What are the different types of cardiovascular diseases, and how many deaths do they cause?
Cardiovascular diseases are a range of related health conditions that develop in the heart and blood vessels. What are the different diseases, and what is their impact worldwide?
Cardiovascular diseases are a range of related health conditions that develop in the heart and blood vessels.
Together, they are the most common cause of death worldwide. In 2019, cardiovascular diseases caused an estimated 18 million deaths globally.
What are the different types of cardiovascular diseases? How many deaths do they cause, and how do their death rates vary worldwide?
In this article, I give an overview of the cardiovascular system, cardiovascular diseases and their impact worldwide.
A brief introduction to the blood circulation system and cardiovascular diseases
The blood circulation system
The blood circulation system supplies oxygen, nutrients, and water to many parts of our body, which keeps us alive. It consists of many organs that each play important roles.1
The lungs are crucial in supplying our organs with oxygen through the blood circulation system. The heart is a powerful muscle that pumps this blood around the body.
But oxygen isn’t the only molecule that needs to be moved around our body. When our organs use oxygen from blood, they exchange it for carbon dioxide, which we remove through our lungs as a waste product. So both molecules – oxygen and carbon dioxide – must be transported around our body.
To separate these two types of blood – oxygen-rich and oxygen-depleted blood – we have two major types of blood vessels: arteries and veins.
Arteries generally carry oxygen-filled blood away from our heart and towards organs.
Veins generally do the opposite: they carry oxygen-depleted blood (which carries carbon dioxide instead) from our organs to our heart.2
What are cardiovascular diseases, and where in the body do they occur?
Cardiovascular diseases are diseases of the heart (“cardiac”) and the blood vessels (“vascular”).
They can occur in different parts of the body but tend to be more severe when they affect the heart, the lung’s blood vessels, or the brain’s blood vessels.
As we’ve seen, the heart and lungs play a key role in circulating blood around the entire body – so damage to them or their blood vessels can be serious.
The brain is also vulnerable to cardiovascular diseases, because it is particularly sensitive to changes in blood flow. It is the control center of the body and is a highly active organ that requires a continuous supply of oxygen and nutrients.
This means that even brief interruptions of blood supply to the brain, such as during a stroke, can cause cells to function improperly or die, which can lead to cognitive problems.
How many deaths are caused by cardiovascular diseases?
Death rates from cardiovascular diseases vary around the world. You can see this in the map below, which shows the estimated death rate from cardiovascular diseases in different countries.
The rate is age-standardized, which means it allows for comparisons among people of the same age, by accounting for differences in population size and age structure.
You can see that death rates from cardiovascular diseases tend to be higher in Africa, Asia, Eastern Europe, and South America.
These differences arise from differences in risk factors for cardiovascular diseases – such as smoking, alcohol consumption, and air pollution – and levels of healthcare to diagnose and treat cardiovascular diseases, which may require long-term management.
In total, around 18 million annual deaths – or around a third of all deaths in 2019 – are estimated to be caused by cardiovascular diseases, globally.
How do the different cardiovascular diseases contribute to this figure?
The chart below shows the estimated number of deaths from different types of cardiovascular disease.
In 2019, almost 9 million deaths were estimated to be caused by ischemic heart disease – when the blood supply to the heart is reduced or blocked.
Around 3 million were from hemorrhagic stroke – when bleeding occurs in the brain or around it. Another 3 million were caused by ischemic stroke – when a clot reduces or blocks the blood supply to the brain or spinal cord.
These estimates come from the World Health Organization (WHO)’s Global Health Estimates. They are based on official data from death certificates and – especially in countries where death registration is lacking – statistical modeling using hospital data, verbal autopsies, medical risk factors, and more.
In addition, in many countries, a share of deaths are not given a precise cause of death on their death certificate – especially when hospital records or medical data is unavailable for the person who died. Instead, their death certificate may simply state that they died from “chest pain”, “heart failure”, or “heart attack” without further detail.
To help standardize data on causes of death for statistical purposes, international organizations re-assign deaths with these imprecise causes, such as “heart attack”, to more specific causes, including ischemic heart disease, based on estimates of the relative share from each type of disease.
This means that there is uncertainty around the precise number of people who die from specific cardiovascular diseases, particularly in poorer countries, where a lower share of deaths are officially registered with a cause of death.
I have previously written an article about this here:
How are causes of death registered around the world?
In many countries, when people die, the cause of their death is officially registered in their country’s national system. How is this determined?
An overview of specific cardiovascular diseases
How do blood vessels get damaged?
Let’s first look at how blood vessels can get damaged.
As we grow older, we experience growing consequences from a range of risk factors that we may be exposed to: high blood pressure (also known as hypertension), high cholesterol, smoking, toxins, inflammation, and other aging processes.
Over time, these risk factors can damage blood vessels. I have made this illustration to show two types of damage to blood vessels: atherosclerosis and aneurysms. These conditions are part of – or can lead to – other cardiovascular diseases.
In atherosclerosis, there is a build-up of fats, cholesterol, and other substances in the walls of blood vessels, usually in arteries (which carry oxygen-rich blood away from our heart and towards our organs). This build-up narrows the space for blood to travel through and limits blood flow to organs.
Sometimes, the build-up can be unstable and can break off from the blood vessel. This can be dangerous, as it can travel through the bloodstream and cause a blood clot to form around it. The clot can then get stuck in smaller blood vessels and cut off blood flow to parts of the body.3
In aneurysms, the walls of blood vessels weaken, which makes the vessels bulge out, and their walls stretch thinner. Aneurysms can develop due to high blood pressure, atherosclerosis, injuries, and other risk factors.
In serious cases, an aneurysm can lead to the tearing or breaking of a blood vessel, which leads to bleeding in the surrounding area and reduces blood flow to other organs, which can cause organ damage.
Diseases of the heart
The heart is the central part of the cardiovascular system: it is a powerful muscle that keeps blood pumping. Because of this, damage to the blood vessels to the heart, or the heart muscles, can affect the whole body.
The illustration below shows the basic structure of the heart and some major diseases of the heart. Below, we’ll look at each of them and look at the death rates across the world from these diseases.
Ischemic heart disease, also known as coronary artery disease, is the most common cause of cardiovascular deaths globally. It develops when there is a blockage of blood flow to the heart, often due to atherosclerosis.
Without proper management, ischemic heart disease can lead to complications such as heart attacks, angina, and silent ischemia.
- Heart attacks, which are formally called “myocardial infarctions” in medicine, are when heart muscle cells die from a lack of blood flow, inflammation, or injury to the heart, and can lead to heart failure and death.4
- Angina is chest pain or discomfort caused by insufficient blood flow to the heart. There are two types of angina. “Unstable angina” develops suddenly and is a medical emergency as it increases the risk of a heart attack, while “stable angina” tends to be more predictable – often occurring after exercise or stress – and goes away after rest or medicine.
- Silent ischemia is when the heart muscle is damaged by a lack of blood flow, but the affected person doesn’t experience the typical symptoms of chest pain or discomfort, which makes it more difficult to recognize.
The map shows the estimated death rate from ischemic heart disease around the world. The death rate is age-standardized, which makes it comparable across different countries and over time.
As you can see, the death rate tends to be higher in Africa and Asia than in Europe and North America. These differences arise from differences in risk factors – such as smoking, alcohol, hypertension, poor diet, and air pollution – and lower healthcare access and resources for screening and treating cardiovascular diseases.5
Hypertensive heart diseases are diseases caused by long-term high blood pressure (hypertension) that put pressure on the heart.
When this happens, the heart’s structure changes – for example, its muscles thicken and its ability to pump blood worsens.6 This can lead to problems with heart rhythm and heart failure.
Hypertensive heart diseases are caused by risk factors – such as uncontrolled hypertension, smoking, alcohol, poor diet (such as diets high in sodium and low in potassium), and air pollution.
The map shows the estimated death rate from hypertensive heart diseases around the world. These estimates come with uncertainties due to a lack of data on blood pressure in the general population from some regions, especially Africa.7
You can see that the estimated death rate tends to be much higher in Africa and Asia, where there tend to be fewer resources for screening, preventing, and treating these conditions. In addition, the prevalence of some risk factors tends to be higher.8
Cardiomyopathies are a range of abnormalities of the heart muscle – for example, conditions that cause them to stretch, thicken, or become rigid – that make it harder for the heart to perform regular functions, and can lead to life-threatening conditions if left untreated.
They are often caused by genetic mutations but can also be caused by other risk factors such as alcohol use.9
Myocarditis is a condition caused by inflammation of the middle muscles of the heart. It can result from viral infections, toxins, drugs, autoimmune diseases, and other immune conditions.10
Endocarditis is an inflammation of the heart's inner lining. It typically arises from infections – usually by Streptococcus and Staphylococcus bacteria – that can enter the bloodstream and adhere to the heart.
These infections can arise naturally, but can also be associated with hospital or medical environments. Staphylococcus bacteria are often found on the skin and in wounds, and they can be transmitted with implants and long-term intravenous insertions, especially without adequate sterilization practices.11
The map shows the estimated death rate from these conditions combined. You can see that death rates tend to be higher in Russia, Eastern Europe, and Southern Africa.
Rheumatic heart diseases can develop as a consequence of rheumatic fever. This is caused by untreated Strep throat and scarlet fever infections, from group A Streptococcus bacteria.12
Rheumatic heart diseases tend to affect children and young adults at higher rates than other heart diseases.13
The map shows the estimated death rate from rheumatic heart diseases. You can see that death rates tend to be much higher in Africa and Asia than in other regions of the world.
Their global burden has declined greatly in many high-income countries over time, due to improved healthcare systems, better access to antibiotics, and overall improved living conditions. You can see this change by moving the slider at the bottom of the map, to see the change over time.
They now largely occur in poorer countries, in regions with poor sanitation, overcrowded living conditions, or lack of clean water and adequate screening and treatment. These factors contribute to the spread of Streptococcal infections and make it harder for people to receive timely diagnosis and treatment.14
Congenital heart diseases develop from heart abnormalities that are present at birth when the heart structure doesn’t form properly during fetal development.15
Diseases of the brain’s blood vessels
The illustration below shows the blood supply to the brain and some major conditions of the brain’s blood circulation system.
Cerebrovascular diseases are a broad category of diseases that affect the brain's blood vessels. This includes aneurysms, which we saw earlier, and strokes.
In a stroke, blood supply is reduced to the brain. This can have serious medical consequences: as we saw earlier, the brain is particularly vulnerable to a lack of blood flow.
Since the brain controls many body parts and is highly active, it requires a continuous supply of oxygen and nutrients. Even a brief interruption of blood supply to the brain can cause cells to function improperly or die, leading to cognitive impairments.
Strokes
Ischemic stroke is when the blood supply to the brain, spinal cord, or retina is reduced or blocked by a clot.
This includes clots that developed in the arteries of these organs or clots that traveled to them from other parts of the body.16
Hemorrhagic stroke is when the blood supply to the brain is reduced by bleeding because a blood vessel tears or breaks. The leaked blood puts pressure on brain cells and damages them.
Both types of stroke can be serious life-threatening medical conditions, as they can affect the brain’s critical functions – including involuntary processes, like the control of our breathing and heart rate – and many other functions of the brain.
The map shows the estimated death rate from both of these combined. You can see that stroke death rates are estimated to be higher in Asia, Africa, and South America.17
Diseases of blood vessels in the lungs and other parts of the body
Diseases of the blood vessels can also affect the lungs and other body parts, as you can see in the illustration below.
Peripheral artery disease develops when narrowed arteries reduce blood flow to the arms or legs. It's typically caused by atherosclerosis.18
Deep vein thrombosis (DVT) develops from blood clots in a deep vein, usually in the legs. While some people don’t experience symptoms, others have pain and swelling. Deep vein thrombosis can also be a serious risk if the blood clot breaks off and travels to other parts of the body – especially if it travels to the lungs and blocks off its blood supply.19
Pulmonary embolism is a condition when a blood clot has blocked one of the lung’s arteries. It can develop as a direct consequence of deep vein thrombosis. This is because the clot has usually traveled to the lungs after developing in another part of the body, such as from deep veins in the legs.
Pulmonary hypertension is a condition of high blood pressure in the blood vessels to the lungs, which usually involves enlargement of the right ventricle of the heart. It can develop from diseases of the lung’s arteries, or other heart or lung conditions, such as chronic obstructive pulmonary disease (COPD).
These other diseases are often classified under ‘other circulatory diseases’ in estimates of death tolls.
Conclusion
Cardiovascular diseases are a group of related diseases that have a large impact on global health. They are the leading cause of death worldwide.
Ischemic heart disease and strokes – both ischemic and hemorrhagic strokes – cause the greatest number of deaths globally. But hundreds of thousands also die annually from other preventable conditions, such as rheumatic heart diseases.
By understanding these conditions, their risk factors, and the blood circulation system, we will be better able to prevent and treat these conditions and reduce this major cause of global mortality.
In the illustration below, I have summarized all the conditions described in this article.
Acknowledgements
Edouard Mathieu and Max Roser provided valuable feedback for this article.
Endnotes
Other organs also play a significant role in the blood circulation. For example, the kidneys filter blood to remove waste and control its fluid balance; the liver detoxifies the blood; the pancreas regulates blood glucose levels; and the intestines absorb and deliver nutrients and water to the bloodstream.
A simple way to remember this is that A is for “artery” and “away from the heart”.
An exception is in the lung’s blood circulation, where pulmonary arteries carry oxygen-depleted blood to the lungs, and pulmonary veins carry oxygen-rich blood back to the heart.
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Saloni Dattani (2023) - “What are the different types of cardiovascular diseases, and how many deaths do they cause?” Published online at OurWorldinData.org. Retrieved from: 'https://ourworldindata.org/cardiovascular-diseases-types-and-death-tolls' [Online Resource]BibTeX citation
@article{owid-cardiovascular-diseases-types-and-death-tolls,
author = {Saloni Dattani},
title = {What are the different types of cardiovascular diseases, and how many deaths do they cause?},
journal = {Our World in Data},
year = {2023},
note = {https://ourworldindata.org/cardiovascular-diseases-types-and-death-tolls}
}
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