AIMS The 2019 report from the European Society of Cardiology (ESC) Atlas provides a contemporary analysis of cardiovascular disease (CVD) statistics across 56 member countries, with particular emphasis on international inequalities in disease burden and healthcare delivery together with estimates of progress towards meeting 2025 World Health Organization (WHO) non-communicable disease targets. METHODS AND RESULTS In this report, contemporary CVD statistics are presented for member countries of the ESC. The statistics are drawn from the ESC Atlas which is a repository of CVD data from a variety of sources including the WHO, the Institute for Health Metrics and Evaluation, and the World Bank. The Atlas also includes novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery obtained by annual survey of the national societies of ESC member countries. Across ESC member countries, the prevalence of obesity (body mass index ≥30 kg/m2) and diabetes has increased two- to three-fold during the last 30 years making the WHO 2025 target to halt rises in these risk factors unlikely to be achieved. More encouraging have been variable declines in hypertension, smoking, and alcohol consumption but on current trends only the reduction in smoking from 28% to 21% during the last 20 years appears sufficient for the WHO target to be achieved. The median age-standardized prevalence of major risk factors was higher in middle-income compared with high-income ESC member countries for hypertension {23.8% [interquartile range (IQR) 22.5-23.1%] vs. 15.7% (IQR 14.5-21.1%)}, diabetes [7.7% (IQR 7.1-10.1%) vs. 5.6% (IQR 4.8-7.0%)], and among males smoking [43.8% (IQR 37.4-48.0%) vs. 26.0% (IQR 20.9-31.7%)] although among females smoking was less common in middle-income countries [8.7% (IQR 3.0-10.8) vs. 16.7% (IQR 13.9-19.7%)]. There were associated inequalities in disease burden with disability-adjusted life years per 100 000 people due to CVD over three times as high in middle-income [7160 (IQR 5655-8115)] compared with high-income [2235 (IQR 1896-3602)] countries. Cardiovascular disease mortality was also higher in middle-income countries where it accounted for a greater proportion of potential years of life lost compared with high-income countries in both females (43% vs. 28%) and males (39% vs. 28%). Despite the inequalities in disease burden across ESC member countries, survey data from the National Cardiac Societies of the ESC showed that middle-income member countries remain severely under-resourced compared with high-income countries in terms of cardiological person-power and technological infrastructure. Under-resourcing in middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, device implantation and cardiac surgical procedures. CONCLUSION A seemingly inexorable rise in the prevalence of obesity and diabetes currently provides the greatest challenge to achieving further reductions in CVD burden across ESC member countries. Additional challenges are provided by inequalities in disease burden that now require intensification of policy initiatives in order to reduce population risk and prioritize cardiovascular healthcare delivery, particularly in the middle-income countries of the ESC where need is greatest.

中文翻译：

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欧洲心脏病学会：2019 年心血管疾病统计

目标 欧洲心脏病学会 (ESC) Atlas 的 2019 年报告对 56 个成员国的心血管疾病 (CVD) 统计数据进行了当代分析，特别强调疾病负担和医疗保健服务方面的国际不平等，以及实现 2025 年目标进展的估计世界卫生组织 (WHO) 非传染性疾病目标。方法和结果 本报告提供了 ESC 成员国的当代 CVD 统计数据。统计数据来自 ESC Atlas，该地图集是来自世界卫生组织、健康指标与评估研究所和世界银行等多种来源的 CVD 数据存储库。该地图集还包括 ESC 赞助的关于人力和资本基础设施以及心血管医疗保健提供的新数据，这些数据是通过对 ESC 成员国国家协会的年度调查获得的。在 ESC 成员国中，肥胖（体重指数≥30 kg/m2）和糖尿病的患病率在过去 30 年中增加了两到三倍，使得世界卫生组织 2025 年阻止这些危险因素上升的目标不太可能实现。更令人鼓舞的是高血压、吸烟和饮酒量有所下降，但从目前的趋势来看，仅在过去20年中吸烟量从28%减少到21%似乎就足以实现世界卫生组织的目标。与高收入 ESC 成员国相比，中等收入国家主要危险因素的年龄标准化患病率中位数较高（23.8% [四分位距 (IQR) 22.5-23.1%] vs. 15.7% (IQR 14.5-21.1%)） )}、糖尿病 [7.7% (IQR 7.1-10.1%) vs. 5.6% (IQR 4.8-7.0%)]，以及男性吸烟者 [43.8% (IQR 37.4-48.0%) vs. 26.0% (IQR 20.9-31.7) %)]尽管在中等收入国家女性吸烟不太常见[8.7% (IQR 3.0-10.8) vs. 16.7% (IQR 13.9-19.7%)]。与高收入人群[2235 (IQR 1896-3602)相比，中等收入人群[7160 (IQR 5655-8115)]因CVD而造成的每10万人的残疾调整生命年的疾病负担存在不平等，其比例是其三倍以上)]国家。与高收入国家相比，中等收入国家的心血管疾病死亡率也更高，其中女性（43% vs. 28%）和男性（39% vs. 28%）的心血管疾病死亡率占潜在寿命损失的比例更大。 ）。尽管ESC成员国之间的疾病负担存在不平等，但ESC国家心脏病学会的调查数据显示，与高收入国家相比，中等收入成员国在心脏病人力和技术基础设施方面仍然严重资源不足。与高收入国家相比，中等收入国家的资源不足与冠状动脉介入、装置植入和心脏外科手术方面的严重程序缺陷有关。结论 目前，肥胖和糖尿病患病率似乎不可避免地上升，这给 ESC 成员国进一步降低 CVD 负担带来了最大的挑战。疾病负担的不平等带来了额外的挑战，现在需要加强政策举措，以降低人口风险并优先考虑心血管医疗保健服务，特别是在需求最大的欧洲共同体中等收入国家。