European cardiovascular disease statistics 2012

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European cardiovascular disease statistics 2012

  1. 1. EuropeanCardiovascularDisease Statistics2012 edition
  2. 2. © European Heart Network and European Society of Cardiology, September 2012ISBN 978-2-9537898-1-2All rights reserved. No part of this publication may be reproduced or transmitted, in any form or by any means, electronic,photocopying or otherwise without prior permission of the publishers. Health professionals and teachers may makephotocopies for educational purposes only, provided that no charge or profit is made for any course or event for which theyare used.Published by the European Heart Network AISBL, Rue Montoyer 31, B-1000 Brussels, Belgium, www.ehnheart.organd the European Society of Cardiology, The European Heart House, 2035 Route des Colles - Les Templiers, 06903 SophiaAntipolis, France, www.escardio.orgEHN Registration No 16416/93 ESC Registration No 40329994800026EHN Business No 449.406.146 Editors: Susanne Løgstrup, European Heart Network, and Sophie O’Kelly, European Society of CardiologyCompiled by Melanie Nichols, Nick Townsend, Peter Scarborough and Mike Rayner, British Heart Foundation HealthPromotion Research Group, Department of Public Health, University of Oxford, Rosemary Rue Building, Old Road Campus,Headington, Oxford, OX3 7LFwww.dph.ox.ac.uk/bhfhprgSuggested citation:Nichols M, Townsend N, Luengo-Fernandez R, Leal J, Gray A, Scarborough P, Rayner M (2012). European CardiovascularDisease Statistics 2012. European Heart Network, Brussels, European Society of Cardiology, Sophia AntipolisThis report arises from the European Heart Health Strategy II project which has received co-funding from theEuropean Union, in the framework of the Health Programme.“Sole responsibility for this report lies with the author; the Executive Agency is not responsible for any use that may be madeof the information contained herein.”
  3. 3. 1European Cardiovascular Disease StatisticsEuropeanCardiovascularDisease Statistics2012 editionMelanie Nichols, Nick Townsend, Peter Scarborough and Mike RaynerBritish Heart Foundation Health Promotion Research GroupDepartment of Public Health, University of OxfordJose Leal, Ramon Luengo-Fernandez and Alastair GrayHealth Economics Research Centre,Department of Public Health, University of Oxford
  4. 4. 2 European Cardiovascular Disease StatisticsAcknowledgementsThe compilers would like to thank Prachi Bhatnagar, João Breda, Michael Hübel, Marleen Kestens and IlariaLeggeri for their help in producing this edition.About the PublishersThe European Heart Network (EHN) is a Brussels-based alliance of heart foundations and likeminded non-governmental organisations throughout Europe with member organisations in 26 countries. The mission of theEuropean Heart Network is to play a leading role in the prevention and reduction of cardiovascular diseases, inparticular heart disease and stroke, through advocacy, networking, education and patient support, so that they areno longer a major cause of premature death and disability throughout Europe.The European Society of Cardiology (ESC) represents over 70,000 cardiology professionals across Europe andthe Mediterranean. Its mission is “to reduce the burden of Cardiovascular Disease in Europe”. It comprises 6Associations, 5 Councils, 18 Working Groups covering a wide variety of sub-specialities as well as 55 NationalCardiac Societies in European and Mediterranean countries, all involved in the advancement of knowledge ofdiseases of the heart and circulation. It also organises the ESC Congress, the largest cardiovascular medical meetingworldwide and edits and publishes nine of the world’s leading journals on cardiology.For further information contact: European Heart Network European Society of Cardiology Rue Montoyer 31 2035 Route des Colles - Les Templiers 1000 Brussels 06903 Sophia Antipolis BELGIUM FRANCE Tel + 32 2 512 91 74 Tel + 33 4 92 94 76 00 Fax + 32 2 503 35 25 Fax + 33 4 92 94 76 01 Email info@ehnheart.org Email advocacy_representation@escardio.org URL www.ehnheart.org URL www.escardio.org
  5. 5. 3European Cardiovascular Disease StatisticsContentsEuropean Cardiovascular DiseaseStatistics 2012Acknowledgements............................................................................................................................................... 2Foreword ................................................................................................................................................. 7Summary ................................................................................................................................................. 8Introduction ................................................................................................................................................. 9Chapter 1 - Mortality .......................................................................................................................................... 10Table 1.1 Total numbers of deaths by cause and sex, latest available year, Europe.................................................14Figure 1.1a Deaths by cause, men, latest available year, Europe...............................................................................16Figure 1.1b Deaths by cause, women, latest available year, Europe.......................................................................... 16Figure 1.1c Deaths by cause, men, latest available year, EU.....................................................................................17Figure 1.1d Deaths by cause, women, latest available year, EU................................................................................ 17Table 1.2 Deaths under 75 by cause and sex, latest available year, Europe............................................................18Figure 1.2a Deaths under 75 by cause, men, latest available year, Europe............................................................... 20Figure 1.2b Deaths under 75 by cause, women, latest available year, Europe........................................................... 20Figure 1.2c Deaths under 75 by cause, men, latest available year, EU..................................................................... 21Figure 1.2d Deaths under 75 by cause, women, latest available year, EU..................................................................21Table 1.3 Deaths under 65 by cause and sex, latest available year, Europe........................................................... 22Figure 1.3a Deaths under 65 by cause, men, latest available year, Europe ...............................................................24Figure 1.3b Deaths under 65 by cause, women, latest available year, Europe............................................................24Figure 1.3c Deaths under 65 by cause, men, latest available year, EU..................................................................... 25Figure 1.3d Deaths under 65 by cause, women, latest available year, EU ................................................................ 25Table 1.4 Age-standardized death rates from CHD, adults aged under 65, by sex, 1980 to 2010, Europe...............26Figure 1.4a Age-standardized death rates from CHD, men aged under 65, latest available year, Europe ...................28Figure 1.4b Age-standardized death rates from CHD, women aged under 65, latest available year, Europe ...............28Figure 1.4c Age-standardized death rates from CHD, men aged under 65, 1980 to 2010, selected countries............29Figure 1.4d Age-standardized death rates from CHD, women aged under 65, 1980 to 2010, selected countries........29Table 1.5 Age-standardized death rates from stroke, adults aged under 65, by sex, 1980 to 2010, Europe.............30Figure 1.5a Age-standardized death rates from stroke, men aged under 65, latest available year, Europe..................32Figure 1.5b Age-standardized death rates from stroke, women aged under 65, latest available year, Europe .............32Figure 1.5c Age-standardized death rates from stroke, men aged under 65, 1975 to 2010, selected countries..........33Figure 1.5d Age-standardized death rates from stroke, women aged under 65, 1975 to 2010, selected countries......33Table 1.6 Potential years of life lost by cause and sex, latest available year, Europe................................................34Chapter 2 - Morbidity......................................................................................................................................... 35Table 2.1 Disability-adjusted life years (DALYs) by cause, 2002, WHO Mortality Sub-Region, EU and Europe.........37Figure 2.1a Disability-adjusted life years lost by cause, 2002, Europe.......................................................................38Figure 2.1b Disability-adjusted life years lost by cause, 2002, EU..............................................................................38Table 2.2 Age-standardized DALYs rate for CHD, stroke and other CVD, 2002, Europe...........................................39Figure 2.2a Age-standardized DALYs rate for CHD, 2002, Europe ............................................................................40Figure 2.2b Age-standardized DALYs rate for stroke, 2002, Europe...........................................................................40Table 2.3 30-day case fatality rate after admission for cardiovascular diseases, 2009 or latest year, Europe ...........41Table 2.4 Rates of hospital discharges from CVD, 1970 to 2009, Europe...............................................................42Table 2.5 Rates of hospital discharges from CHD, 1970 to 2009, Europe...............................................................43Table 2.6 Rates of hospital discharges from stroke, 1970 to 2009, Europe.............................................................44
  6. 6. 4 European Cardiovascular Disease StatisticsChapter 3 – Treatment........................................................................................................................................ 45Table 3.1 Reported medication at discharge: hospital patients with established CHD, 2006/07, ............................46 EUROASPIRE III Survey populationsTable 3.2 Reported medication, hospital patients with established CHD, 1995/96, 1999/2000 and 2006/07, ........47 EUROASPIRE survey populationsFigure 3.2 Reported medication use in hospital patients with established CHD, 1995/96, 1999/2000 and 2006/07, .48 EUROASPIRE survey populationsTable 3.3 Rates of surgical procedures for treating CVD, 2005 to 2010, Europe.....................................................49Figure 3.3a Rates of evacuation of subdural haematoma and intracranial haemorrhage, ..........................................50 latest available year, EuropeFigure 3.3b Rates of transluminal coronary angioplasty, latest available year, Europe.................................................50Figure 3.3c Rates of bypass anastomosis for heart revascularization, latest available year, Europe.............................51Chapter 4 – Smoking.......................................................................................................................................... 52Table 4.1 Prevalence of smoking, adults aged 15 years and over, by sex, 1980 to 2009, Europe............................54Figure 4.1a Prevalence of smoking, men aged 15 years and over, latest available year, Europe .................................56Figure 4.1b Prevalence of smoking, women aged 15 years and over, latest available year, Europe ............................56Figure 4.1c Prevalence of smoking, men, 1980 to 2010, selected countries..............................................................57Figure 4.1d Prevalence of smoking, women, 1980 to 2010, selected countries.........................................................57Table 4.2 Prevalence of smoking, 15 year olds, by sex, 1989/90, to 2009/10, Europe ...........................................58Figure 4.2a Prevalence of smoking, boys aged 15 years, 2009/10, Europe ...............................................................59Figure 4.2b Prevalence of smoking, girls aged 15 years, 2009/10, Europe................................................................59Figure 4.2c Change in smoking rates among 15 year olds, by sex, 1993/94 to 2009/10, Europe...............................60Table 4.3 Estimated number of deaths attributable to passive smoking, ................................................................61. adults aged 20 years and over, 2002, EuropeChapter 5 – Diet ............................................................................................................................................... 62Table 5.1 Frequency of vegetable consumption, adults, by sex, EU........................................................................64Table 5.2 Frequency of fruit consumption, adults, by sex, EU................................................................................65Table 5.3 Daily vegetable consumption, children aged 11, 13 and 15 years, by sex, 2009/10, Europe....................66Table 5.4 Daily fruit consumption, children aged 11, 13 and 15 years, by sex, 2009/10, Europe............................67Figure 5.3 Daily vegetable consumption, 15 year olds, by sex, 2009/10, Europe......................................................68Figure 5.4 Daily fruit consumption, 15 year olds, by sex, 2009/10, Europe..............................................................68Table 5.5 Total energy consumption, 1970 to 2007, Europe..................................................................................69Figure 5.5a Total energy consumption, 1970 to 2007, by region, Europe..................................................................70Figure 5.5b Total energy consumption, 2007, Europe...............................................................................................70Table 5.6 Vegetable consumption, 1970 to 2007, Europe......................................................................................71Figure 5.6a Vegetable consumption, 1970 to 2007, by region, Europe......................................................................72Figure 5.6b Vegetable consumption, 2007, Europe...................................................................................................72Table 5.7 Fruit consumption, 1970 to 2007, Europe..............................................................................................73Figure 5.7a Fruit consumption, 1970 to 2007, by region, Europe..............................................................................74Figure 5.7b Fruit consumption, 2007, Europe ..........................................................................................................74Table 5.8 Total fat consumption and percentage of total energy available from fat, 1970 to 2007, Europe...............75Figure 5.8 Percentage of energy available from fat, 2007, Europe...........................................................................76
  7. 7. 5European Cardiovascular Disease StatisticsChapter 6 – Physical Activity............................................................................................................................... 77Table 6.1 Frequency of exercising or playing sport, adults, 2009, EU.....................................................................79Table 6.2 Frequency of participating in informal physical activity, adults, 2009, EU................................................80Figure 6.1 Prevalence of adults who do no moderate intensity physical activity in a typical week, 2009, EU.............81Figure 6.2 Prevalence of adults who participate in physical activity (excluding sport) ..............................................81 at least 5 times per week, 2009, EUTable 6.3 Prevalence of insufficiently active adults, aged 15 years and older, 2008, by sex, Europe........................82Table 6.4 Prevalence of children who participate in at least one hour of moderate to vigorous physical activity ......83 (MVPA) per day, by sex, 2005/06 and 2009/10, EuropeFigure 6.4a Prevalence of 11 year olds participating in 1 hour or more of MVPA per day, by sex, 2009, Europe.........85Figure 6.4b Prevalence of 13 year olds participating in 1 hour or more of MVPA per day, by sex, 2009, Europe.........85Figure 6.4c Prevalence of 15 year olds participating in 1 hour or more of MVPA per day, by sex, 2009, Europe.........85Table 6.5 Prevalence of children who watch television for two or more hours per day on weekdays, by sex, ...........86 2005/06 and 2009/10, EuropeFigure 6.5a Prevalence of 11 year olds watching 2 or more hours of television per day, by sex, 2009, Europe............88Figure 6.5b Prevalence of 13 year olds watching 2 or more hours of television per day, by sex, 2009, Europe............88Figure 6.5c Prevalence of 15 year olds watching 2 or more hours of television per day, by sex, 2009, Europe............88Chapter 7 – Alcohol............................................................................................................................................ 89Table 7.1 Alcohol consumption, adults aged 15 years and over, 1970 to 2010, Europe..........................................90Figure 7.1a Alcohol consumption, adults aged 15 years and over, 2007, Europe.......................................................91Figure 7.1b Alcohol consumption, adults aged 15 years and over, 1970 to 2010, selected countries.........................91Chapter 8 – Blood Pressure................................................................................................................................. 92Table 8.1 Prevalence of raised blood pressure or blood pressure medication use, adults aged 25 years and ..........93 over, by sex, 2008, EuropeFigure 8.1 Prevalence of raised blood pressure, adults aged 25 years and over, by sex, 2008, Europe.....................94Table 8.2 Mean systolic blood pressure, adults aged 25 and over, by sex, 1980 to 2008, Europe...........................95Chapter 9 – Blood Cholesterol.............................................................................................................................. 97Table 9.1 Prevalence of raised blood cholesterol, adults aged 25 years and over, by sex, 2008, Europe..................98Figure 9.1 Prevalence of raised cholesterol (≥6.2mmol/L), by sex, 2008, Europe.....................................................99Table 9.2 Mean blood cholesterol levels, by sex, 1980 to 2008, Europe...............................................................100Chapter 10 – Overweight and Obesity................................................................................................................. 102Table 10.1 Prevalence of overweight and obesity, by sex, latest available year, Europe............................................104Figure 10.1a Prevalence of obesity among adult men, latest available year, Europe...................................................105Figure 10.1b Prevalence of obesity among adult women, latest available year, Europe...............................................105Table 10.2 Mean BMI, adults aged 20 years and over, by sex, 1980 to 2008, Europe............................................106Figure 10.2a Mean BMI, men aged 20 years and over, 2008, Europe.......................................................................108Figure 10.2b Mean BMI, women aged 20 years and over, 2008, Europe...................................................................108Table 10.3 Prevalence of childhood overweight, by sex, latest available year, Europe..............................................109Chapter 11 – Diabetes...................................................................................................................................... 110Table 11.1 Prevalence of diabetes, adults, 1980 to 2009, Europe..........................................................................111Figure 11.1a Prevalence of diabetes, adults, latest available year, Europe.................................................................112Figure 11.1b Prevalence of diabetes, 1980 to 2009, selected countries....................................................................112Table 11.2 Prevalence of raised blood glucose, adults aged 25 and over, 2008, Europe ........................................113Table 11.3 Trends in mean blood glucose levels, by sex, 1980 to 2008, Europe.....................................................114
  8. 8. 6 European Cardiovascular Disease StatisticsChapter 12 – Economic Costs............................................................................................................................ 116Table 12.1 Total cost of CVD, CHD and cerebrovascular diseases, 2009, EU..........................................................118Table 12.2 Health care costs of CVD (€ thousands) by country, 2009, EU..............................................................119Figure 12.2 Percentage of total healthcare expenditure on CVD in the EU, 2009, by resource use category.............120Table 12.3 Health care costs of CHD (€ thousands) by country, 2009, EU.............................................................121Table 12.4 Health care costs of cerebrovascular diseases (€ thousands) by country, 2009, EU..............................122Table 12.5 Non health-care costs (€ thousands) of CVD, CHD and cerebrovascular diseases, by country,..............123 2009, EUAppendix ............................................................................................................................................. 124Map ............................................................................................................................................. 125
  9. 9. 7European Cardiovascular Disease StatisticsForewordThis is the fourth edition of European Cardiovascular Disease Statistics. This fourth edition is published jointly by theEuropean Heart Network, the European Society of Cardiology and the British Heart Foundation Health PromotionResearch Group, Department of Public Health, University of Oxford. It is part of the European Heart Health StrategyII (EuroHeart II) project and benefits from co-funding from the European Union in the framework of the healthprogramme.CVD remains the main cause of death in Europe with very significant differences in mortality rates between countries.The differences are greatest between Northern, Southern and Western European countries and Central and EasternEuropean Countries. There are also differences between Western and Southern European countries with SouthernEuropean countries still having lower death rates from CVD than Western European countries. However, policymakers need to consider the differences and take a close look at risk factor prevalence and trends. Differencesbetween Southern and Western European countries may persist but they are narrowing. This may be good news forWestern Europe not necessarily for Southern Europe.The data presented in the fourth edition of European Cardiovascular Disease Statistics show that our efforts toreduce mortality from cardiovascular diseases have been successful. Most noticeably, following steep increasesin CVD mortality in some Central and Eastern European countries, these countries are now since the mid-2000experiencing a decrease. However, the cost to the European Union economies of cardiovascular diseases (CVD) isnot decreasing.A read through the chapters of the European Cardiovascular Disease Statistics confirms that Europe suffers badlyfrom lack of data and, particularly, lack of comparable data. This is true for prevalence and incidence rates, rates ofsurgical procedures as well as for diets. The European Union has an important task in developing standard methodsfor collecting information or agreed procedures for calibration of locally appropriate methods and questionnaires, toensure effective service planning and quality of care for patients across the European Union.Susanne LøgstrupDirectorEuropean Heart NetworkIsabel BardinetChief Executive OfficerEuropean Society of Cardiology
  10. 10. 8 European Cardiovascular Disease StatisticsSummary• Each year cardiovascular disease (CVD) causes over 4 million deaths in Europe and over 1.9 million deaths inthe European Union (EU).• CVD causes 47% of all deaths in Europe and 40% in the EU.• CVD is the main cause of death in women in all countries of Europe and is the main cause of death in men inall but 6 countries.• Death rates from CHD are generally higher in Central and Eastern Europe than in Northern, Southern andWestern Europe.• Death rates from stroke are many times higher in Central and Eastern Europe than in Northern, Southern andWestern Europe.• CVD mortality is now falling in most European countries, including Central and Eastern European countrieswhich saw large increases until the beginning of the 21st century.• Smoking remains a major public health issue in Europe. Although smoking has declined in many Europeancountries the rate of decline is now slow and rates remain stable or are increasing in some countries, particularlyamong women.• Women are now smoking nearly as much as men in many European countries and girls often smoke more thanboys.• Fruit and vegetable consumption has increased overall across Europe in recent decades, while overall fatconsumption has remained stable.• Few adults in European countries participate in adequate levels of physical activity, with inactivity more commonamong women than men.• Levels of obesity are high across Europe in both adults and children, although rates vary substantially betweencountries.• The prevalence of diabetes in Europe is high and has increased rapidly over the last ten years, increasing bymore than 50% in many countries.• Overall CVD is estimated to cost the EU economy almost €196 billion a year.• Of the total cost of CVD in the EU, around 54% is due to health care costs, 24% due to productivity losses and22% due to the informal care of people with CVD.
  11. 11. 9European Cardiovascular Disease StatisticsIntroductionThe aim of the publicationThis is the fourth edition of European Cardiovascular Disease Statistics. European Cardiovascular Disease Statisticsis designed for policy makers, health professionals, medical researchers and anyone else with an interest incardiovascular diseases (CVD). It provides the most recent statistics related to the incidence, prevalence, causesand effects of the diseases.The aim of European cardiovascular disease statistics is to show: I. the extent to which CVD is a major health problem in Europe; II. where, in Europe, this problem is greatest; III. the variability in efforts to treat and prevent CVD across Europe as shown by differences in levels of treatmentand in levels of risk factors for the disease; IV. changes in CVD mortality, morbidity, treatment and risk factors over time; V. the economic costs of CVD in the European Union.European Cardiovascular Disease Statistics is divided into 12 sections. The first two sections on mortality andmorbidity deal with the burden of CVD in Europe. Next there is a section on treatment. Then there are four sectionson the main aspects of lifestyle which affect the risk of CVD: smoking, diet, physical activity and alcohol consumption.These are followed by four sections on the main pathophysiological risk factors: raised blood pressure, raised bloodcholesterol, overweight/obesity and diabetes. The final section provides information about the economic costs ofCVD in the European Union (EU). Each section contains a set of tables and graphs and a brief description of thedata presented.In European Cardiovascular Disease Statistics we aim only to describe and not to explain. So, although there maybe relationships between various geographical and temporal patterns observed, we have made no attempt to drawany conclusions about the strength of these relationships or about causality.Sources and scope of the dataIn compiling the first 11 sections of European Cardiovascular Disease Statistics we have only consulted internationalsources: that is the World Health Organization (WHO), the WHO MONICA (monitoring trends in cardiovasculardisease) Project, the Food and Agriculture Organization of the United Nations (FAO), the EU, the European Societyof Cardiology, etc. In the final section on economic costs, we have also consulted national sources. It should benoted that the data presented are extremely variable in quality and are only a selection of those available. Theoriginal sources need to be consulted for further information.We also investigated several sources of data from which we have not extracted statistics: either because the dataprovided were similar, but less comprehensive or less recent than those we have included, or were not directlyrelevant to the focus of the publication.There are many different definitions of ‘Europe’. We have chosen to use the member states of the World HealthOrganization’s European Region as our definition of ‘Europe’. (An appendix includes a map and lists the memberstates of the World Health Organization’s European Region and of the EU). The number of European countriescovered in the tables and graphs varies considerably. We have, where possible, given an overall figure for Europeand also for the EU.
  12. 12. 10 European Cardiovascular Disease Statistics1. MortalityTotal mortalityDiseases of the heart and circulatory system (cardiovascular disease or CVD) are the main cause of death in Europe:accounting for over 4 million deaths each year1. Nearly half (47%) of all deaths are from CVD (52% of deaths inwomen and 42% of deaths in men). The main forms of CVD are coronary heart disease (CHD) and stroke2. Justunder half of all deaths from CVD in both men and women are from CHD, with stroke accounting for nearly a thirdof deaths in women and a quarter of deaths in men (Table 1.1, Figures 1.1a and 1.1b).CVD is also the main cause of death in the European Union (EU) accounting for 1.9 million deaths each year. Fortypercent of all deaths in the EU (43% of deaths in women and 36% of deaths in men) are from CVD - slightly lessthan for Europe as a whole. Over a third of deaths from CVD in the EU are from CHD and just over a quarter arefrom stroke (Table 1.1, Figures 1.1c and 1.1d).CHD by itself is the single most common cause of death in Europe: accounting for 1.8 million deaths in Europe eachyear. Over one in five women (22%) and one in five men (20%) die from the disease (Table 1.1). CHD is also thesingle most common cause of death in the EU, accounting for over 681,000 deaths in the EU each year: 15% ofdeaths among men, and 13% of deaths among women (Table 1.1).Stroke by itself is the second single most common cause of death in Europe: accounting for almost 1.1 million deathsin Europe each year. Over one in seven women (15%) and one in ten men (10%) die from the disease (Table 1.1).Stroke is also the second most common single cause of death in the EU, accounting for over 460,000 deaths in theEU each year. Around one in every twelve men (8%) and one in ten women (11%) die from the disease (Table 1.1).CVD is the main cause of death for women in all countries of Europe for which we have mortality data and it is themain cause of death for men in all but 6 of these countries (exceptions are France, Israel, the Netherlands, SanMarino, Slovenia and Spain). CVD causes more than 50% of deaths in women in 29 countries, mostly in Centraland Eastern Europe. In nine countries CVD causes more than 50% of deaths in men: Azerbaijan, Belarus, Bulgaria,Georgia, Montenegro, Romania, FYR Macedonia, Romania, Ukraine and Uzbekistan (Table 1.1).CVD remains the main cause of death for women in all 27 countries of the EU and it is the main cause of death formen in all these countries except France, the Netherlands, Slovenia and Spain3. For men living in EU countries CVDcauses between 60% (Bulgaria) and 25% (France) of deaths3and for women between 70% (Bulgaria) and 30%(France and the Netherlands) of deaths3(Table 1.1).Deaths before the age of 75CVD is the main cause of death before the age of 75 in Europe, accounting for almost 1.5 million deaths each year.Thirty eight percent of deaths before the age of 75 in women and 37% of deaths before the age of 75 in men arefrom CVD (Tables 1.1 and 1.2, Figures 1.2a and 1.2b).CVD is the main cause of death before the age of 75 for men in 29 of the 51 countries of Europe for which we havemortality data and in 23 countries for women. CVD causes between 50% (Bulgaria) and 17% (France)3of deathsbefore the age of 75 in men, and between 57% (Ukraine) and 13% (Iceland) of deaths before the age of 75 inwomen (Table 1.2).
  13. 13. 11European Cardiovascular Disease StatisticsIn the EU, CVD is the second largest cause of death before the age of 75 (after cancer), accounting for almost490,000 deaths. CVD causes 27% of premature deaths in the EU, while cancer causes 39%. Twenty nine percentof deaths before the age 75 in men and 25% of deaths before the age of 75 in women are from CVD (Tables 1.1and 1.2, Figures 1.2c and 1.2d).CVD is the main cause of death before the age of 75 for men in 11 countries out of 27 in the EU: Bulgaria, Cyprus,Czech Republic, Estonia, Finland, Hungary, Latvia, Lithuania, Poland, Romania and Slovakia. For women it is themain cause in five countries: Bulgaria, Estonia, Latvia, Lithuania and Romania (Table 1.2).CHD by itself is the single most common cause of death before the age of 75 in Europe, accounting for over734,000 deaths. Nineteen percent of deaths before the age of 75 in men and 17% of deaths before the age of 75in women are from CHD (Table 1.2, Figures 1.2a and 1.2b).CHD by itself is the single most common cause of death before the age of 75 in the EU, accounting for over 206,000deaths. In the EU, CHD causes 13% of deaths before the age of 75 in men – more than the most common formof cancer in men – lung cancer – which causes 10% of deaths. CHD causes 9% of deaths before the age of 75in women – more that the most common form of cancer in women – breast cancer – which causes 8% of deaths(Table 1.2, Figures 1.2c and 1.2d).Stroke accounts for over 370,000 deaths among those aged 75 and under in Europe. Stroke accounts for around8% of all deaths in Europe among men aged under 75 and 11% of deaths among women aged under 75.Stroke accounts for almost 110,000 deaths among those aged 75 and under in the EU. Of the deaths in the EUamong those aged under 75, 6% of male deaths and 7% of female deaths were due to stroke.Deaths before the age of 65CVD is the main cause of death before the age of 65 in Europe: accounting for over 680,000 deaths each year.Thirty one percent of deaths before the age of 65 in men and 26% of deaths before the age of 65 in women arefrom CVD (Tables 1.1 and 1.3, Figures 1.3a and 1.3b).CVD is the main cause of death before the age of 65 for men in 26 of the 51 countries of Europe for which we havemortality data and in 17 countries for women. CVD causes between 43% (Bulgaria) and 15% (France)3of deathsbefore the age of 65 in men, and between 38% (Bulgaria) and 6% (Iceland) of deaths before the age of 65 inwomen (Table 1.3).CVD is the second largest cause of death before the age of 65 in the EU, accounting for over 211,000 deaths. CVDcauses 22% of deaths in this age group, while cancer causes 36%. One quarter (25%) of deaths before the age65 in men and 18% of deaths before the age of 65 in women are from CVD (Tables 1.1 and 1.3, Figures 1.3c and1.3d).CVD is the main cause of death before the age of 65 for men in nine countries in the EU (Bulgaria, Cyprus, Estonia,Finland, Latvia, Lithuania, Poland, Romania and Slovakia). For women it is the main cause of death before the ageof 65 only in Bulgaria (Table 1.3).CHD by itself is the single most common cause of death before the age of 65 in Europe: accounting for just over330,000 deaths. Sixteen percent of deaths before the age of 65 in men and 10% of deaths before the age of 65 inwomen are from CHD (Table 1.3, Figures 1.3a and 1.3b).
  14. 14. 12 European Cardiovascular Disease StatisticsIn the EU CHD causes almost 92,000 deaths before the age of 65. In the EU, CHD causes 12% of deaths beforethe age of 65 in men - more than the most common form of cancer in men - lung cancer - which causes 10% ofdeaths. CHD causes 6% of deaths before the age of 65 in women - less than the most common form of cancer inwomen - breast cancer - which causes 10% of deaths (Table 1.3, Figures 1.3c and 1.3d).Stroke accounts for almost 150,000 deaths among those aged 65 and under in Europe. Stroke accounts for around6% of all deaths in Europe among men aged under 65 and just over 7% of deaths among women aged under 65.Stroke accounts for almost 42,000 deaths among those aged 65 and under in the EU. Of the deaths in the EUamong those aged under 65, 4% of male deaths and 5% of female deaths were due to stroke.Death ratesDeath rates from CHD are generally higher in Central and Eastern Europe than in Northern, Southern and WesternEurope. For example the death rate for men aged under 65 living in the Russian Federation is more than thirteentimes higher than in France, and for women it is almost sixteen times higher. Western European countries generallyhave higher rates than Southern European Countries. For example the death rate for both men and women agedunder 65 living in Ireland is 1.7 times higher than in Italy (Table 1.4, Figures 1.4a and 1.4b).Death rates from stroke are higher in Central and Eastern Europe than in Northern, Southern and Western Europe.For example the death rate in men and women aged under 65 living in Kyrgyzstan is around twenty times higherthan in Norway (Table 1.5, Figures 1.5a and 1.5b).Over the past 30 years death rates from CHD have been consistently falling in most Northern and Western Europeancountries, however trends in Central and Eastern European countries have been more mixed, including relativestability in some places for example Bulgaria (Figure 1.4c, 1.4d) and rapid increases in countries includingUkraine and Belarus. Since around 2000 to 2005, however, rates are now also falling in the majority of Centraland Eastern European countries. Between 1999 and 2009, death rates for men aged under 65 living in Icelandand the Netherlands fell by 57% and 55% respectively, while in countries such as Ukraine, the Russian Federationand Lithuania, small decreases in death rates for that decade overall (up to 10% decreases from 1999 rates) hidea pattern of steep increases until the mid-2000s, followed by equally steep falls in recent years. Among women,Estonia recorded a remarkable decrease of 60% in death rates from CHD between 1999 and 2009, while theNetherlands and Norway showed a halving of rates over the same period. Only in Lithuania and Kyrgyzstan weredeath rates from CHD for women higher in 2009 than in 1999 (Table 1.4, Figures 1.4c and 1.4d).Death rates from stroke are falling rapidly in most European countries with few exceptions. For both men andwomen aged under 65, the largest percentage decreases in death rates from stroke were in Estonia (57% and68% respectively between 1999 and 2009). Almost all European countries recorded very substantial decreasesin death rates from stroke for the last ten years of available data. The main exception was Slovakia, where smallincreases in rates was evident overall between 1999 and 2009 (7% for men and 6% for women), however ratesvaried substantially from year to year, and if 1998 to 2008 were taken as the example, there was an 11% decreasein death rates among men and 21% decrease among women (Table 1.5, Figure 1.5c and 1.5d).Years of Life Lost due to preventable early deathPotential Years of Life Lost (PYLL) provides a way of weighting deaths occurring at younger ages, which shouldbe preventable. The calculation of PYLL involves summing up deaths occurring at each age and multiplying thiswith the number of remaining years to live up to 70 years (or other selected age limit)4. Data from the OECD showthat CVD makes a significant, yet highly variable contribution to potential years of life lost before age 70 in Europe.Among men, CVD accounts for between 12% of all PYLL in Portugal, France and Israel, to 25% or more of all
  15. 15. 13European Cardiovascular Disease StatisticsPYLL in Estonia, Hungary and the Russian Federation (Table 1.6). Among women, the countries with the greatestproportion of years lost due to CVD were Slovakia and the Russian Federation, while the lowest proportions of PYLLdue to CVD were in Iceland and Israel.1 When we state, in this section, that CVD is the main cause of death we are comparing “Diseases of the circulatory system” (Chapter IX 10th Revision) of theInternational Classification of Diseases, with other chapters (e.g. Chapter II “Neoplasms”). When we state that CHD is the most common cause of death we arecomparing CHD ( Chapter IX, I20-I25, 10th Revision) with all diseases within all chapters (e.g. with lung cancer, Chapter II, C33-C34, 10th Revision).2 The following ICD codes have been used for collating mortality data in this chapter, and where available, elsewhere in this report: CVD (ICD-10 codes I00-I99;ICD-9 codes 3900-4599; ICD-8 codes 3900-4589) CHD (ICD-10 codes I20-I25; ICD-9 and ICD-8 codes 4100-4149) Stroke (ICD-10 codes I60-I69; ICD-9 andICD-8 codes 4300-4380). For externally collated data, see source for details.3 Data from the WHO MONICA project suggest that official mortality statistics in France under-report deaths from CVD compared to other countries. MONICA data fromthe French populations included in the MONICA Project (Lille, Strasbourg and Toulouse) show an underestimate of CHD deaths of over 75%. (See WHO MonicaProject (2003) MONICA Monograph and Multimedia Sourcebook: World’s largest study of heart disease stroke, risk factors and population trends 1979-2002.Edited by Hugh Tunstall-Pedoe for the WHO MONICA Project. WHO: Geneva). Table 1.1 also highlights that doctors in France have a much higher rate of reportingdeaths from “all other causes”. Together these suggest that the true numbers and proportions of deaths from CVD and CHD in France are likely to be higher thanthose reported in Table and Figures 1.1.4 Organisation for Economic Co-operation and Development (OECD). OECD Health Data 2012: Definitions, Sources and Methods. http://www.oecd.org/health/healthdata: OECD, June 2012.
  16. 16. 14 European Cardiovascular Disease StatisticsMenYearAllcausesCoronaryheartdiseaseStrokeOtherCVDStomachcancerColo-rectalcancerLungcancerBreastcancerOthercancerRespiratorydiseaseInjuriesandpoisoningAllothercausesAlbania20049,9491,5931,5211,5652336046409505447932,226Armenia200914,2534,1501,3001,02928817998761,5561,0349132,811Austria201036,6927,1851,8694,6654791,1062,386126,4812,1712,7157,623Azerbaijan200726,5173,3803,9596,19537910242881,8961,5791,7456,846Belarus200970,56525,5197,4112,8001,3931,0292,81505,3823,02610,89510,295Belgium200550,9496,3803,0726,1455111,5355,038178,0016,5123,9529,786BosniaandHerzegovina199117,0102,0061,7643,5313342171,20601,5706481,6784,056Bulgaria200858,3038,06510,35216,6328831,3402,877265,4162,7002,9807,032Croatia200926,0194,8853,2682,9425321,0592,176193,9511,3531,8893,945Cyprus20092,78046215939228501683397214217690CzechRepublic200954,08012,1014,8207,1307072,2773,977158,5313,5054,1766,841Denmark200627,0133,2571,9692,9152271,0332,077164,7162,3881,5916,824Estonia20098,0101,8815341,3281532014761,0673011,0031,066Finland200925,1526,0241,7562,0782785371,43243,5601,3332,9015,249France2008271,67121,52513,49733,2562,9038,82022,15319355,03817,19022,40674,690Georgia200924,1913,0533,7435,90327316163821,6474141,3087,049Germany2010409,02267,40323,57658,4925,77713,34029,38110769,62732,00920,18789,123Greece200957,0157,4616,6549,0318421,3515,34109,2795,6092,8978,550Hungary200966,32415,5886,2467,7211,0022,7545,687148,7323,6694,85010,061Iceland20091,033204751021341631937179192Ireland200915,0442,9198721,0542325601,06332,7591,8061,3702,406Israel200819,4952,5439161,4662766251,066212,9751,5811,3816,645Italy2008284,02738,17625,31835,1585,9259,81225,36613452,26121,16614,48156,230Kazakhstan200978,64713,4348,80911,2341,4137722,63004,8064,99513,36117,193Kyrgyzstan200920,1255,1612,8657774269033458791,7552,6645,169Latvia200914,5644,0271,7211,43228532484151,7174311,6422,139Lithuania200921,8286,4162,1021,5984075141,14942,5151,0773,2832,763Luxembourg20091,79818914728822541641312154174293Malta20101,48931910388226012225116489271Monaco198725223266946250409842Montenegro20093,0122562031,0592234208240165167658Netherlands201065,9776,0043,4628,8099262,6636,5363212,9816,6603,24014,664Norway200919,8642,8431,3761,9841717581,23073,4791,9851,5514,480Poland2009203,82625,40715,91342,2933,4605,51616,3926927,00012,20618,62336,947Portugal200953,6913,9506,1274,7791,4122,0972,720158,1846,3993,08714,921RepublicofMoldova201023,2117,5062,824879312372746111,7911,6142,8634,293Romania2010137,95727,02122,49024,4822,3553,0007,7056015,0378,0629,56118,184RussianFederation20091,048,314278,933143,80390,79620,26517,25542,70624075,18055,463173,089193,290SanMarino2005116612319612022378Serbia200952,3776,7597,23211,7497381,5343,752305,9382,5892,7099,347Slovakia200927,4467,7172,6602,4634001,0121,59293,6971,8432,3253,728Slovenia20099,2931,0598671,09122947373341,7926061,0331,406Spain2009199,09520,32013,21621,2793,5338,31917,2967133,84724,9299,77346,512Sweden201043,9198,2043,1115,7393781,3091,92267,6822,5512,91210,105Switzerland200729,5444,6371,5853,8853219252,10485,5682,0202,3066,275Tajikistan200515,8313,2671,2873,1272826511307421,3901,2804,278TFYRMacedonia20039,8321,2801,7252,12523320055509324064401,936Turkmenistan199816,5173,6486262,8611674015107222,5431,8423,917Ukraine2009351,395136,36940,34322,7535,6966,01712,0099324,88814,86138,48249,884UnitedKingdom2009270,80447,30619,17121,3223,1768,50419,7607750,74035,95813,23351,557Uzbekistan200574,56920,3738,40410,46191817875413,1126,3177,70616,345TotalEU2,417,769356,366191,784321,66036,55278,561184,354897401,620201,613154,701489,661TotalEurope4,370,407888,194436,861510,98371,250110,286261,4361,348550,079307,978423,857808,135Table1.1Totalnumbersofdeathsbycauseandsex,latestavailableyear,Europe
  17. 17. 15European Cardiovascular Disease StatisticsSource:WHOGlobalMortalityDatabasehttp://www.who.int/healthinfo/morttables/en/index.html WomenYearAllcausesCoronaryheartdiseaseStrokeOtherCVDStomachcancerColo-rectalcancerLungcancerBreastcancerOthercancerRespiratorydiseaseInjuriesandpoisoningAllothercausesAlbania20047,7991,0651,6611,486138411411385533892911,896Armenia200913,3073,8751,8641,3071671932274971,2997513092,818Austria201040,5077,7563,2748,4473789991,2661,5025,1502,0451,4858,205Azerbaijan200723,9222,6955,1306,2852291181192511,4951,4885205,592Belarus200964,53225,23610,1721,9029601693571,1944,6291,0913,00115,821Belgium200551,9855,1104,7209,1733161,3981,3842,2685,8015,6412,50813,666BosniaandHerzegovina199113,6701,1812,0254,2901701722342721,1934494133,271Bulgaria200852,2206,36012,08817,9956081,1806011,3133,7881,7669195,602Croatia200926,3955,6574,6564,5683408016238982,9279101,0983,917Cyprus20092,40221521850523404910228018195694CzechRepublic200953,34113,6647,3729,0135091,5481,4781,6077,0402,8881,7706,452Denmark200628,2052,9792,6633,1881541,0241,7081,2463,4262,8651,0817,871Estonia20098,0892,4518511,751150207133236906146281977Finland200924,7525,5102,6242,3692095545968193,0098771,2496,936France2008260,80316,21918,78043,3861,7437,7896,83811,63434,50715,48614,63289,789Georgia200922,4342,8354,4665,7251691341365001,3793523436,395Germany2010449,74665,72337,97499,5214,40012,27613,62717,46652,93428,50613,125104,194Greece200951,3014,4618,83912,0074621,0291,1061,9146,0045,1618049,514Hungary200964,09017,5987,8999,8698222,1772,7662,1696,4382,7972,3379,218Iceland200996914684118322693612210439226Ireland200913,8542,2091,2421,3961253716916761,9161,8875242,817Israel200819,7462,1711,1282,0341806114959712,7651,6196557,117Italy2008297,44337,33838,29951,2994,2528,5057,74312,19538,69816,6059,84472,665Kazakhstan200964,13111,57510,23611,0238517755661,3684,6162,7293,89716,495Kyrgyzstan200915,7735,3772,917477166104912418881,2508043,458Latvia200915,3684,5662,9151,4172443641784381,5532195162,958Lithuania200920,2048,0013,6711,5042814722335941,9634848852,116Luxembourg20091,8231161913921371718524315296393Malta20101,521327161154951377922112930323Monaco198725165173211982512549Montenegro20092,8541613171,2221747657318511065592Netherlands201070,0814,3785,37710,9795242,4073,6783,2139,4136,3562,50921,247Norway200921,4782,5351,9542,7971557808306712,4662,1371,0456,108Poland2009181,11422,36820,45151,5331,8714,5875,9565,24223,2488,4465,67431,738Portugal200951,2733,6088,1586,8509691,5197391,6205,1275,8031,39015,490RepublicofMoldova201020,4209,0603,3488951703451814571,2488198293,068Romania2010121,76626,27626,81529,2751,1842,3101,9513,15310,5614,6702,81812,753RussianFederation2009962,229306,244228,73188,15415,20621,0888,72723,51766,55323,99951,487128,523SanMarino2005103316315373191114Serbia200951,6236,1159,49215,6044281,0861,3031,6144,6251,6141,0308,712Slovakia200925,4679,2953,3212,7932847074677462,9201,3286322,974Slovenia20099,4579291,2942,1921303132974341,3426575661,303Spain2009185,83815,29417,94132,0072,1635,8413,1296,12921,21318,3534,72359,045Sweden201046,6006,8084,4917,5912841,2471,6611,3955,7662,5061,74713,104Switzerland200731,5454,3982,5405,5682218159991,2683,8811,7131,4768,666Tajikistan200513,0822,4391,3583,27116739611096211,3574483,212TFYRMacedonia20038,1747861,8642,404123130862406483011331,459Turkmenistan199813,1793,2477502,97110264461005781,9897362,596Ukraine2009355,344174,61360,13926,3923,7045,8182,3488,08919,1116,22810,45438,448UnitedKingdom2009288,81335,42530,51127,3141,8557,15515,29211,67838,25140,7387,84872,746Uzbekistan200566,01619,1449,79310,9406211842817952,9795,1402,43613,703TotalEU2,418,063324,984272,140443,92023,96266,14173,67589,953291,718176,69280,088574,790TotalEurope4,237,039915,548636,832643,45748,25699,69191,676133,263416,523233,244161,603856,946Table1.1continued...
  18. 18. 16 European Cardiovascular Disease StatisticsFigure 1.1a Deaths by cause, men, latest available year, EuropeFigure 1.1b Deaths by cause, women, latest available year, EuropeCoronary heart disease 20%Stroke 10%Other CVD 12%Stomach cancer 2%Colo-rectal cancer 2%Lung cancer 4%All other causes 20%Injuries and poisoning 10%Respiratory disease 7%Other cancer 13%Coronary heart disease 22%Stroke 15%Other CVD 15%Stomach cancer 1%Colo-rectal cancer 2%Breast cancer 3%All other causes 20%Injuries and poisoning 4%Respiratory disease 6%Other cancer 10%Lung cancer 2%
  19. 19. 17European Cardiovascular Disease StatisticsFigure 1.1c Deaths by cause, men, latest available year, EUFigure 1.1d Deaths by cause, women, latest available year, EUCoronary heart disease 15%Stroke 8%Other CVD 13%Stomach cancer 2%Colo-rectal cancer 3%Lung cancer 8%All other causes 20%Injuries and poisoning 6%Respiratory disease 8%Other cancer 17%Coronary heart disease 14%Stroke 11%Other CVD 18%Stomach cancer 1%Colo-rectal cancer 3%Breast cancer 4%All other causes 24%Injuries and poisoning 3%Respiratory disease 7%Other cancer 12%Lung cancer 3%
  20. 20. 18 European Cardiovascular Disease StatisticsTable1.2Deathsunder75bycauseandsex,latestavailableyear,EuropeMenYearAllcausesCoronaryheartdiseaseStrokeOtherCVDStomachcancerColo-rectalcancerLungcancerBreastcancerOthercancerRespiratorydiseaseInjuriesandpoisoningAllothercausesAlbania20046,0841,0206577781845434707083077561,273Armenia20099,0422,42965352020011873641,1065288001,948Austria201017,1632,5805441,2122165761,63753,2217401,9294,503Azerbaijan200719,5702,3842,3644,1762938538261,3041,1141,6855,777Belarus200950,36315,7444,7892,3111,0967312,34704,3062,11610,3896,534Belgium200523,4112,6679882,0302637313,08284,0552,0173,0714,499BosniaandHerzegovin199112,6091,6651,1601,7532851791,06601,2824181,6033,198Bulgaria200832,8294,4004,4657,5176038242,404183,2171,4912,6225,268Croatia200914,4242,3631,3591,2323176251,601122,1425491,4792,745Cyprus20091,25224843862027117219162177279CzechRepublic200930,2445,3041,7223,3234421,3962,95694,9731,7113,4374,971Denmark200612,7641,1976471,0861465171,29572,3897151,1463,619Estonia20095,133905288794117118336528193933921Finland200912,8062,5096471,03417130085421,7524852,3452,707France2008120,9498,0163,8729,1731,5133,94114,7819927,1714,31515,01633,052Georgia200915,6751,7172,0253,48221012553121,0782621,2265,017Germany2010193,25326,6567,63719,7473,1837,24918,9386835,70411,18814,20448,679Greece200923,3794,0921,5802,0284385583,27304,3121,4662,4433,189Hungary200940,7997,6402,9193,9996391,7334,498135,4941,9243,9877,953Iceland20094056018335203683156867Ireland20097,3451,28827438812732163011,3714401,2311,274Israel20088,656860292481151278685141,3524821,0473,014Italy2008108,65312,5185,3089,1382,9194,71113,7528022,5334,1609,39024,144Kazakhstan200964,41610,1576,5428,5461,2295862,33104,0924,06313,03413,836Kyrgyzstan200915,6792,9181,9056803557429323951,2112,6065,240Latvia20099,8392,4069151,05619119363949873211,5471,580Lithuania200914,3163,1759961,12626729185141,4066203,0792,501Luxembourg20098588352841333113014158145136Malta201071713134321534901483467132Monaco1987951571303160192713Montenegro20091,852171905511423162148101143449Netherlands201028,9282,5531,1342,9645301,4333,807126,4291,6382,1346,294Norway20097,7199893384909035772641,4204711,0891,745Poland2009126,37614,0498,08819,8482,2963,50312,0274215,2985,67116,91828,636Portugal200923,6001,6761,7361,2688041,0311,88383,6621,5102,2447,778RepublicofMoldova201016,9773,9331,755676256296667101,2811,1872,7394,177Romania201081,69913,4029,8389,7471,6461,9546,341369,1664,8648,71915,986RussianFederation2009799,234186,61385,29270,38615,70811,95735,46017959,86642,652164,708126,413SanMarino200540216225014062Serbia200928,8953,7883,1424,5684961,0163,036123,4001,1992,2146,024Slovakia200917,1453,6051,3201,4032656621,21172,3709742,1373,191Slovenia20095,18657533437613727252049281648081,068Spain200980,6918,0793,4746,0421,8023,82410,6534015,0695,7677,13018,811Sweden201015,6072,4937211,2541926441,07623,0666341,8913,634Switzerland200712,0661,5033281,0881724371,30452,7325141,6072,376Tajikistan200511,8282,1728121,760220589706351,0691,2503,755TFYRMacedonia20036,13491592481018514348307312113781,354Turkmenistan199814,5512,7054872,3731503814506792,4351,8063,733Ukraine2009251,62480,54423,90515,3544,6854,53310,3507420,74210,67736,84543,915UnitedKingdom2009114,89019,6174,7567,4731,4404,25410,6924123,3309,86210,16023,265Uzbekistan200558,23413,1545,5257,65879120567211,9345,5637,55515,176TotalEU1,149,832151,86464,332114,22820,39541,130118,456512198,91163,024118,910258,070TotalEurope2,576,004489,685208,702243,95347,48963,073181,934837310,360140,170373,950515,851
  21. 21. 19European Cardiovascular Disease StatisticsSource:WHOGlobalMortalityDatabasehttp://www.who.int/healthinfo/morttables/en/index.html WomenYearAllcausesCoronaryheartdiseaseStrokeOtherCVDStomachcancerColo-rectalcancerLungcancerBreastcancerOthercancerRespiratorydiseaseInjuriesandpoisoningAllothercausesAlbania20043,310438524490992696117420158256686Armenia20095,5281,159560402971231493818682191911,379Austria20109,2928444546401233707917912,8843656041,426Azerbaijan200713,2521,2502,3582,821149102892271,3248284843,620Belarus200924,5897,9773,6691,1446061042469423,1146572,5663,564Belgium200513,3629387651,1771035188921,3693,8409231,2021,635BosniaandHerzegovin19917,9638041,1061,7381271271902429462373712,075Bulgaria200818,0851,8143,1344,5713226294299233,1666366581,803Croatia20097,6791,0811,0267571463373885181,880207417922Cyprus200961851325113212866191324291CzechRepublic200916,1632,2291,0971,8872516919688924,3738299372,009Denmark20068,511486478533793911,0637222,3247384381,259Estonia20092,50836819340881878015854440217332Finland20096,223592376398842323544981,787238708956France200860,6641,9902,4184,3506402,5474,2846,46320,0901,8305,35410,698Georgia20099,6268931,5672,21810597953851,3371552762,498Germany2010107,8448,6274,98110,3181,7034,5008,5079,70631,8706,0234,97716,632Greece200911,5521,1431,0761,2841943716199792,6157895411,941Hungary200923,0363,7541,8492,2643911,0772,0691,4334,8231,0941,1773,105Iceland20092451191228342080262122Ireland20094,330389212236551493684281,354312364463Israel20085,724316199345912532615971,8282562651,313Italy200861,9123,9793,6254,9331,5233,1103,9386,58321,0301,9042,5788,709Kazakhstan200936,5675,1465,3605,1876365584331,1623,7731,8743,6218,817Kyrgyzstan20099,1231,7111,43333711880652037826807492,965Latvia20095,3701,0887214951381811073091,089125382735Lithuania20096,9161,4038135511532231394051,420188690931Luxembourg200948419254710183843148395344Malta20104485325322262548171241626Monaco1987540513122393313Montenegro20091,21577109382103355631844356203Netherlands201019,4199508761,4742491,0282,4741,9506,2081,2168832,111Norway20094,792317185234592934793481,385396379717Poland200961,4215,0445,0678,9869682,2464,2723,51215,9672,4623,4219,476Portugal200912,4916611,1127694316384311,0023,0026966423,107RepublicofMoldova201010,3632,7691,5154931342521303741,2354047122,345Romania201044,7286,7037,1726,0886631,2841,3372,1728,5212,0022,2026,584RussianFederation2009419,39196,91769,38236,9829,23112,3885,60517,85446,27613,76043,38367,613SanMarino200532034414213010Serbia200918,5871,9502,6493,3932616269881,1563,8196216492,475Slovakia20098,8751,7548407471523633284802,1264044331,248Slovenia20092,4931591932095312417221079173220289Spain200937,8762,0562,1433,1337652,0551,9783,29011,6101,9612,0456,840Sweden201010,1048684455931204399957933,1625566861,447Switzerland20077,202414267486923276417281,7832705871,607Tajikistan20058,3581,2877501,50412834521025259434302,603TFYRMacedonia20034,01347883969390937119749712688841Turkmenistan19989,6931,6334332,034825742924951,8137022,310Ukraine2009145,86855,09620,4267,1592,7284,0381,7326,52415,0133,2188,63721,297UnitedKingdom200977,2776,5513,8444,7306412,8027,8206,50023,1617,4573,44710,324Uzbekistan200540,3488,5374,2036,2425091772467012,7634,2282,30010,442TotalEU632,00254,51343,96660,9049,90726,12044,50651,725178,26732,95634,91794,221TotalEurope1,425,524244,774162,543135,97425,41246,25656,59984,663268,61664,078102,061234,548Table1.2continued...
  22. 22. 20 European Cardiovascular Disease StatisticsFigure 1.2a Deaths under 75 by cause, men, latest available year, EuropeFigure 1.2b Deaths under 75 by cause, women, latest available year, EuropeCoronary heart disease 19%Stroke 6%Other CVD 10%Stomach cancer 2%Colo-rectal cancer 2%Lung cancer 7%All other causes 20%Injuries and poisoning 15%Respiratory disease 5%Other cancer 12%Coronary heart disease 17%Stroke 11%Other CVD 10%Stomach cancer 2%Colo-rectal cancer 3%Breast cancer 6%All other causes 16%Injuries and poisoning 7%Respiratory disease 5%Other cancer 19%Lung cancer 3%
  23. 23. 21European Cardiovascular Disease StatisticsFigure 1.2c Deaths under 75 by cause, men, latest available year, EUFigure 1.2d Deaths under 75 by cause, women, latest available year, EUCoronary heart disease 13%Stroke 6%Other CVD 10%Stomach cancer 2%Colo-rectal cancer 4%Lung cancer 10%All other causes 22%Injuries and poisoning 10%Respiratory disease 6%Other cancer 17%Coronary heart disease 9%Stroke 7%Other CVD 10%Stomach cancer 2%Colo-rectal cancer 4%Lung cancer 7%All other causes 15%Injuries and poisoning 5%Respiratory disease 5%Other cancer 28%Breast cancer 8%
  24. 24. 22 European Cardiovascular Disease StatisticsMenYearAllcausesCoronaryheartdiseaseStrokeOtherCVDStomachcancerColo-rectalcancerLungcancerBreastcancerOthercancerRespiratorydiseaseInjuriesandpoisoningAllothercausesAlbania20043,448515223349117251630400172681803Armenia20095,3471,3133052251126138716352467251,337Austria20109,0471,13520350610923582021,6362481,5252,628Azerbaijan200711,7511,2679302,1341474722949737311,5613,728Belarus200933,5448,2972,4221,6856173631,38002,7931,3579,3815,249Belgium200512,2191,2393688721133041,37932,1776552,6122,497BosniaandHerzegovina19919,3801,22671399319313475709412741,5272,622Bulgaria200818,5862,3331,8273,7712944181,47972,2428122,2523,151Croatia20097,5221,11246955916224986671,2421901,2161,450Cyprus2009707143183810135419926152153CzechRepublic200917,5632,6377341,7122526841,51583,0009082,9983,115Denmark20067,0785722925267721559321,3152679662,253Estonia20093,0594101234275853150299109834596Finland20097,5091,1392856189412638829622041,9931,698France200873,8544,3171,7954,6858001,9368,8435915,8291,89312,62721,070Georgia20098,6868078201,692875927507061411,0833,016Germany201090,07810,5392,5638,0041,4632,7947,9933316,6263,45610,91025,697Greece200912,4232,5086166752122171,59102,0416192,1381,806Hungary200924,9954,0171,3272,1933548712,81273,8991,0123,3095,194Iceland200923929101739224966034Ireland20094,2386101102015714530017491591,139767Israel20085,1924291262778113435088142109201,843Italy200851,2135,4161,7944,0081,2101,9295,4644511,1781,2327,70411,233Kazakhstan200947,2436,0813,5525,6797273121,38202,5872,71312,42311,787Kyrgyzstan200912,0811,5651,1115632184519025148572,5074,509Latvia20095,8231,176361681937929926012141,330987Lithuania20099,0671,49446572714512041349123452,7111,731Luxembourg2009490442139314570812412780Malta20103896815164184290125965Monaco198743626019010045Montenegro2009999823626078879345120261Netherlands201014,7591,2924471,3402516561,70863,3645621,7893,344Norway20094,3304951202285017634907411889601,023Poland200982,2038,1144,34511,4181,3011,6936,7332610,3032,93315,21920,118Portugal200912,9837636465284074611,02752,4045751,8094,358RepublicofMoldova201011,7931,93593446816116146491,0488552,4803,278Romania201048,9307,0684,0094,5058859563,877186,5812,9827,52710,522RussianFederation2009564,175107,13640,46052,8659,1015,82420,79411637,41629,775152,507108,181SanMarino20051910310107060Serbia200915,2811,9621,1481,9142344651,780102,1254871,8123,344Slovakia200910,9661,88464185715633668941,6695701,8922,268Slovenia20092,86229811616971111259152945639624Spain200943,8684,1101,4462,8519101,7095,569238,7202,2506,02410,256Sweden20107,5271,0662245289125641121,3762271,5261,820Switzerland20076,5397321334549020965341,3521911,3091,412Tajikistan20057,794925321752119436104247711,1933,185TFYRMacedonia20033,3375043532799971283043384316915Turkmenistan199811,4871,5232621,59389289904782,2411,7723,402Ukraine2009157,91433,86610,48611,3722,6552,1255,8374212,7796,65833,42538,669UnitedKingdom200960,9179,4011,9353,5656121,9074,3782611,6193,7669,09114,617Uzbekistan200539,7436,1012,6804,34243513644711,9474,5237,10712,024TotalEU633,35373,79326,72655,46010,03218,25658,843287110,30126,105100,902152,648TotalEurope1,601,240251,70294,342144,16925,53728,94195,708491180,80878,820335,997364,725Table1.3Deathsunder65bycauseandsex,latestavailableyear,Europe
  25. 25. 23European Cardiovascular Disease StatisticsSource:WHOGlobalMortalityDatabasehttp://www.who.int/healthinfo/morttables/en/index.html WomenYearAllcausesCoronaryheartdiseaseStrokeOtherCVDStomachcancerColo-rectalcancerLungcancerBreastcancerOthercancerRespiratorydiseaseInjuriesandpoisoningAllothercausesAlbania20041,7981711692026220539325595227451Armenia20092,599340137134446594277538101137732Austria20104,566255177219691484344491,1011404391,135Azerbaijan20076,5294307001,0867366561878605364132,122Belarus200912,1492,2571,260685297441286361,7644682,0862,524Belgium20056,567311296438422255508401,2313089101,416BosniaandHerzegovina19914,52843149369381791102006291213261,365Bulgaria20088,1046059221,5791622932606051,5143255151,324Croatia20093,0622512752227313520127970069261596Cyprus2009325191222710164877153168CzechRepublic20098,0236783577101383185575462,0064057311,577Denmark20064,236163197190451845334288642233301,079Estonia20091,16790551373634439124021178242Finland20093,38518615619347118190324693101566811France200834,9717981,0381,9433381,2602,8674,2457,6847794,1419,878Georgia20094,104244414703565454246608822131,430Germany201047,3532,4701,6223,2557981,7624,4615,11010,4472,0303,45811,940Greece20095,213563285303951433385861,315306386893Hungary200911,6751,2326199091974801,3228812,1585448462,487Iceland20091191240413113591921Ireland20092,428157921062980195274560106307522Israel20083,07110772134571271373857541011961,001Italy200827,8001,1661,1141,6437061,3821,9843,9367,3446631,8026,060Kazakhstan200922,3901,8772,4072,5523142992608712,4011,2223,3046,883Kyrgyzstan20096,3495537212568356321695324927002,755Latvia20092,53729520923470545019048688310551Lithuania20093,459396225279858282255623105562765Luxembourg2009251781867202759154044Malta201021313101511112297571129Monaco19871900600113224Montenegro200957634301456104543751645127Netherlands201010,3653883626141175151,3881,3312,4044817122,053Norway20092,566112748833146248225599141316584Poland200933,9681,9812,0643,5395281,0942,7312,4167,8781,2352,8117,691Portugal20096,0232043452571952922796591,2362564551,845RepublicofMoldova20105,61082661427585120752586452485921,872Romania201021,2392,2372,0461,9052985947601,3934,1241,1881,6565,038RussianFederation2009226,00232,19022,30321,4114,5585,6773,04012,03427,4519,34137,16450,833SanMarino20051600221128000Serbia20097,8536087248401372845937171,6442864771,543Slovakia20094,615536289338931711913051,0372343461,075Slovenia20091,17753594223619912032019141240Spain200919,5546997971,1274011,0091,3252,2444,8838691,5434,657Sweden20104,646292169188561834414661,1351635161,037Switzerland20073,75512610419953163373427857101463889Tajikistan20055,174430274591742237813876934062,179TFYRMacedonia20031,7702022481833541361352945664476Turkmenistan19986,9436331851,213524726733451,6916722,006Ukraine200967,19113,3796,1793,8891,3551,8678624,3309,0982,0057,08717,140UnitedKingdom200939,0152,3341,5232,0302701,3483,3674,1908,4822,8362,8179,818Uzbekistan200524,8362,7991,6863,0803181211615751,9383,4532,1498,556TotalEU312,87518,12815,04822,2334,85211,85824,49531,98869,97613,46226,56074,275TotalEurope731,88476,12954,11960,82612,70021,30631,13154,243122,39634,79183,879180,364Table1.3continued...
  26. 26. 24 European Cardiovascular Disease StatisticsFigure 1.3a Deaths under 65 by cause, men, latest available year, EuropeFigure 1.3b Deaths under 65 by cause, women, latest available year, EuropeCoronary heart disease 10%Stroke 8%Other CVD 8%Stomach cancer 2%Other cancer 17%Respiratory disease 5%Injuries and poisoning 11% Colo-rectal cancer 2%Lung cancer 2%Breast cancer 2%All other causes 25%Coronary heart disease 16%Stroke 6%Other CVD 9%Stomach cancer 1%Colo-rectal cancer 2%Lung cancer 6%All other causes 23%Injuries and poisoning 21%Respiratory disease 5% Other cancer 11%
  27. 27. 25European Cardiovascular Disease StatisticsFigure 1.3c Deaths under 65 by cause, men, latest available year, EUFigure 1.3d Deaths under 65 by cause, women, latest available year, EUCoronary heart disease 12%Stroke 4%Other CVD 9%Stomach cancer 2%Colo-rectal cancer 3%Lung cancer 9%All other causes 24%Injuries and poisoning 16%Respiratory disease 4%Other cancer 17%Coronary heart disease 6%Stroke 5%Other CVD 7%Stomach cancer 2%Colo-rectal cancer 4%Lung cancer 8%All other causes 24%Injuries and poisoning 8%Respiratory disease 4%Breast cancer 10%Other cancer 22%
  28. 28. 26 European Cardiovascular Disease StatisticsMen1980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010Albania36374238343035423637404039414548Armenia104108107113100119127137143145145130143134125120123115114124120115120117Austria83858584797774736764616361585857555551484743383330303030272829Azerbaijan15115315215016117116118820919721919120319919017917317515815515613955Belarus137139153136141137146150159164198201216207215219207222233234199207213Belgium77737370656257524743403838403738373634342727BosniaandHerzegovina67707173707073Bulgaria77717880838384838385899191105100105941019587848384828081747064Croatia70696665636570686865656873746965656265575856525553Cyprus1110404141404140CzechRepublic1431381351351431321271161091039787817873686560585554545149Denmark55514341383531302626242021Estonia170158175171163156164174173179203214195161140167137137136136126123104102918575Finland126121118110102968782787468656365545254514846444139France3938383637373633322928272625242323222221212019191717161615Georgia14113212812013415315015016117416717615214514113213213073626048Germany616260585553504745423938363533323130282726Greece545255545356535654535352525050515254535451535052555049524748Hungary1301411431411411391401361351331361391411431311321231171181191089994979710597948788Iceland11797137107100788387576063516462514245344839313433393021292621Ireland142140136143135132127126113110103101889486837871716260535246443935403434Israel8989907977697671615350525147444333313430282725212019192018Italy626058585453514945444141393836343231312827252424211919Kazakhstan145144146129135132134143143150178187215220207209194207200204202188193182176157126Kyrgyzstan11111210398107105105103104109135158152153136132119123127124130128127139136121144Latvia187184169180187191159169166172191191225264285246194174177156156164162148145156161157137129Lithuania126133150137145140149167168181198195179155131122125116130126128132146145142134116Luxembourg85931118691787473585654475251484754373629353335283128362229Malta130107108117887892809177725771665849465354504446444238453632402632Netherlands92898683808178716664585550484644433938353428272822222018171615Norway1039794858273726257594947474035363227272725242221Poland9388908997102107110106112112116109999088858578726663615756545146Portugal484540414541394041373841383933333330312926262929191816RepublicofMoldova1231271291121089795108113105116140148136136120139134124126130132146134130125128138Romania6267667272767680767585911021111101131171151061009697979690868682817875RussianFederation169163163167173162146150147152161161178231267239214192188208224232244251243242215198197186SanMarino018001787Serbia696469636264616666605954Slovakia129122122120115108979692868579767472787878Slovenia71686355495457596254464249474340423539343330313329Spain4443424242414139383535363634333334323231302827272524242322Sweden787565636155545150444339383736333129282627252323Switzerland35293130292623232220212020TFYRMacedonia68767281707570737071727062Tajikistan99918180858693908989107107114988384908779858586Turkmenistan148143145148151156180171171166220199195203189175Ukraine149150145125129123128136147160175190208207201186198208205216218225234219217186UnitedKingdom14313713213212812612211711010297938886767469656258524947444139373533Uzbekistan124123119113108119122125124125139142141141121126121122115129127118121Table1.4AgestandardizeddeathratesfromCHD,adultsagedunder65,bysex,1980to2010,Europe(deathsper100,000)
  29. 29. 27European Cardiovascular Disease StatisticsWomen1980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010Albania1011101281111121212131513151716Armenia333532374333353837424134383534323028282926302627Austria201818191717161614141415141613141513131410111087776676Azerbaijan5251535860625971788390717375706665665960564418Belarus4241433740363639394251505555555954596159464948Belgium18171616161413141110999101010899877BosniaandHerzegovina22252426232324Bulgaria2219222224242220222224252527242625262524232224222118181515Croatia15161717161518191816161717171617161515141412111111Cyprus22788795CzechRepublic353431333433302928282522201918171616141312131211Denmark141613111099977666Estonia393440393535373936404248443637353230282828222019151613Finland2522191816151413121110121011998977776France76766666555554444444343333333Georgia48464744475251505359575547494343414122141413Germany1415141413131212111099988887766Greece10111112111110121111101010101011101110119101011111010111010Hungary353937383740383737373838394038373433343330292827282825242423Iceland132320221912132313189138157887151491311634431Ireland413840373935353431302721242421211719171412111110998979Israel3032312624222322211817171515171410897765544434Italy1312111211101099988877776665555444Kazakhstan464446384037383943435456666763615962595658535453504333Kyrgyzstan454242403941383938394655605551464148454847484751474653Latvia474745454746403941404347526171584440403434383334343437332926Lithuania333534293434373742384344433827282423252525272731292624Luxembourg2318171521161318121410129131087786581071031385Malta4937223024143435202631222616181416171517171517146117612106Netherlands192018181818171616141315131413121211101099987665555Norway20191717181616141413109101110987666645Poland18171718202121222224242424222020181917161313131212111010Portugal1213121311111111111010119119988787777444RepublicofMoldova73737261565150525853596873736759626558636356605853504951Romania24242426252726282727272931353435383736343233323128282625242321RussianFederation474443444644373736373839435867605348455054566163596053474744SanMarino00180880Serbia222121202120202120181716Slovakia343234333233292627212121211918211920Slovenia16121212111214121513101181188865755455Spain98888777777766666656555544444Sweden1616141515141212121010910109997777776Switzerland6677654554443TFYRMacedonia22232424232625252222231925Tajikistan48473939394343454542526160554136444353444141Turkmenistan625562616172807476721008587988268Ukraine5252504141393841444755606666655863646568707074686457UnitedKingdom3634343434333231302828262423212019181715141312111010998Uzbekistan5752575249525754606067727064596558605663585459Table1.4continued...Source:WHOMortalityDatabasehttp://www.who.int/healthinfo/morttables/en/index.html Notes:Blankcellsindicatedatawerenotavailable
  30. 30. 28 European Cardiovascular Disease StatisticsDeaths per 100,000100 to 22050 to 10030 to 5020 to 30<20no dataFigure 1.4a Age-standardized death rates from CHD, men aged under 65, latest available year, EuropeDeaths per 100,00040 to 7020 to 4010 to 205 to 10<5no dataFigure 1.4b Age-standardized death rates from CHD, women aged under 65, latest available year, Europe
  31. 31. 29European Cardiovascular Disease StatisticsFigure 1.4c Death rates from CHD, men aged under 65, 1980 to 2010, selected countriesFigure 1.4d Death rates from CHD, women aged under 65, 1980 to 2010, selected countries198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201080706050403020100Deaths/100,000BulgariaFranceHungaryKazakhstanRussian FederationUnited KingdomBulgariaFranceHungaryKazakhstanRussian FederationUnited Kingdom300250200150100500Deaths/100,0001980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010
  32. 32. 30 European Cardiovascular Disease StatisticsMen1980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010Albania33312932252125242726272226222320Armenia272427282730323337374540393534303129273735302828Austria27272527262321202018181616151516151413121111987766675Azerbaijan5858565357534445445054504953474139413436383945Belarus5955595150525556616273737779798074818279646262Belgium19181818171515131312131312111110111191098BosniaandHerzegovina30313134343542Bulgaria6161626165666462666468687583786966706959635960555555575049Croatia48504747484645434342404640384138333429293029282722Cyprus971087665CzechRepublic464442394439363331302725242423212020171716141413Denmark1313141212151112121312911Estonia544962544759536360686668666052535255504548414137302622Finland2423222622212118181817161713151414141112121110France201919181817171514131312111210101010910888877776Georgia70778073656969697472666962626367696461576448Germany14161414141313121110109988887776Greece222120202120181818191719171717171817161517151514151414121212Hungary615962666867636059616261616258575552515149454543393434323229Iceland161219108151998612787989674584646537Ireland2423222121181717151515131114121211111111101088877576Israel231718171617161612111211131312131310108997788665Italy25242322222120191716151515131312111110109988766Kazakhstan696765615858646665657382888888918794818393889184847674Kyrgyzstan848077706867717579849811412610610710410411011011010510710810711294105Latvia666561616263555155586864678186787265625656606255555553484240Lithuania413941384033404141424745433738343130363335363638383236Luxembourg25282029313025242120211715121813171012810161316978410Malta32263233192229381615102016161012148887131286886767Netherlands1514141214121211111111101011111010109999987766655Norway121512121310111310101110998876766675Poland28242425272930303030313232323131293532323029302827272625Portugal535045454341413637343537353430292928262425242220141414RepublicofMoldova52526958565454656863718085838474818382777977807168666666Romania44454446474847524948505154707374777973666264656257565349464542RussianFederation72737172757265646464666771871039790858290981001031041019987787671SanMarino9000060Serbia474549444342423836353032Slovakia353132302829312524212422191918242827Slovenia34273637323235333034262725252022181819181316121312Spain2424222121211918181615151414131312121111101010999988Sweden1212111212121211101110101098888776765Switzerland6676564445444TFYRMacedonia39444545475144434640464445Tajikistan49484039424040404146453835282316201919303125Turkmenistan86949390869049567666766659493030Ukraine5859635354545559656973778682797172747068676769666457UnitedKingdom2321202019191917161515151413131313121211111010998887Uzbekistan6568666262616364656261757273695852555758544856Table1.5Agestandardizeddeathratesfromstroke,adultsagedunder65,bysex,1980to2010,Europe(deathsper100,000)
  33. 33. 31European Cardiovascular Disease StatisticsSource:WHOMortalityDatabasehttp://www.who.int/healthinfo/morttables/en/index.htmlNotes:Blankcellsindicatedatawerenotavailable Women1980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010Albania20221921201418151617161913141516Armenia172328232422272725323228273023232420212224181811Austria14151314141212121089108988989877665454444Azerbaijan3740414342393429283538353736333332302827312629Belarus3534383434323233353642424444424339414240302726Belgium121313121110111099878877886766BosniaandHerzegovina20242427262627Bulgaria3838423939373736353536383939363533353532302928262626252522Croatia30262925262525242323222521192219171617141412131212Cyprus16544473CzechRepublic25242221221818171515141213101111109987766Denmark10888898778877Estonia35323432283033273040373833302725252321192015161315118Finland141313121111121010999810787868656France1010999887766665555555544444434Georgia39404444384039403842353128343131312928232521Germany898888777666655555444Greece16171515141313131212111212101010981098887777665Hungary363634363635343230313030282826272524242422212018181514131412Iceland1313699878911754581184510334355461Ireland221918181616151111111111109101010981010767646655Israel1819151615121111999899877555554444323Italy1515141413121211101099888777666555444Kazakhstan424142434038424140404653565557585555504853494945424141Kyrgyzstan565560554851504858606479847866727269717371677268585564Latvia334034353738333328353332384342394033343031303127272524221918Lithuania262325222422242323232325242223211816171917151618171614Luxembourg20149191615181412131311131391287138131012787775Malta161719181387121215151012765663574755565654Netherlands119109999878888878788777876655554Norway999876788665655654544443Poland17171715171817181717171717161616161817161514141312121111Portugal302926262524222320192020181816151615141412121110777RepublicofMoldova38406052464746485447515661586055536060565355555245403937Romania33333232343334373533333433434244444342383636363533312825242219RussianFederation414242434544414039383838414854514846454750505050474640353431SanMarino09009150Serbia343434323030272625242119Slovakia17161615151514108107897891111Slovenia1715141518151816131514111011991197877566Spain1515131213111110988877766656555544444Sweden787777776776666655454444Switzerland4444443333333TFYRMacedonia30333434353233323334303430Tajikistan43403733343338333537363728232316211721303226Turkmenistan64646876646939434647554642342321Ukraine3536373535343434363943454746433940393835353332312826UnitedKingdom1817171615151414131211111111101010999888776665Uzbekistan4344474548434245444543515050444137374037353035Table1.5continued...
  34. 34. 32 European Cardiovascular Disease StatisticsDeaths per 100,00035 to 6525 to 3515 to 255 to 15<5no dataFigure 1.5b Age-standardized death rates from stroke, women aged under 65, latest available year, EuropeDeaths per 100,00050 to 10530 to 5020 to 3010 to 20<10no dataFigure 1.5a Age-standardized death rates from stroke, men aged under 65, latest available year, Europe
  35. 35. 33European Cardiovascular Disease StatisticsFigure 1.5c Death rates from stroke, men aged under 65, 1980 to 2010, selected countriesFigure 1.5d Death rates from stroke, women aged under 65, 1980 to 2010, selected countries1980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010706050403020100Deaths/100,000BulgariaFranceHungaryKazakhstanRussian FederationUnited Kingdom19801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920101201101009080706050403020100Deaths/100,000BulgariaFranceHungaryKazakhstanRussian FederationUnited Kingdom
  36. 36. 34 European Cardiovascular Disease StatisticsMen WomenYears lost per 100,000 males, aged 0-69 years oldand cause-specific percentage of totalYears lost per 100,000 females, aged 0-69 years oldand cause-specific percentage of totalYearAllcausesCVD CHD StrokeAllcausesCVD CHD StrokeAustria 2010 4,315 684 16% 392 9% 82 2% 2,136 250 12% 87 4% 70 3%Belgium 2005 4,914 764 16% 359 7% 116 2% 2,601 347 13% 95 4% 109 4%Czech Republic 2010 5,473 1,242 23% 612 11% 169 3% 2,449 416 17% 139 6% 85 3%Denmark 2006 4,705 714 15% 287 6% 157 3% 2,684 292 11% 82 3% 109 4%Estonia 2010 8,819 2,187 25% 952 11% 253 3% 2,846 545 19% 167 6% 112 4%Finland 2010 4,963 990 20% 475 10% 144 3% 2,164 262 12% 79 4% 76 4%France 2008 4,847 583 12% 221 5% 101 2% 2,287 218 10% 42 2% 61 3%Germany 2010 4,074 757 19% 355 9% 97 2% 2,191 286 13% 83 4% 66 3%Greece 2009 4,627 1,122 24% 745 16% 176 4% 1,954 337 17% 162 8% 85 4%Hungary 2009 8,920 2,269 25% 1,171 13% 404 5% 3,907 740 19% 319 8% 168 4%Iceland 2009 3,219 708 22% 298 9% 118 4% 1,598 113 7% 12 1% 51 3%Ireland 2010 3,798 675 18% 392 10% 84 2% 2,169 253 12% 84 4% 78 4%Israel 2009 3,469 422 12% 203 6% 71 2% 2,002 159 8% 42 2% 41 2%Italy 2009 3,486 584 17% 253 7% 98 3% 1,874 207 11% 52 3% 61 3%Luxembourg 2009 3,917 636 16% 267 7% 111 3% 1,991 211 11% 46 2% 54 3%Netherlands 2010 3,230 532 16% 210 7% 80 2% 2,249 251 11% 66 3% 70 3%Norway 2010 3,456 541 16% 296 9% 88 3% 2,091 186 9% 67 3% 48 2%Poland 2010 7,845 1,832 23% 604 8% 318 4% 2,953 522 18% 115 4% 151 5%Portugal 2010 4,793 559 12% 226 5% 181 4% 2,206 221 10% 50 2% 91 4%RussianFederation2010 17,756 5,125 29% 2,552 14% 967 5% 6,136 1,565 25% 604 10% 428 7%Slovakia 2010 7,326 1,784 24% 960 13% 303 4% 3,033 619 20% 250 8% 154 5%Slovenia 2010 4,625 748 16% 363 8% 150 3% 2,158 258 12% 55 3% 113 5%Spain 2009 3,884 620 16% 288 7% 107 3% 1,843 198 11% 49 3% 61 3%Sweden 2010 3,112 541 17% 283 9% 69 2% 1,861 206 11% 84 5% 55 3%Switzerland 2007 3,477 514 15% 261 8% 59 2% 2,037 186 9% 47 2% 45 2%United Kingdom 2010 4,045 784 19% 445 11% 110 3% 2,500 309 12% 109 4% 77 3%Table 1.6 Potential years of life lost by cause and sex, latest available year, EuropeSource: OECD Health Data 2011 http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT# Notes: The PYLL per 100 000 population are calculated by the OECD Secretariat based on age-specific death statistics provided by the World Health Organization.The total OECD population in 2010 is taken as the reference population for age standardisation.
  37. 37. 35European Cardiovascular Disease Statistics2. MorbidityIn addition to being the largest contributor to mortality in Europe, CVD also makes a very large contribution tomorbidity. Morbidity from CVD may be described using a number of different measurements, including hospitaldischarge rates, prevalence, incidence rates and case-fatality rates. Europe-wide data for each of these measuresremains limited, however, and comparability of many estimates is relatively low.Hospital discharge ratesHospital discharge rates measure the number of patients who leave a hospital after receiving care. Hospital dischargerates for cardiovascular diseases in Europe show very large variation between countries, which do not necessarilyreflect the same patterns as mortality rates. The annual rate of discharges for CVD in Europe in 2008 and 2009was just under 2,500 per 100,000 population. For specific diagnoses, the rates were just over 800 CHD dischargesand 440 stroke discharges per 100,000 population. Europe-wide rates have been steady since around 2004, aftersubstantial increases in the preceding two decades (Tables 2.4, 2.5 and 2.6).In the EU, hospital discharge rates for all CVD combined were close to the European rates, at around 2,400 per100,000 population. For CHD specifically, the most recent discharge rates in EU countries were around 80% of theoverall European rates, at just over 600 per 100,000. Hospital discharge rates from stroke in the EU were around10% lower than the European average, at just over 390 per 100,000.Case fatality ratesCase fatality rates describe the percentage of people diagnosed with a given condition that die of the disease withina defined period of time.Evidence from several European countries has demonstrated that a substantial proportion of the observed reductionsin coronary heart disease mortality in recent decades has been due to reductions in case fatality rates1-3. Thereremain large differences, however, even between high income European countries. Reported admission-based casefatality rates in 21 European OECD countries (Table 2.3) show more than three-fold differences in acute myocardialinfarction (AMI) case fatality rates, from 2.3% in Denmark to 8.6% in Belgium.Case fatality rates for stroke appear to have changed much less in recent decades and worldwide data show thatalthough incidence of stroke has decreased in high income countries, case fatality rates have shown comparativelylimited improvement4. In Europe, 30-day in-hospital fatalities for ischaemic stroke varied between 2.6% in Denmarkand 9.7% in Slovenia. Case fatality rates for haemorrhagic stroke were substantially higher, varying between 6.5% inFinland up to 38.6% in Belgium. The median age-standardized case-fatality rates reported for AMI, ischemic strokeand haemorrhagic stroke, respectively, were 4.7%, 4.4% and 18.6%.Years of life lost in disability and disability-adjusted life years lostIn 2004 the WHO Burden of Disease project synthesized data from WHO member states to make an estimate ofthe morbidity caused by different diseases5. The main measure of the burden of disease was the DALY (DisabilityAdjusted Life Year) – an aggregate of years of life lost due to premature death and years of healthy life lost due todisability. These estimates have not been updated since, and revisions will await the release of the Global Burdenof Disease 2010 study in late 2012.
  38. 38. 36 European Cardiovascular Disease StatisticsIn developed European countries, 17% of all DALYs lost were due to CVD, making it the second largest single causeafter neuropsychiatric disorders. In less developed European nations, the proportion of DALYs lost due to CVDexceeds that of neuropsychiatric disorders. In the EU, over 12 million DALYs are lost each year to CVD (Table 2.1,Figures 2.1a and 2.1b).The highest morbidity rates for CVD appear in Eastern Europe and in countries of the former Soviet Union. The age-standardized rates of DALYs lost for CHD in Ukraine, Russia and Belarus are at least three times higher than ratesin Spain, France and Italy. The situation is similar for stroke, where the rate of DALYs lost in Russia is nearly 1,800per 100,000, compared to only 360 per 100,000 in the UK (Table 2.2, Figures 2.2a and 2.2b).1 Smolina K, Wright FL, Rayner M, Goldacre MJ. Determinants of the decline in mortality from acute myocardial infarction in England between 2002 and 2010:linked national database study. BMJ 2012;344:d8059.2 Mannsverk J, Wilsgaard T, Njolstad I, Hopstock LA, Lochen ML, Mathiesen EB, et al. Age and gender differences in incidence and case fatality trends for myocar-dial infarction: a 30-year follow-up. The Tromso Study. Eur J Cardiovasc Prev Rehabil 2011.3 Sala C, Grau M, Masia R, Vila J, Subirana I, Ramos R, et al. Trends in Q-wave acute myocardial infarction case fatality from 1978 to 2007 and analysis of the ef-fectiveness of different treatments. Am Heart J 2011;162(3):444-50.4 Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a sys-tematic review. Lancet Neurol 2009;8(4):355-69.5 World Health Organization. World Health Report, 2004.
  39. 39. 37European Cardiovascular Disease StatisticsWHO MORTALITY SUB-REGIONEUR-A EUR-B EUR-C EUROPE EU-27DALYslost(000s)% of totalDALYslostDALYslost(000s)% of totalDALYslostDALYslost(000s)% of totalDALYslostDALYslost(000s)% of totalDALYslostDALYslost(000s)% of totalDALYslostCardiovascular disease 8,837 17 8,175 22 17,405 29 34,416 23 12,129 19Coronary heart disease 3,569 7 3,382 9 8,800 14 15,752 10 4,931 8Stroke 2,653 5 2,522 7 5,618 9 10,793 7 3,675 6Diabetes 1,105 2 566 1 522 1 2,192 1 1,288 2Cancer 8,548 17 3,289 9 5,322 9 17,159 11 10,273 16Lung cancer 1,668 3 620 2 956 2 3,243 2 2,053 3Cancer of the colon and rectum 1,027 2 285 1 550 1 1,862 1 1,200 2Breast cancer 939 2 277 1 487 1 1,703 1 1,061 2Infectious diseases 888 2 2,171 6 2,562 4 5,621 4 1,135 2Diarrhoeal diseases 110 0 485 1 97 0 692 0 133 0Sexually transmitted diseases exc. HIV 79 0 149 0 125 0 353 0 121 0HIV/AIDS 198 0 52 0 976 2 1,226 1 229 0Respiratory infections 690 1 1,524 4 901 1 3,115 2 877 1Neuropsychiatric disorders 13,720 27 7,055 19 8,562 14 29,338 20 16,024 25Alcohol use disorders 2,226 4 636 2 1,799 3 4,660 3 2,631 4Alzheimer and other dementias 1,987 4 398 1 549 1 2,934 2 2,121 3Depression 4,113 8 2,626 7 2,598 4 9,337 6 4,923 8Respiratory diseases 3,405 7 1,547 4 1,782 3 6,734 4 3,667 6Digestive diseases 2,414 5 1,900 5 3,082 5 7,396 5 3,302 5Musculo-skeletal (non-rheumatic) disease 2,195 4 1,513 4 1,924 3 5,632 4 2,824 4Unintentional injuries 3,041 6 3,123 8 8,317 14 14,481 10 4,235 7Road traffic injuries 1,233 2 641 2 1,732 3 3,606 2 1,514 2Intentional injuries (e.g. suicide, violence) 1,039 2 935 2 4,489 7 6,462 4 1,435 2All causes 51,699 100 37,828 100 60,729 100 150,256 100 64,356 100Table 2.1 Disability-adjusted life years (DALYs) by cause, 2002, WHO Mortality Sub-Region, EU and EuropeNotes: WHO mortality sub-regions: EUR-A, very low child and adult mortality; EUR-B, low child and adult mortality; EUR-C, low child, high adult mortality.Figures for EUR-A, EUR-B and EUR-C vary slightly from those reported in the World Health Report 2004. This is due to revisions of the estimates for HIV/AIDS, malaria,schistomiasis and intestinal helminth infections. Source: World Health Organization (2004) The World Health Report 2004. WHO: Geneva. www.whosis.int
  40. 40. 38 European Cardiovascular Disease StatisticsFigure 2.1b Disability-adjusted life years lost by cause, 2002, EUFigure 2.1a Disability-adjusted life years lost by cause, 2002, EuropeCHD 8%Stroke 6%Other CVD 8%Cancer 16%Neuropsychiatric disorders 25%Injuries 9%All other causes 31%CHD 11%Stroke 7%Other CVD 5%Cancer 11%Neuropsychiatric disorders 20%Injuries 14%All other causes 32%
  41. 41. 39European Cardiovascular Disease StatisticsAge-standardised DALYs lost per 100,000CHD Stroke Other CVDAlbania 1,107 1,006 884Andorra* 313 271 266Armenia 1,750 855 413Austria 579 349 431Azerbaijan 2,316 767 795Belarus 2,497 1,239 543Belgium 512 356 321Bosnia and Herzegovina* 925 1,107 1,514Bulgaria 1,344 1,188 1,485Croatia 973 989 570Cyprus 638 289 832Czech Republic 945 629 452Denmark 478 401 359Estonia 1,449 819 714Finland 687 411 299France 259 271 360Georgia 2,103 1552 504Germany 574 338 481Greece 620 592 454Hungary 1,137 731 654Iceland 470 278 176Ireland 671 361 359Israel 370 214 284Italy 409 335 363Kazakhstan 2,452 1,469 1,326Kyrgyzstan 1,885 1,939 687Latvia 1,606 1,102 803Lithuania 1,444 620 608Luxembourg 403 420 397Macedonia, TFYR 838 1,066 1,043Malta 709 365 235Moldova 1,922 1,327 312Monaco* 247 250 322Netherlands 460 329 411Norway 503 309 267Poland 949 598 657Portugal 431 836 301Romania 1,176 1,162 793Russian Federation 2,630 1,747 1,174San Marino 431 282 689Serbia and Montenegro 1,087 1,102 1,149Slovakia 1,037 387 795Slovenia 552 524 492Spain 368 294 274Sweden 506 300 284Switzerland 380 200 318Tajikistan 1,886 571 1,912Turkey 1,332 1,132 790Turkmenistan 2,860 620 2,825Ukraine 2,539 1,207 633United Kingdom 657 359 298Uzbekistan 1,907 975 1,159Table 2.2 Age-standardized DALYs rate for CHD, stroke and other CVD, 2002, EuropeSource: World Health Organization (2004) The World Health Report 2004. WHO: Geneva.Notes: The estimates should be interpreted as the best estimates of WHO, rather than the official viewpoint of member states. For details on age-standardisation, see source.* accuracy of estimates is lower than for other countries, due to data quality.
  42. 42. 40 European Cardiovascular Disease StatisticsAge-standardized DALYslost per 100,0002,000 to 3,0001,500 to 2,0001,000 to 1,500500 to 1,000<500no dataFigure 2.2a Age-standardized DALYs rate for CHD, 2002, EuropeAge-standardized DALYslost per 100,0002,000 to 3,0001,500 to 2,0001,000 to 1,500500 to 1,000<500no dataFigure 2.2b Age-standardized DALYs rate for stroke, 2002, Europe
  43. 43. 41European Cardiovascular Disease StatisticsSources:OECDHealthData2011http://www.oecd.org/els/healthpoliciesanddata/Thetotalrateshavebeenage-sexstandardizedtothe2005OECDpopulation(45+). Notes:Ratesare‘admissionbased’rates,reflectingfatalitiesoccuringinthesamehospitalonly.Blankcellsindicatedatawerenotavailable. Table2.330-daycasefatalityrateafteradmissionforcardiovasculardiseases,2009orlatestyear,Europe30-daycase-fatalityrateafteradmissionforAMI30-daycase-fatalityrateafteradmissionforischaemicstroke30-daycase-fatalityrateafteradmissionforhemorrhagicstrokeYearCruderateAge-sexstandardizedrate(%)CruderateAge-sexstandardizedrate(%)CruderateAge-sexstandardizedrate(%)Austria20098.65.76.33.115.612.1Belgium200713.48.615.38.645.838.6CzechRepublic20096.64.310.35.821.318.0Denmark20093.92.34.62.619.716.4Finland200910.64.85.82.89.36.5Germany200910.46.88.04.017.613.8Iceland20097.13.08.02.819.714.1Ireland20096.84.310.26.125.223.9Israel20096.84.55.93.524.220.9Italy20096.53.77.33.422.217.6Luxembourg20095.05.28.34.530.624.3Netherlands20077.25.38.65.727.322.4Norway20095.02.56.52.816.611.6Poland20094.83.9Portugal20089.76.611.16.225.423.0SlovakRepublic20097.35.710.77.129.025.5Slovenia20096.44.715.39.728.825.1Spain20098.45.611.06.127.423.9Sweden20076.62.98.43.917.212.8Switzerland20086.94.58.24.319.914.8UnitedKingdom20099.15.212.96.723.319.3

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