The Lancet Regional Health. Western Pacific (Aug 2024)
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 regionsResearch in context
- Rachel Sze Jen Goh,
- Bryan Chong,
- Jayanth Jayabaskaran,
- Silingga Metta Jauhari,
- Siew Pang Chan,
- Martin Tze Wah Kueh,
- Kannan Shankar,
- Henry Li,
- Yip Han Chin,
- Gwyneth Kong,
- Vickram Vijay Anand,
- Keith Andrew Chan,
- Indah Sukmawati,
- Sue Anne Toh,
- Mark Muthiah,
- Jiong-Wei Wang,
- Gary Tse,
- Anurag Mehta,
- Alan Fong,
- Lohendran Baskaran,
- Liang Zhong,
- Jonathan Yap,
- Khung Keong Yeo,
- Derek J. Hausenloy,
- Jack Wei Chieh Tan,
- Tze-Fan Chao,
- Yi-Heng Li,
- Shir Lynn Lim,
- Koo Hui Chan,
- Poay Huan Loh,
- Ping Chai,
- Tiong Cheng Yeo,
- Adrian F. Low,
- Chi Hang Lee,
- Roger Foo,
- Huay Cheem Tan,
- James Yip,
- Sarita Rao,
- Satoshi Honda,
- Satoshi Yasuda,
- Takashi Kajiya,
- Shinya Goto,
- Bryan P. Yan,
- Xin Zhou,
- Gemma A. Figtree,
- Mamas A. Mamas,
- Yongcheol Kim,
- Young-Hoon Jeong,
- Moo Hyun Kim,
- Duk-Woo Park,
- Seung-Jung Park,
- A Mark Richards,
- Mark Y. Chan,
- Gregory Y.H. Lip,
- Nicholas W.S. Chew
Affiliations
- Rachel Sze Jen Goh
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Bryan Chong
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Jayanth Jayabaskaran
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Silingga Metta Jauhari
- Department of Biostatistics, Cardiovascular Research Institute, National University Heart Centre (Singapore), NUHS; Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Siew Pang Chan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Biostatistics, Cardiovascular Research Institute, National University Heart Centre (Singapore), NUHS; Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Martin Tze Wah Kueh
- Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Malaysia; UCD School of Medicine and Medical Science, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
- Kannan Shankar
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Henry Li
- University of New South Wales, Australia
- Yip Han Chin
- Ministry of Health Holdings, Ministry of Health, Singapore
- Gwyneth Kong
- Ministry of Health Holdings, Ministry of Health, Singapore
- Vickram Vijay Anand
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Keith Andrew Chan
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore; Section of Adult Cardiology, Chong Hua Hospital, Philippines Don Mariano Cui Street, Fuente Osmeña, Cebu City, 6000, Philippines
- Indah Sukmawati
- Cardiovascular Department, Siloam Hospitals Lippo Village, Pelita Harapan University, Tangerang, Indonesia
- Sue Anne Toh
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Medicine, National University Hospital, Singapore; NOVI Health, Singapore; Regional Health System Office, National University Health System, Singapore
- Mark Muthiah
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore
- Jiong-Wei Wang
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore
- Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, 300211, China; Kent and Medway Medical School, Canterbury, Kent, CT2 7NT, United Kingdom
- Anurag Mehta
- Division of Cardiology, Virginia Commonwealth University, Richmond, VA, USA
- Alan Fong
- Clinical Research Center, Institute for Clinical Research, Sarawak General Hospital, Kuching, Malaysia; Department of Cardiology, Sarawak Heart Center, Kota Samarahan, Malaysia
- Lohendran Baskaran
- Department of Cardiovascular Medicine, National Heart Centre Singapore, and Duke-National University of Singapore, Singapore; CVS.AI, National Heart Research Institute, National Heart Centre Singapore, Singapore, 169609, Singapore; Cardiovascular Sciences Academic Clinical Program & Cardiovascular Metabolic Disorder Program, Duke National University of Singapore Medical School, Singapore, 169857, Singapore
- Liang Zhong
- CVS.AI, National Heart Research Institute, National Heart Centre Singapore, Singapore, 169609, Singapore; Cardiovascular Sciences Academic Clinical Program & Cardiovascular Metabolic Disorder Program, Duke National University of Singapore Medical School, Singapore, 169857, Singapore; Department of Biomedical Engineering, National University of Singapore, Singapore, 117583, Singapore
- Jonathan Yap
- Department of Cardiovascular Medicine, National Heart Centre Singapore, and Duke-National University of Singapore, Singapore
- Khung Keong Yeo
- Department of Cardiovascular Medicine, National Heart Centre Singapore, and Duke-National University of Singapore, Singapore
- Derek J. Hausenloy
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Duke-NUS Medical School, Cardiovascular and Metabolic Disorders Programme, Singapore, Singapore; National Heart Centre Singapore, National Heart Research Institute Singapore, Singapore, Singapore; University College London, The Hatter Cardiovascular Institute, London, UK
- Jack Wei Chieh Tan
- Department of Cardiovascular Medicine, National Heart Centre Singapore, and Duke-National University of Singapore, Singapore
- Tze-Fan Chao
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Yi-Heng Li
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Shir Lynn Lim
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore; Pre-hospital Emergency Research Centre, Duke-NUS Medical School, Singapore
- Koo Hui Chan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Poay Huan Loh
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore; Department of Cardiology, Ng Teng Fong General Hospital, Singapore, Singapore
- Ping Chai
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Tiong Cheng Yeo
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Adrian F. Low
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Chi Hang Lee
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Roger Foo
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Huay Cheem Tan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- James Yip
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Sarita Rao
- Department of Cardiology, Apollo Hospital, Indore, India
- Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Takashi Kajiya
- Clinical Research Center, Tenyoukai Central Hospital, 6-7 Izumi-cho, Kagoshima, 892-0822, Japan
- Shinya Goto
- Department of Medicine (Cardiology), Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
- Bryan P. Yan
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong
- Xin Zhou
- Department of Cardiology, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China
- Gemma A. Figtree
- Department of Cardiology, Royal North Shore Hospital, Australia
- Mamas A. Mamas
- Keele Cardiovascular Research Group, School of Medicine, Keele University, United Kingdom
- Yongcheol Kim
- Yonsei University College of Medicine and Cardiovascular Center, Yongin Severance Hospital, Yongin, South Korea
- Young-Hoon Jeong
- CAU Thrombosis and Biomarker Center, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea and Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea
- Moo Hyun Kim
- Department of Cardiology, Dong-A University Hospital, Busan, Republic of Korea
- Duk-Woo Park
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Seung-Jung Park
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- A Mark Richards
- Christchurch Heart Institute, University of Otago, New Zealand; Cardiovascular Research Institute, National University Heart Centre Singapore, Singapore
- Mark Y. Chan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore; Corresponding author. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road s119228, Singapore.
- Gregory Y.H. Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Nicholas W.S. Chew
- Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore; Corresponding author. Department of Cardiology, National University Heart Centre, National University Health System, Singapore, 5 Lower Kent Ridge Road, 119074, Singapore.
- Journal volume & issue
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Vol. 49
p. 101138
Abstract
Summary: 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).