CVD is a group of conditions affecting the heart or blood vessels – they include heart attacks and strokes, as well as arrhythmias and congenital heart disease. CVD is closley interlinked with other chronic diseases such as diabetes or kidney disease, but also vascular dementia which is often caused by heart disease and stroke.
Over the past 50 years, CVD mortality has declined, but cardiovascular events like heart attacks and strokes remain by far the leading cause of death in the EU, accounting for around 1 in 3 of all deaths and impacting the lives of some 60 million people who live with CVD1. More broadly, CVD accounts for 47% and 39% of all deaths in women and men respectively in the wider European Region2.
The fight against CVD mortality seems to have peaked and, in some countries, mortality has even started to increase again. Unless we do something now, the number of citizens suffering from CVD will increase dramatically.
Beyond the human costs, CVD also takes a considerable toll on healthcare systems, productivity and informal care by caregivers, with an estimated cost of EUR 282 billion per year in the EU3.
The projected number of people living with stroke will increase from nine million in 2017 to 12 million in 2040 in the European region4.
Cardiovascular disease can affect anyone. CVD knows no gender, no age. Around 20% of all premature deaths (before the age of 65) in the EU are caused by CVD5.
Many cardiovascular conditions cannot be prevented but are inherited and some may not manifest themselves until adulthood. Age, however, still is a factor: risk and prevalence of CVD increases even further with age, leading to unpreventable functional decline. This is of utmost relevance in view of Europe’s ageing population.
Cardiovascular diseases can also be triggered by other chronic conditions or their therapies, like diabetes, hypertension, kidney disease, pulmonary disease, and cancer. Lately, infectious diseases heavily impacted cardiovascular health, for example through inflammation of the heart muscle resulting from Covid-19 (for further information, please see special section on Covid-19 and CVD).
In 2040, 155 million Europeans will be over 656.
The COVID-19 pandemic made life even harder for people living with CVD: both in terms of access to and delivery of care, as well as coping with heart health and cardiovascular complications. There were reports of people no longer feeling safe to go to the hospital or even to their GP. Procedures and examinations were postponed or cancelled altogether. Importantly, the pandemic showed that patients with heart diseases such as heart failure were more severely affected and that cardiovascular events occur more frequently in the weeks after a severe COVID-19 infection.
Improving cardiovascular health is key in making our healthcare systems more resilient to pandemics. COVID-19 has brought to light the high vulnerability of CVD patients, showing that by reducing the burden of CVD and other chronic conditions, the European population will be more resilient to future health threats.
Data shows that pre-existing cardiovascular conditions are particularly important predictors of COVID-19 severity and mortality.
Despite the great advances in medical care of the past years, tremendous inequalities remain in patients’ access to appropriate cardiovascular care within and between EU countries. Death rates from CVD are higher in Central and Eastern Europe than in Northern, Southern and Western Europe, for example.
These inequalities, that lead to differences in access and in awareness, have to be addressed.
The age-standardised death rate for heart disease is 13-fold higher in women in Lithuania than in France, and 9-fold higher in men. For stroke, the age-standardised death rate is 7-fold higher in women in Bulgaria than in France, and 8-fold higher in men.
Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2021 (GBD 2021) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2022. Available from https://vizhub.healthdata.org/gbd-results/.
ESC Cardiovascular Realities 2020
Luengo-Fernandez et al., Economic burden of
cardiovascular diseases in the European Union: a population-based cost study,
European Heart Journal 2023 https://doi.org/10.1093/eurheartj/ehad583
At What Cost: The
economic impact of stroke in Europe: https://www.safestroke.eu/wp-content/uploads/2020/10/01.-At_What_Cost_EIOS_Factsheet.pdf
ESC-EHN, Fighting Cardiovascular Disease: a
blueprint for EU action: https://www.mepheartgroup.eu/wp-content/uploads/05748-CVD-plan_FINAL.pdf
Eurostat (2017) People in the EU — population projections
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