Cardiovascular Deaths to Surge 73% by 2050 Despite Medical Advances, Finds Study

Future healthcare systems must prepare for a rapid rise in the total global burden of cardiovascular disease (CVD) mortality, which is projected to increase by 73.4% between 2025 and 2050, primarily driven by the ageing global population, according to a study published in the September Issue of European Journal of Preventive Cardiology.

While improved medical care is reflected in a projected 30.5% decline in age-standardized mortality rates, the continued dominance of atherosclerotic diseases, led by ischaemic heart disease and high systolic blood pressure, necessitates tailored, region- and sex-specific preventive strategies.

Cardiovascular disease significantly contributes to worldwide mortality and escalating healthcare costs. The new research forecasts major geopolitical trends in cardiovascular disease (CVD) mortality and associated risk factors over the next 25 years. Utilizing historical mortality and disability-adjusted life years (DALYs) data from the Global Burden of Disease (GBD) 2019 study (1990–2019), this analysis aims to project geospatial trends to assist policy-makers in healthcare planning and the design of appropriate, region-specific interventional strategies.

Top 5 key highlights of the study include:

1. Crude mortality will skyrocket due to population ageing: Despite progress in medical treatment, future healthcare systems must prepare for a rapid rise in the total burden of CVD. Global crude CV mortality is projected to increase by 73.4% between 2025 and 2050, resulting in an expected 35.6 million cardiovascular deaths in 2050, up from 20.5 million in 2025. This substantial increase in total deaths is primarily driven by the ageing global populace and population growth.

2. Age-standardized rates show improved treatment outcomes: Age-standardized cardiovascular mortality is projected to fall globally by 30.5% by 2050. This decline reflects the anticipated improvement in medical care following a CVD diagnosis. However, the age-standardized prevalence is expected to remain relatively constant (−3.6%), suggesting that the net effect of global primary prevention efforts will likely remain unchanged.

3. Atherosclerotic diseases and hypertension remain the dominant threats: Atherosclerotic diseases, specifically Ischaemic Heart Disease (IHD) and stroke, are identified as the main contributors underpinning the continued rise in the global CVD burden. IHD is projected to remain the leading cause of cardiovascular deaths, accounting for an estimated 20 million deaths in 2050. The primary risk factor driving mortality worldwide is forecasted to be high systolic blood pressure (SBP), which is projected to cause 18.9 million deaths by 2050.

4. Metabolic risk factors are accelerating the fastest: Globally, metabolic risk factors will remain the leading category underlying CV mortality (51.7 million deaths), ahead of behavioural (18.8 million) and environmental factors (9.5 million). The risk factors associated with the fastest growing rates of crude CV mortality between 2025 and 2050 are high Body-Mass Index (BMI) (144.6% increase) and high Fasting Plasma Glucose (FPG) (126.9% increase). High BMI is projected to be associated with the greatest rise in crude CV deaths in regions undergoing rapid urbanization, including Southeast Asia, East Asia and Oceania, South Asia, and Sub-Saharan Africa.

5. Central Europe, Eastern Europe, and Central Asia: Unique deterioration and higher projected rates of CV mortality: The super-region of Central Europe, Eastern Europe, and Central Asia is projected to incur the highest age-standardized cardiovascular mortality rate in 2050 (305 deaths per 100,000 population). Furthermore, this region is the only super-region anticipated to witness a rise in age-standardized mortality rates (ASMR) across a broad range of CVDs (7 out of 11 examined CVDs*), implying a potential deterioration in prevention and treatment effectiveness in this area.

The projected 73.4% rise in crude CV mortality by 2050, resulting in 35.6 million deaths, demonstrates that population ageing will rapidly increase the total CV burden. Although age-standardized mortality is expected to fall by 30.5%, reflecting improved medical care, the net effect of primary prevention will remain largely unchanged, given the constant age-standardized prevalence. This challenge, dominated by Ischaemic Heart Disease (IHD) and high systolic blood pressure, and a high BMI, necessitates targeted, regional, and sex-specific interventions, vital to arrest the CVD trajectory.

*11 CVDs included in the study are ischaemic heart disease (IHD), stroke, hypertensive heart disease (HHD), atrial fibrillation and flutter, cardiomyopathy and myocarditis, non-rheumatic valvular heart disease (VHD), aortic aneurysm, rheumatic heart disease, peripheral artery disease (PAD) and endocarditis.

Reference: Chong B, Jayabaskaran J, Jauhari SM, Chan SP, Goh R, Kueh MTW, Li H, Chin YH, Kong G, Anand VV, Wang JW, Muthiah M, Jain V, Mehta A, Lim SL, Foo R, Figtree GA, Nicholls SJ, Mamas MA, Januzzi JL, Chew NWS, Richards AM, Chan MY. Global burden of cardiovascular diseases: projections from 2025 to 2050. Eur J Prev Cardiol. 2025 Aug 25;32(11):1001-1015. doi: 10.1093/eurjpc/zwae281. PMID: 39270739.