Circulatory diseases – notably heart attack and stroke – were the main cause of mortality in most OECD countries in 2023, accounting for 28% of all deaths across OECD countries (see Figure 3.2 in section on “Main causes of mortality”). The predominant cause of death among circulatory diseases are ischaemic heart diseases (i.e. heart attacks) and cerebrovascular diseases (i.e. strokes). These are most associated with a build-up of fatty deposits in the arteries, restricting blood flow, which is linked to many clinical (i.e. high cholesterol, diabetes), and behavioural (i.e. unhealthy eating habits, low physical activity) risk factors.
While mortality rates due to circulatory diseases have declined in most OECD countries over time, population ageing, rising obesity and diabetes rates, delays in diagnoses, and inadequate management may impair further reductions (OECD, forthcoming[1]). Furthermore, mortality rates due to circulatory diseases are 46% higher for men than women across OECD countries, primarily because of a greater prevalence of risk factors among men, such as smoking, hypertension, and high cholesterol (see Chapter 2 “Which diseases affect men and women differently – and why this matters” and Chapter 4 “Non-medical determinants and risk factors”).
In 2023, heart attacks and other ischaemic heart diseases (IHDs) accounted for 11% of all deaths, with an average of 112 deaths per 100 000 population due to IHDs. This is 27 deaths per 100 000 lower than in 2013, with similar declines seen in most OECD countries. However, rates increased in Mexico, Colombia and Poland by more than 30%, with increases partly linked to rising obesity rates and diabetes prevalence. A significant increase was also seen in accession country Peru.
Mortality rates due to IHDs ranged from fewer than 40 deaths per 100 000 population in Luxembourg, the Netherlands, France, Japan and Korea to over 250 deaths per 100 000 in Colombia, Latvia, Mexico, the Slovak Republic, Hungary and Lithuania (Figure 3.7). As well as obesity rates and diabetes prevalence, higher rates in Mexico, Latvia and Lithuania may also be linked to higher than average 30‑day mortality rates due to acute myocardial infarction after admission to hospital (see section on “Mortality following acute myocardial infarction” in Chapter 6).
Cerebrovascular diseases (including strokes) were the underlying cause of 6% of deaths across OECD countries in 2023. As well as causing many deaths, strokes have a significant disability burden. Mortality rates were higher than 100 deaths per 100 000 population in Lithuania, Latvia, and in OECD accession countries Croatia, Bulgaria and Romania (Figure 3.7). Mortality rates from stroke have fallen in all OECD Member countries since 2013, with an average reduction of 28% across OECD countries. For strokes, as for IHDs, a reduction in certain risk factors – notably smoking – has contributed to the lower mortality rate, alongside improved survival rates following an acute episode, reflecting better quality of care (see section on “Mortality following ischaemic stroke” in Chapter 6).
Socio‑economic inequalities in mortality from circulatory diseases are wide in most OECD countries, largely reflecting socio‑economic differences in major risk factors. Many of these deaths could be prevented, but trends in several risk factors are heading in the wrong direction, and diagnosis and management can also improve. While smoking rates have fallen overall, diabetes, high cholesterol, high blood pressure, low physical activity, obesity, and work-related stress are on the rise in many OECD countries (OECD, forthcoming[1]). A number of public health, fiscal and regulatory measures can incentivise citizens to adopt healthier lifestyles and promote better diagnosis and management, thereby reducing the burden of cardiovascular diseases on societies.
