Current global health policy goals include a 25% reduction in premature mortality from noncommunicable diseases by 2025. In this 2-part review, we provide an overview of the current epidemiological data on cardiovascular diseases (CVD), its risk factors, and describe strategies aimed at reducing its burden. In part 1, we examine the global epidemiology of cardiac conditions that have the greatest impact on CVD mortality; the predominant risk factors; and the impact of upstream, societal health determinants (eg, environmental factors, health policy, and health systems) on CVD. Although age-standardized mortality from CVD has decreased in many regions of the world, the absolute number of deaths continues to increase, with the majority now occurring in middle- and low-income countries. It is evident that multiple factors are causally related to CVD, including traditional individual level risk factors (mainly tobacco use, lipids, and elevated blood pressure) and societal level health determinants (eg, health systems, health policies, and barriers to CVD prevention and care). Both individual and societal risk factors vary considerably between different regions of the world and economic settings. However, reliable data to estimate CVD burden are lacking in many regions of the world, which hampers the establishment of nationwide prevention and management strategies. A 25% reduction in premature CVD mortality globally is feasible but will require better implementation of evidence-based policies (particularly tobacco control) and integrated health systems strategies that improve CVD prevention and management. In addition, there is a need for better health information to monitor progress and guide health policy decisions.

当前的全球卫生政策目标包括：到2025年将非传染性疾病的过早死亡率降低25％。在这一由两部分组成的综述中，我们概述了有关心血管疾病（CVD）的当前流行病学数据，其危险因素，并描述了旨在解决的策略减轻负担。在第1部分中，我们研究了对CVD死亡率影响最大的全球心脏疾病流行病学；主要危险因素；上游社会决定因素（例如，环境因素，卫生政策和卫生系统）对CVD的影响。尽管在世界许多地区，按年龄划分的心血管疾病死亡率均已降低，但绝对死亡人数仍在增加，现在大多数发生在中低收入国家。显然，多种因素与CVD有因果关系，包括传统的个人水平风险因素（主要是吸烟，脂质和血压升高）和社会水平的健康决定因素（例如，卫生系统，健康政策以及CVD预防和护理的障碍）。在世界不同地区和经济环境之间，个人和社会风险因素均存在很大差异。但是，世界上许多地区缺乏可靠的数据来估计CVD负担，这阻碍了全国范围内预防和管理策略的建立。在全球范围内将CVD的过早死亡率降低25％是可行的，但将需要更好地实施基于证据的政策（特别是烟草控制）和改善CVD预防和管理的综合卫生系统策略。此外，