A comparative analysis of cardiovascular disease mortality trends attributable to risk factors in the United States and globally from 1990 to 2019: an analysis of the Global Burden of Disease Study 2019.

Background: Trends in cardiovascular disease (CVD) mortality from key risk factors both in the United States (US) and globally have not been well characterized. Methods: This analysis utilized Global Burden of Disease (GBD) 2019 data to determine age-standardized mortality rates (ASMR) and disability-adjusted life years (DALYs) for CVDs attributed to risk factors in the US and globally. Total percentage change (TPC, 95 % CI) was calculated to assess temporal trends in CVD mortality and disease burden related to key risk factors, examining two periods: 1990-2010 and 2010-2019. Results: Overall CVD mortality declined in the US and globally from 1990-2019. CVD mortality declined globally by a TPC of -0.24 (-0.26 to -0.22) between 1990-2010 but only by -0.11 (-0.15 to -0.07) between 2010-2019. Similar changes were seen in the US. CVD mortality attributed to common risk factors, including dietary risks, high LDL-c, kidney dysfunction, smoking, and secondhand smoking, changed significantly between 2010-2019 compared to the prior two decades, with slower declines in CVD mortality both globally and in the US. Furthermore, CVD mortality attributed to high body mass index, elevated fasting plasma glucose, and elevated systolic blood pressure in the US plateaued from 2010-2019. Trends in DALYs attributed to these risk factors paralleled those observed for mortality. Conclusions: Despite major reductions in CVD mortality and disease burden from 1990 to 2010, mortality linked to key risk factors plateaued globally and in the US after 2010. Continued public health efforts targeting key risk factors are needed to further reduce CVD-related mortality and disability.