Heart disease and stroke worldwide tied to national income
Science Daily, July 09
An analysis of heart disease and stroke statistics collected in 192
countries by the World Health Organization (WHO) shows that the relative
burden of the two diseases varies widely from country to country and is
closely linked to national income, according to researchers at the
University of California, San Francisco.
Reporting in the journal Circulation, the UCSF scientists found that
developing countries tend to suffer more death and disability by stroke
than heart disease — opposite the situation in the United States and
other countries with higher national incomes.
This observation may help health officials design interventions that
best fit the needs of developing countries.
“In general, heart disease is still the number one cause of death
worldwide, but there is quite a lot of variation across the globe,” said
Anthony S. Kim, MD, MAS, assistant professor of neurology at UCSF who
conducted the study with S. Claiborne Johnston, MD, PhD, professor of
neurology and associate vice chancellor of research at UCSF.
The research highlighted the wide variation in the mortality rate for
stroke, for instance, which ranged from a worldwide low of 25 deaths per
100,000 in the island nation of Seychelles to a high of 249 deaths per
100,000 in Kyrgyzstan — a rate nearly 10 times greater. In the United
States, there are 45 deaths per 100,000 people due to stroke.
Heart disease and stroke are two diseases separated by a common
pathology. Both are caused by reduced or restricted blood flow to vital
organs, and the two diseases share many of the same common risk factors,
such as hypertension, diabetes, high cholesterol, obesity, physical
inactivity and smoking.
But because they affect very different tissues — the heart and the
brain — the two diseases diverge in terms of symptoms, approaches to
critical care, follow-up treatment and the duration and cost of
recovery. Awareness of these differences was what motivated the study.
Using data from the World Health Organization’s Global Burden of
Disease project, Kim and Johnston compared death and disability from
heart disease and stroke country by country with income data obtained
from the World Bank.
“There was a striking association with national income,” Kim said.
In the United States, for instance, heart disease is the number one
killer and stroke the number four, according to the Centers for Disease
Control and Prevention. According to the WHO data, the same is true
throughout the Middle East, most of North America, Australia and much of
Western Europe.
In many developing countries, the opposite is true. Stroke claims
more lives and is associated with greater disease burdens in China and
throughout many parts of Africa, Asia and South America. In all, nearly
40 percent of all nations have a greater burden of stroke compared to
heart disease.
“This is significant,” said Kim, “because knowing that the burden of
stroke is higher in some countries focuses attention on developing a
better understanding of the reasons for this pattern of disease and may
help public health officials to prioritize resources appropriately.”
|