Each year, cardiovascular disease (CVD) kills 3.9 million people in the 53 member states of the World Health Organization European Region and over 1.8 million in the European Union (EU).
CVD is responsible for 49 % of all deaths in women across Europe and 40% of the deaths in men, killing more people than all cancers combined.
The main forms of CVD are ischaemic heart disease (IHD) and stroke:
- Just under half of all deaths from cardiovascular disease are from ischeamic heart disease. IHD accounts for 1.73 million deaths in Europe and for over 632 000 deaths in the EU each year. In the EU, around 14% of men and 12% of women die from IHD.
- Stroke is the second single most common cause of death in Europe, accounting for 988.000 deaths each year. Stroke is also the second most common single cause of death in the EU, accounting for over 425.000 deaths in the EU each year. In Europe over 13% of women and 9% of men die from the disease.
CVD is the main cause of death in women in all but 2 countries of Europe and is the main cause of death in men in all but 12 countries in Europe.
Comparing the CVD mortality burden across individual European countries reveals substantial variation, with a higher burden typically found in Central and Eastern European countries compared to that in Northern, Southern and Western countries. This is evident across both EU and non-EU member states. Within the EU, the proportion of all deaths due to CVD ranges from 23% in France to 60% in Bulgaria among men, while in women, the burden ranges from 25% in Denmark to 70% in Bulgaria. Outside the EU, the CVD mortality burden varies from 24% in Israel to 59% in Ukraine among men, and from 25% in Israel to 75% in Ukraine among women.
In all European countries for which data are available, age-standardised mortality rates for IHD are higher in males than in females. In addition, strong geographical disparities are apparent, with relatively high rates observed in Eastern and Central Europe (particularly post-Soviet states) and lower rates in Northern, Western and Southern Europe.
Age-standardised death rates for stroke are also higher in males than females for all European countries in the latest available year. Moreover, death rates for stroke are higher in Eastern and Central regions than in Northern, Southern and Western regions.
Over the past 30 years, mortality rates from IHD have been declining in most Northern and Western European countries in both males and females. Long-term trends in Central and Eastern countries have been less consistent however, with sharp decreases followed by increases and then further decreases in countries such as Ukraine and Russia, and more gradual increases followed by decreases in other countries such as Romania. Since around 2000 to 2005, age-standardised death rates from IHD have been falling in the majority of European countries, including those in Central and Eastern regions.
Similar trends in age-standardised mortality rates are seen for stroke, with steady declines occurring since the 1980s in most Northern, Southern and Western European countries compared to more recent decreases in Central and Eastern European countries.
CVD is the main cause of deaths before the age of 75 in Europe: accounting for more than 1.3 million deaths each year while all cancers combined account for 1,1 million deaths. 35% of deaths before the age of 75 in women and equally 35% of deaths before the age of 75 in men are from CVD.
CVD is the second main cause of death before the age of 75 in the EU: accounting for almost 463.000 deaths. CVD causes 26% of deaths in this age group while cancer causes 40%. Among men under 75 years in the EU, CVD causes 298,000 deaths (27%) compared to 402,000 (37%) due to cancer, while in women it accounts for around 139,000 deaths (23%) compared to 279,000 (46%) from cancer.
CVD is the main cause of death before the age of 65 in Europe, accounting for 667.000 deaths, while all cancers combined account for 607.000deaths. Among men in Europe, CVD is the most common cause of death under 65 years, responsible for around 479,000 deaths (31%), compared to around 351,000 (22%) from cancer. By contrast, in women under 65 years, CVD is the second largest single cause of mortality, accounting for 188,000 deaths (26%), compared to 256,000 (35%) from cancer
Within the EU, CVD is the second largest cause of mortality in those under 65 years, responsible for around 192,000 (22% of deaths under 65 years) per year, compared to around 339,000 (38%) from cancer. Among men under 65 years in the EU, CVD causes around 142,000 deaths (24%), compared to 194,000 (33%) from cancer. Among women it causes just over 50,000 deaths (17%) each year, compared to just over 144,000 deaths (48%) from cancer.
Data from the WHO Mortality Database show that CVD makes a sizeable contribution to potential years of life lost (PYLL) in Europe, although considerable variation exists between countries. Within the EU, the contribution of CVD to PYLL among men ranges from 11% in France to 39% in Bulgaria; among women in the EU, the contribution ranges from 7% in Luxembourg to 33% in Bulgaria. Outside of the EU, CVD in men contributes to between 10% of PYLL in Israel and 33% in Montenegro, and in women to between 7% of PYLL in Iceland and Israel and 31% of PYLL in Montenegro.
CVD is estimated to cost the EU economy almost €210 billion per year. Of the total cost of CVD in the EU, around 53% (€111 billion) is due to health care costs, 26% (€54 billion) to productivity losses and 21% (€45 billion) to the informal care of people with CVDCVD cost the health care systems of the EU just under €111 billion in 2015. This represents a cost per capita of €218 per annum, around 8% of the total health care expenditure across the EU. The cost of inpatient hospital care for people who have CVD accounted for about 50% of these costs (€57 billion), and that of drugs for about 25% (€28 billion).
The amount spent on health care for people with CVD varies widely across the EU. Cost per capita varied seven-fold in 2015, from €48 in Bulgaria to €365 in Finland. Percentage of total health care expenditure spent on CVD varied from 3% in Sweden to 19% in Hungary.
When looking at non health care costs, in 2015, production losses due to mortality and morbidity associated with CVD cost the EU almost €54 billion, with 58% of this cost due to death (€32 billion) and 42% due to illness (€23 billion) in those of working age.