The European Heart Network and the British Heart Foundation marked Valentine's day (14 February) with the publication of the second edition of European cardiovascular disease statistics. ENH Director Susanne Logstrup looks behind the figure.
Cardiovascular disease (CVD) remains the main cause of death in Europe, accounting for over 4.35 million deaths each year. CVD also remains the main cause of death in the European Union, where it accounts for over 1.9 million deaths each year. Only in France and San Marino is CVD not the main killer of men (although it is the main cause of death in women in all countries of Europe).
CVD causes nearly half of all deaths in Europe (49%) and in the EU (42%). Moreover, CVD is the main cause of years of life lost from early death in Europe and the EU – around one third of years of life lost from early death are due to CVD. CVD is also the main cause of the disease burden (illness and death) in Europe (23% of all the disease burden) and the second main cause of the disease burden in the EU (18%).
Whereas CVD mortality, incidence and case fatality are falling in most Northern, Southern and Western European countries, it is either not falling as fast or rising in Central and Eastern European countries.
Perhaps surprsingly, more women die from CVD than men. But men die younger.
In the EU more than 1 million women die every year from CVD and more than 865 000 men die every year from CVD. But whereas a little more than 65 000 women under 65 die every year from CVD, almost a 165 000 men under 65 die every year from CVD. Under the age of 75 almost a 165 000 women die every year from CVD but around 385 000 men die every year from CVD in the EU.
Whichever way one views it, CVD kills too many people and most of the premature deaths due to CVD are avoidable for both men and women.
Prevalence of Risk Factors
The underlying risk factors are largely the same for women and for men and include smoking, raised blood pressure and cholesterol, physical inactivity as well as stress and other psycho-social factors.
In most EU Member States, men smoke more than women with. Both women and men in the EU generally eat to little fruit and vegetables, but often men eat less than women, and both men and women have too high a fat intake. For people aged under 64, men suffer more from elevated blood pressure and men also tend to suffer more from elevated blood cholesterol levels. There are more men in the EU who are overweight than women but there are more women who are obese than men. The prevalence of diabetes seems to be higher amongst women than men in the EU.
Differences in Men and Women
However, although the risk factors are similar in both sexes they may differ in relative importance. For instance, diabetic women suffer from CHD risk 8 fold more than non diabetic whereas the risk among diabetic men’s risk is 3 fold than non-diabetic men.
Women are to a certain extent protected from CVD before their menopause through their oestrogen levels; therefore they experience CVD approximately 10 years later in life than men. Men and women are also different when it comes to disease processes, clinical presentation and outcomes.
Such differences need to be acknowledged by all those concerned with CVD prevention, care and treatment. There is not a choice to be made between women and men at any of these intervention levels. For men, women and the society it is essential that awareness of CVD and its risk factors is high. Years of life can be gained and quality of life improved.
Costs of CVD
If CVD is tackled in a comprehensive way in the EU – and indeed in the wider Europe – there may also be significant financial savings to be made.
According to the "European cardiovascular disease statistics" CVD is estimated to cost the EU economy €169 billion a year. This represents a total annual cost per capita of €3 724. Of the total cost of CVD in the EU, around 62% is due to direct healthcare costs, 21% to productivity losses and 17% to the informal care of people with CVD.
