared with middle-income countries (100 versus 55, respectively). In addition, middle-income countries reported lower rates per million of percutaneous coronary interventions (1355 versus 2330, respectively), transcatheter aortic valve implantation (4.0 versus 153.4), and pacemaker implantation (147.0 versus 831.9) compared with high-income countries.
How Much Do Cardiovascular Diseases Weigh on the Economy?
According to economic data from the ESC Burden of CVD project developed in collaboration with the Nuffield Department of Population Health at the University of Oxford, it is estimated that Cardiovascular diseases cost the EU economy €282 billion per yeara cost of 630 euros per person, ranging from 381 euros in Cyprus to 903 euros in Germany.
Of the total cost of cardiovascular disease:
- 46% is due to health care
- 9% to social assistance
- 28% to informal care
- 17% to lost productivity.
In practice, according to data recently presented based on 2021 information, in the 27 EU countries the cost of these pathologies would be around 282 billion euros. And above all, they would be as many as 155 billion euros spent for the‘long term care of patients: in practice approximately 11% of European healthcare costs. The largest item, which accounts for 46%, is linked to healthcare.
- 25 billion euros go to social assistance (9%)
- 79 billion euros for so-called “informal” care (these costs include work or free time, valued in monetary terms, that relatives and friends have given up to provide unpaid care
- 15 billion euros of productivity losses are linked to illness and/or disability (5%)
- 32 billion euros of productivity losses due to premature death (12%).
