Despite being preventable, cardiovascular diseases (CVD) are the leading cause of death in the Asia-Pacific, and the burden is rising. CVDs accounted for 40% of all deaths in the Western Pacific Region and nearly a quarter of deaths in the South-East Asia Region in 2021.
CVD covers a range of diseases related to the circulatory system, including ischaemic heart disease (IHD) and cerebrovascular disease (or stroke). Ischemic heart disease is caused by the accumulation of an atherosclerotic plaque in the inner wall of a coronary artery, restricting blood flow to the heart. Cerebrovascular diseases refer to a group of diseases that relate to problems with the blood vessels that supply the brain. Common types of cerebrovascular disease include ischemic stroke, which develops when the brain’s blood supply is blocked or interrupted, and haemorrhagic stroke, which occurs when blood leaks from blood vessels onto the subarachnoid space or the surface of the brain. The majority of CVD is caused by risk factors that can be controlled, treated, or modified, such as high blood pressure, high blood glucose, high blood cholesterol, obesity, lack of physical activity, tobacco use (see indicator “Tobacco” in Chapter 4) and excessive alcohol consumption.
In 2021, cardiovascular diseases were responsible for over 6 000 DALYs per 100 000 population in upper-middle-, and lower-middle- and low-income countries and territories (Figure 3.13). Notably, the rate of DALYs for CVD in DPRK, the Solomon Islands, Fiji and the Philippines was over 8 000 per 100 000 population across all ages in 2021. This contrasted with Singapore, New Zealand, Australia and Korea where DALYs were below 3 500 per 100 000 population. The large variation in mortality may be due to differences in the prevalence of risk factors for CVD and access to high quality acute care (see indicator “In-hospital mortality following acute myocardial infarction and stroke” in Chapter 7) across countries and territories.
Cardiovascular disease can cause disability by leading to severe impairments in the body’s vital functions, Events such as heart attacks and strokes can result in chronic issues such as reduced mobility, paralysis, cognitive impairments, and persistent pain. In 2021, cardiovascular diseases accounted for over 400 years lived with disability (YLDs) per 100 000 population across all ages in upper-middle‑income countries and territories in the Asia-Pacific, and over 500 YLDs in high-income countries Figure 3.14). Japan experienced more than 800 YLDs per 100 000 population from cardiovascular diseases in 2021. In contrast, YLDs in lower-middle- and low-income countries were significantly lower, approximately two‑thirds the level of high-income countries in the region and half the level of OECD countries.
In high-income countries in the Asia-Pacific, ischemic heart disease was the leading cause of death and disability from cardiovascular disease, accounting for 44% of all DALYs from CVD in 2021 (Figure 3.15). In upper-middle- and lower-middle- and low-income countries and territories, both ischemic heart disease and strokes impose a similarly high burden, both accounting for roughly 40% of all DALYs each. Hypertensive heart disease accounted for an average of 4% to 6% of DALYs from CVD in the region, while cardiomyopathy, myocarditis, endocarditis, and rheumatic heart disease accounted for 4% or less of DALYs on average.
Given the already high incidence of CVDs in Asia, and the ageing and growing population, this raises the need for targeted and effective interventions within the region. One such intervention is the South-East Asia-HEARTS or SEAHEARTS initiative being rolled out by countries to reduce the burden of cardiovascular diseases. This initiative brings together efforts made for risk factor reduction (tobacco control, salt reduction and eliminating industrially produced trans-fatty acids) and improving hypertension and diabetes treatment cascade in the broader context of NCD prevention and control.
