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What are the current cardiovascular realities?

Describing contemporary CVD statistics collected from ESC member countries, the third scientific report from the ESC Atlas Project was published earlier this year in the European Heart Journal.1 The new ESC Cardiovascular Realities 2022 booklet has just been released, which provides an illustrated summary of these statistics.

“According to the figures, an estimated 113 million people live with CVD across ESC member countries and it remains the most common cause of death within the region,” says Professor Panos Vardas (Hygeia Hospitals Group - Athens, Greece), ESC President 2012–2014 and Chief Strategy Officer of the ESC’s European Heart Agency. “The disease statistics presented in ESC Cardiovascular Realities 2022 emphasise the challenges we currently face. And as populations continue to age, the burden of heart disease will continue to grow.”

The booklet highlights the astonishing disparities that still exist between the 57 ESC member countries, particularly between the high-income countries of western Europe and the middle-income countries of eastern Europe and north Africa. However, across all ESC member countries, evidence suggests that World Health Organization (WHO) noncommunicable diseases targets for 2025, including reversing the rising prevalence of obesity and diabetes, and lowering elevated blood pressure, are unlikely to be met.

In addition to updating national data on risk factors, economic burden, CVD morbidity/mortality and CV healthcare delivery, extensive new material is presented, including sociodemographic and environmental determinants. Atlas Writing Group Chair, Professor Adam Timmis (William Harvey Research Institute, Queen Mary University London - London, UK) explains, “Although environmental risk factors receive relatively little attention from cardiologists, they make a substantial contribution to CVD risk, which rivals the impact of smoking, hypertension and physical inactivity on population health.” He continues, “The situation is compounded by increasing urbanisation which threatens heart health due to dirty air, noise, social deprivation and stress. It is estimated that up to 40% of people living in the EU are exposed to noise levels beyond the region’s residential limits.”

The spiralling costs associated with CVD cannot be ignored. “The economic burden of CVD in the EU appears to exceed €210 billion,” says Prof. Vardas. “A shift in emphasis towards disease prevention is needed to provide a cost-effective means of reducing the burden of CVD. More widespread access to novel therapies should also be a priority.” The booklet describes just how severely under-resourced middle-income countries are compared with high-income countries, in terms of both cardiological person-power and technological infrastructure. And it shows that novel treatments such as percutaneous heart valve implantation and left ventricular assist devices are largely the preserve of high-income countries, with very low usage in middle-income countries.

Professor Hugo Katus (University of Heidelberg - Heidelberg, Germany), Chair of the ESC Advocacy Committee, explains why this booklet is so important: "Despite the immense burden that CVD represents, it does not receive the attention that policy makers give to other diseases. ESC Cardiovascular Realities 2022 serves not only as an information source, but also as a catalyst for the development of targeted strategies aimed at reducing the burden in those countries where the need is greatest.” He concludes: “This document enables local authorities to take stock of their country's performance and identify areas where bold action is needed across all aspects of CV care, including prevention, detection, treatment and rehabilitation, if WHO 2025 targets are to be met."

To find out more about the ESC Atlas of Cardiology, go to: To collect a copy of the new ESC Cardiovascular Realities 2022 and learn about how the ESC’s data initiatives impact on the ESC’s mission, visit the ‘World of Data’ Cube in the Lounge & Exchange Area.

Access ESC Cardiovascular Realities 2022 online.


1. Timmis A, et al. Eur Heart J. 2022;43:716–799.

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.