Cardiovascular Risk and Events in 17 Low-, Middle-, and High-Income Countries

In a large study, cardiac risk-factor burden was correlated with cardiovascular disease and mortality. High-income countries had a high risk burden but low rates of major cardiovascular events, which suggests that contributors other than risk factors influence outcome. Worldwide, 18 million deaths annually are attributed to cardiovascular diseases. 1 From the 1930s to the 1950s, the rate of cardiovascular disease increased in high-income countries, but during this period, the rates were low in middle- and low-income countries. 2 , 3 Since the mid-1970s, the rate of death from cardiovascular diseases has declined markedly in several high-income countries, owing to reductions in risk factors and improved management of cardiovascular disease. 4 By contrast, the incidence of cardiovascular disease has been increasing in some low-income and middle-income countries, 5 , 6 with 80% of the global burden estimated to occur in these countries. 1 It is not . . .