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European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
European cardiovascular disease statistics 2012
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  • 1. EuropeanCardiovascularDisease Statistics2012 edition
  • 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 26 European Cardiovascular Disease StatisticsMen1980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010Albania36374238343035423637404039414548Armenia104108107113100119127137143145145130143134125120123115114124120115120117Austria83858584797774736764616361585857555551484743383330303030272829Azerbaijan15115315215016117116118820919721919120319919017917317515815515613955Belarus137139153136141137146150159164198201216207215219207222233234199207213Belgium77737370656257524743403838403738373634342727BosniaandHerzegovina67707173707073Bulgaria77717880838384838385899191105100105941019587848384828081747064Croatia70696665636570686865656873746965656265575856525553Cyprus1110404141404140CzechRepublic1431381351351431321271161091039787817873686560585554545149Denmark55514341383531302626242021Estonia170158175171163156164174173179203214195161140167137137136136126123104102918575Finland126121118110102968782787468656365545254514846444139France3938383637373633322928272625242323222221212019191717161615Georgia14113212812013415315015016117416717615214514113213213073626048Germany616260585553504745423938363533323130282726Greece545255545356535654535352525050515254535451535052555049524748Hungary1301411431411411391401361351331361391411431311321231171181191089994979710597948788Iceland11797137107100788387576063516462514245344839313433393021292621Ireland142140136143135132127126113110103101889486837871716260535246443935403434Israel8989907977697671615350525147444333313430282725212019192018Italy626058585453514945444141393836343231312827252424211919Kazakhstan145144146129135132134143143150178187215220207209194207200204202188193182176157126Kyrgyzstan11111210398107105105103104109135158152153136132119123127124130128127139136121144Latvia187184169180187191159169166172191191225264285246194174177156156164162148145156161157137129Lithuania126133150137145140149167168181198195179155131122125116130126128132146145142134116Luxembourg85931118691787473585654475251484754373629353335283128362229Malta130107108117887892809177725771665849465354504446444238453632402632Netherlands92898683808178716664585550484644433938353428272822222018171615Norway1039794858273726257594947474035363227272725242221Poland9388908997102107110106112112116109999088858578726663615756545146Portugal484540414541394041373841383933333330312926262929191816RepublicofMoldova1231271291121089795108113105116140148136136120139134124126130132146134130125128138Romania6267667272767680767585911021111101131171151061009697979690868682817875RussianFederation169163163167173162146150147152161161178231267239214192188208224232244251243242215198197186SanMarino018001787Serbia696469636264616666605954Slovakia129122122120115108979692868579767472787878Slovenia71686355495457596254464249474340423539343330313329Spain4443424242414139383535363634333334323231302827272524242322Sweden787565636155545150444339383736333129282627252323Switzerland35293130292623232220212020TFYRMacedonia68767281707570737071727062Tajikistan99918180858693908989107107114988384908779858586Turkmenistan148143145148151156180171171166220199195203189175Ukraine149150145125129123128136147160175190208207201186198208205216218225234219217186UnitedKingdom14313713213212812612211711010297938886767469656258524947444139373533Uzbekistan124123119113108119122125124125139142141141121126121122115129127118121Table1.4AgestandardizeddeathratesfromCHD,adultsagedunder65,bysex,1980to2010,Europe(deathsper100,000)
  • 29. 27European Cardiovascular Disease StatisticsWomen1980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010Albania1011101281111121212131513151716Armenia333532374333353837424134383534323028282926302627Austria201818191717161614141415141613141513131410111087776676Azerbaijan5251535860625971788390717375706665665960564418Belarus4241433740363639394251505555555954596159464948Belgium18171616161413141110999101010899877BosniaandHerzegovina22252426232324Bulgaria2219222224242220222224252527242625262524232224222118181515Croatia15161717161518191816161717171617161515141412111111Cyprus22788795CzechRepublic353431333433302928282522201918171616141312131211Denmark141613111099977666Estonia393440393535373936404248443637353230282828222019151613Finland2522191816151413121110121011998977776France76766666555554444444343333333Georgia48464744475251505359575547494343414122141413Germany1415141413131212111099988887766Greece10111112111110121111101010101011101110119101011111010111010Hungary353937383740383737373838394038373433343330292827282825242423Iceland132320221912132313189138157887151491311634431Ireland413840373935353431302721242421211719171412111110998979Israel3032312624222322211817171515171410897765544434Italy1312111211101099988877776665555444Kazakhstan464446384037383943435456666763615962595658535453504333Kyrgyzstan454242403941383938394655605551464148454847484751474653Latvia474745454746403941404347526171584440403434383334343437332926Lithuania333534293434373742384344433827282423252525272731292624Luxembourg2318171521161318121410129131087786581071031385Malta4937223024143435202631222616181416171517171517146117612106Netherlands192018181818171616141315131413121211101099987665555Norway20191717181616141413109101110987666645Poland18171718202121222224242424222020181917161313131212111010Portugal1213121311111111111010119119988787777444RepublicofMoldova73737261565150525853596873736759626558636356605853504951Romania24242426252726282727272931353435383736343233323128282625242321RussianFederation474443444644373736373839435867605348455054566163596053474744SanMarino00180880Serbia222121202120202120181716Slovakia343234333233292627212121211918211920Slovenia16121212111214121513101181188865755455Spain98888777777766666656555544444Sweden1616141515141212121010910109997777776Switzerland6677654554443TFYRMacedonia22232424232625252222231925Tajikistan48473939394343454542526160554136444353444141Turkmenistan625562616172807476721008587988268Ukraine5252504141393841444755606666655863646568707074686457UnitedKingdom3634343434333231302828262423212019181715141312111010998Uzbekistan5752575249525754606067727064596558605663585459Table1.4continued...Source:WHOMortalityDatabasehttp://www.who.int/healthinfo/morttables/en/index.html Notes:Blankcellsindicatedatawerenotavailable
  • 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. 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. 30 European Cardiovascular Disease StatisticsMen1980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010Albania33312932252125242726272226222320Armenia272427282730323337374540393534303129273735302828Austria27272527262321202018181616151516151413121111987766675Azerbaijan5858565357534445445054504953474139413436383945Belarus5955595150525556616273737779798074818279646262Belgium19181818171515131312131312111110111191098BosniaandHerzegovina30313134343542Bulgaria6161626165666462666468687583786966706959635960555555575049Croatia48504747484645434342404640384138333429293029282722Cyprus971087665CzechRepublic464442394439363331302725242423212020171716141413Denmark1313141212151112121312911Estonia544962544759536360686668666052535255504548414137302622Finland2423222622212118181817161713151414141112121110France201919181817171514131312111210101010910888877776Georgia70778073656969697472666962626367696461576448Germany14161414141313121110109988887776Greece222120202120181818191719171717171817161517151514151414121212Hungary615962666867636059616261616258575552515149454543393434323229Iceland161219108151998612787989674584646537Ireland2423222121181717151515131114121211111111101088877576Israel231718171617161612111211131312131310108997788665Italy25242322222120191716151515131312111110109988766Kazakhstan696765615858646665657382888888918794818393889184847674Kyrgyzstan848077706867717579849811412610610710410411011011010510710810711294105Latvia666561616263555155586864678186787265625656606255555553484240Lithuania413941384033404141424745433738343130363335363638383236Luxembourg25282029313025242120211715121813171012810161316978410Malta32263233192229381615102016161012148887131286886767Netherlands1514141214121211111111101011111010109999987766655Norway121512121310111310101110998876766675Poland28242425272930303030313232323131293532323029302827272625Portugal535045454341413637343537353430292928262425242220141414RepublicofMoldova52526958565454656863718085838474818382777977807168666666Romania44454446474847524948505154707374777973666264656257565349464542RussianFederation72737172757265646464666771871039790858290981001031041019987787671SanMarino9000060Serbia474549444342423836353032Slovakia353132302829312524212422191918242827Slovenia34273637323235333034262725252022181819181316121312Spain2424222121211918181615151414131312121111101010999988Sweden1212111212121211101110101098888776765Switzerland6676564445444TFYRMacedonia39444545475144434640464445Tajikistan49484039424040404146453835282316201919303125Turkmenistan86949390869049567666766659493030Ukraine5859635354545559656973778682797172747068676769666457UnitedKingdom2321202019191917161515151413131313121211111010998887Uzbekistan6568666262616364656261757273695852555758544856Table1.5Agestandardizeddeathratesfromstroke,adultsagedunder65,bysex,1980to2010,Europe(deathsper100,000)
  • 33. 31European Cardiovascular Disease StatisticsSource:WHOMortalityDatabasehttp://www.who.int/healthinfo/morttables/en/index.htmlNotes:Blankcellsindicatedatawerenotavailable Women1980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010Albania20221921201418151617161913141516Armenia172328232422272725323228273023232420212224181811Austria14151314141212121089108988989877665454444Azerbaijan3740414342393429283538353736333332302827312629Belarus3534383434323233353642424444424339414240302726Belgium121313121110111099878877886766BosniaandHerzegovina20242427262627Bulgaria3838423939373736353536383939363533353532302928262626252522Croatia30262925262525242323222521192219171617141412131212Cyprus16544473CzechRepublic25242221221818171515141213101111109987766Denmark10888898778877Estonia35323432283033273040373833302725252321192015161315118Finland141313121111121010999810787868656France1010999887766665555555544444434Georgia39404444384039403842353128343131312928232521Germany898888777666655555444Greece16171515141313131212111212101010981098887777665Hungary363634363635343230313030282826272524242422212018181514131412Iceland1313699878911754581184510334355461Ireland221918181616151111111111109101010981010767646655Israel1819151615121111999899877555554444323Italy1515141413121211101099888777666555444Kazakhstan424142434038424140404653565557585555504853494945424141Kyrgyzstan565560554851504858606479847866727269717371677268585564Latvia334034353738333328353332384342394033343031303127272524221918Lithuania262325222422242323232325242223211816171917151618171614Luxembourg20149191615181412131311131391287138131012787775Malta161719181387121215151012765663574755565654Netherlands119109999878888878788777876655554Norway999876788665655654544443Poland17171715171817181717171717161616161817161514141312121111Portugal302926262524222320192020181816151615141412121110777RepublicofMoldova38406052464746485447515661586055536060565355555245403937Romania33333232343334373533333433434244444342383636363533312825242219RussianFederation414242434544414039383838414854514846454750505050474640353431SanMarino09009150Serbia343434323030272625242119Slovakia17161615151514108107897891111Slovenia1715141518151816131514111011991197877566Spain1515131213111110988877766656555544444Sweden787777776776666655454444Switzerland4444443333333TFYRMacedonia30333434353233323334303430Tajikistan43403733343338333537363728232316211721303226Turkmenistan64646876646939434647554642342321Ukraine3536373535343434363943454746433940393835353332312826UnitedKingdom1817171615151414131211111111101010999888776665Uzbekistan4344474548434245444543515050444137374037353035Table1.5continued...
  • 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. 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. 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. 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. 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. 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. 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. 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. 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. 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
  • 44. 42 European Cardiovascular Disease StatisticsTable2.4RatesofhospitaldischargesfromCVD,1970to2009,EuropeDischargesper100,0001970197519801985199019952000200120022003200420052006200720082009Albania417540520614665646623668719705785Andorra586610799799729701677683753726Armenia1,0921,2361,2257626395996767868339319721,0351,1421,224Austria3,0043,3203,6303,6143,7143,6773,7793,7463,7693,8043,777Azerbaijan1,481595472484515541570572616641672653Belarus3,4444,5774,7495,0495,2265,3095,1655,3745,5995,7505,786Belgium2,2352,3562,3472,3242,2752,2992,2332,2042,168BosniaandHerzegovina964905Bulgaria1,4511,7901,7791,7741,8692,0132,2922,6002,9112,8353,0243,1803,3313,712Croatia1,1361,2651,2321,7601,6921,7301,7811,7981,8501,9471,9261,9041,892Cyprus607690809549818927837820840813757844670CzechRepublic3,0513,2613,4303,4363,5223,6183,5143,3683,2543,1513,168Denmark2,2922,2012,5432,5462,5742,5142,5582,5592,5382,4692,4232,501Estonia2,3382,6643,2393,2453,1743,3093,3873,2433,3603,3723,4943,327Finland3,2933,8583,7853,6543,6463,6623,6703,1213,0332,913France2,3072,3032,2952,2602,2752,2832,3022,2682,273Georgia1,635507454427520531642649762837975971Germany2,9553,2673,3053,3003,5273,4173,3103,3233,3923,463Greece7789781,1911,4041,5932,0102,3092,4322,5312,5922,6712,7082,797Hungary3,1714,2394,0394,2484,4484,4534,4954,3763,8613,863Iceland1,9351,8631,9191,8781,8191,7101,8301,5451,480Ireland1,4401,4201,4921,4751,4471,4211,2681,2411,2021,1811,163Israel1,7542,0471,9111,9251,8341,7491,6591,6381,6001,5021,482Italy2,1282,3492,5822,5722,5522,4442,4292,3632,3302,2482,179Kazakhstan1,5971,2071,3141,3891,5191,6381,7851,8051,8561,8171,8991,970Kyrgyzstan1,1581,2171,2579031,0411,0369751,0009771,1301,2571,3851,326Latvia1,8982,4232,4452,5983,1443,1373,1753,2893,3993,6363,8163,9003,8933,190Lithuania1,6341,9782,6282,6873,2014,1023,8903,8984,0424,0814,1544,0474,0594,2264,283Luxembourg2,6122,3642,4392,4332,3822,2362,2492,172Malta6666655927418357277516569421,183Montenegro1,0591,2491,4001,5391,5831,7591,7331,6361,7101,6701,6541,677Netherlands1,3381,4141,5831,4031,3691,4111,4511,5441,5581,5721,5801,626Norway2,1942,3492,3662,3882,5002,4802,4672,4952,4492,4522,368Poland1,3441,5301,8142,0522,8802,9262,5562,6452,5503,085Portugal9441,1251,1641,2131,2211,2201,2061,1941,3321,388RepublicofMoldova1,3161,6261,7271,5801,3151,3111,5581,9832,0322,0232,1002,1532,3002,327Romania1,7841,9141,7372,0242,4222,7412,9652,7982,8822,5893,1592,8263,0573,178RussianFederation2,2262,2552,7633,0203,0203,1083,2673,4143,479Serbia1,4551,5871,5541,6911,7971,8121,8231,9322,0942,160Slovakia2,5342,4432,5692,5392,5012,5642,6792,6882,4632,6842,697Slovenia1,2861,3911,4241,5601,6851,7381,7181,7451,7921,8511,9601,9401,9181,976Spain5376917751,0591,3331,3421,3591,3681,3591,3391,3231,3231,315Sweden2,7962,9962,6392,5852,5382,5052,4822,4672,4552,441Switzerland1,6991,6491,6781,6801,7191,7351,775Tajikistan939653533561622678735771879918925933TFYRMacedonia7591,1841,2671,3981,4241,3811,4771,5561,4301,443Turkey2703905318969091,0091,1041,2111,2621,1461,0471,1831,180Turkmenistan8211,4051,2471,3591,4621,3851,2251,2491,3681,4261,522Ukraine2,1192,6012,7922,5682,6122,7912,9643,1053,2803,4623,5863,6773,7813,744UnitedKingdom1,4221,4051,4011,3891,3781,3531,3211,3041,3111,305Uzbekistan1,2179591,0591,1781,2341,2691,3941,4441,5521,5581,586EuropeanRegion1,9202,0212,2262,3112,3512,4092,4522,4302,4582,4532,4942,498EU1,9792,1912,3962,4232,4492,4812,4802,3972,4202,3782,436Source:WHOEurope.HealthforAllDatabase(HFA-DB)http://data.euro.who.int/hfadb/ Notes:Blankcellsindicatedatawerenotavailable.
  • 45. 43European Cardiovascular Disease StatisticsDischargesper100,0001970197519801985199019952000200120022003200420052006200720082009Albania121157146172191195187188204196250Andorra126142186156120149150179157Armenia334437521318282258288324350382411434469505Austria391587748923940946988982994990954Azerbaijan499201154162155166184175179186214230Belarus1,6352,2122,2962,2782,4522,5412,5692,6412,7202,7132,864Belgium689736719716711721678653632BosniaandHerzegovina181139Bulgaria4605245455535425424895796637218549321,0171,273Croatia295334309495457458490491503486470469490Cyprus223293339222332360293248269279194257198CzechRepublic1,2231,0411,1071,0581,0971,062983905851776771Denmark700684790803844817831823766731684695Estonia9369901,1171,0941,0351,0381,0479981,0901,002999900Finland1,1531,3691,1601,1401,1281,1381,091923865791France503512517521521513519504497Georgia677181194193236263311333404399483463Germany9471,0601,0111,0031,0831,042977959938916Greece191241296412521722777829867872921936970Hungary9611,113943879895904876857791808Iceland790724763769738639704576571Ireland477457485493478455422418392375354Israel834938823815765704641619577516501Italy493520600593606599606582570550529Kazakhstan522436419519521552583606533547684721Kyrgyzstan324321365156322324307328357385364394497Latvia8491,0941,1631,1661,2631,2781,2691,3421,3391,3811,4561,4531,4721,189Lithuania1,2831,3271,5261,4151,3741,3521,3801,3761,3761,3111,3041,2971,312Luxembourg819868907931856738689606Malta184204185260304271238188288351Montenegro342421487487559595541555521509565Netherlands500543612523510521522553539529527526Norway890876944938981971952981972952899Poland332397541598958886774778742884Portugal225277274285283285276254328339RepublicofMoldova508689665562419373444571578547588592656659Romania637752809848723649473492364367374RussianFederation8889361,1031,1681,1781,2011,2581,3131,330Serbia373423400460486490507570629644Slovakia1,089955954917874861884836737810780Slovenia309313349347366381394401392411433417397411Spain102164202278363361365362356338328317302Sweden868959905912878856820786766745Switzerland518499501502498484498Tajikistan174122136169176195217249264265266TFYRMacedonia141321480573623658617666605551Turkey385699144206226250291303365454534524Turkmenistan26956543845373428271924Ukraine6147197286651,1971,2841,3801,4501,5551,6461,7121,7611,8251,809UnitedKingdom523521519508504488471458444421Uzbekistan321300347392398444443472588448EuropeanRegion609643738759769790800795802801804803EU575652707706709719705664655632631Table2.5RatesofhospitaldischargesfromCHD,1970to2009,EuropeSource:WHOEurope.HealthforAllDatabase(HFA-DB)http://data.euro.who.int/hfadb/ Notes:Blankcellsindicatedatawerenotavailable.
  • 46. 44 European Cardiovascular Disease StatisticsTable2.6Ratesofhospitaldischargesfromstroke,1970to2009,EuropeDischargesper100,0001970197519801985199019952000200120022003200420052006200720082009Albania45808280919194108124130150Andorra1071231131011171061078494Armenia101128194132130129147163161172162177187195Austria194427671577586545580577570559549Azerbaijan1135345485348525262657173Belarus5698969129491,0371,0831,0631,0921,1431,1541,163Belgium362390393391377378368363358BosniaandHerzegovina131119Bulgaria134268293323426468586666717592616615622613Croatia233297281411394396392383409437426411410Cyprus11613114389140149137146149120126157120CzechRepublic558619625633631626615601572543550Denmark430394452435424411404384373364356358Estonia380497502499536570608619613639705714Finland681820658661645646633561564550France222220221219223228227223229Georgia19254747479809598102132142149Germany487462464462542512497506513526Greece117190230256274330404424438434415448464Hungary5988328459691,0821,2081,2761,2171,0511,053Iceland244237228206254206207180149Ireland234250258251247252171169165166168Israel203253259258247250249247246237235Italy394436489494503491485475470457446Kazakhstan176169210234278293321351355362377405Kyrgyzstan91107145124153155142142145174188229236Latvia282383445542638669695713732795838852838692Lithuania408512671780698757790804839826816874859Luxembourg233184164164173167165168Malta797765736154715868107Montenegro163169185194201197197183192203206Netherlands181175193184185193200212224229226229Norway382320321328353345342345331331309Poland130159191232370417345355344388Portugal287336345350338336327308305310RepublicofMoldova181230293270271247328418429475518540543608Romania280328404442461516523669629580587RussianFederation370458595653668684720760769Serbia338360362380400431420410419459Slovakia491452473475465473518515458483462Slovenia219268249255230230222225228228235226218232Spain89107112176213221224228227223225223223Sweden613617446418422417418417410397Switzerland212210204207218211220Tajikistan1093138445242475665666469TFYRMacedonia121199218240224237224243247261Turkey27507110614816617419321215296100100Turkmenistan82132134147162169145153183192209Ukraine244358486467540585629671723770798828859862UnitedKingdom204206214213212212210207213223Uzbekistan112799499102105116117116127120EuropeanRegion299333380398410428441440442438442443EU304342367372383399403393399389392Source:WHOEurope.HealthforAllDatabase(HFA-DB)http://data.euro.who.int/hfadb/ Notes:Blankcellsindicatedatawerenotavailable.
  • 47. 45European Cardiovascular Disease Statistics3. TreatmentSurgical procedures for treating CVDRates of surgical procedures for CVD vary widely across Europe and it appears that data collection and quality alsovaries substantially. The comparability of the data across countries is limited by variability in the way in which healthcare provision is organised in countries and the information that is collected for national statistics – for instancein some countries, data do not include private hospitals. In data provided by the European Commission ‘Eurostat’database, there were no consistent geographical patterns in rates of surgical interventions for CVD (Table 3.3).Rates of surgery for stroke treatment (evacuation of subdural haematoma and intracranial haemorrhage) werehighest in Switzerland, Finland and Germany, and lowest in Slovenia, the Netherlands and Romania. Rates ofcoronary angioplasty were lowest in Portugal and Romania, and highest in Germany, where the rate of this surgerywas more than double that in Austria and the Czech Republic, which had the next highest rates, and more than 20times the rate in Portugal. For heart bypass anastomosis surgery, rates were highest in Switzerland, Germany andEstonia, and lowest in Finland, Romania and Slovakia.Medications for treatment and prevention of CVDThe European Society of Cardiology EUROASPIRE project has collected, among other data, information on drugprescriptions for patients with diagnosed cardiovascular conditions in hospitals in a number of European countries.While not necessarily representative of national prescribing patterns these data do give some indication of the scaleof drug use across Europe. The EUROASPIRE III survey, in 2006/07, showed that the use of drugs for secondaryprevention in CHD patients varied considerably across survey populations1. Anti-platelet drugs (including aspirin)were the most widely used drugs, which were used by between 88% and 99% of patients in the countries studied.The use of statins varied more than two-fold (from 38% of patients in Lithuania to 96% of patients in Finland), as didthe use of lipid-lowering drugs. The use of ACE inhibitors varied two-fold (from 46% of patients in Belgium to 90%of patients in Poland). Anti-coagulant drugs varied most dramatically between countries, from below 5% of patientsin half of the 22 countries, to 36% of patients in Germany (Table 3.1).Comparable data are now available on eight countries that have taken part in all three EUROASPIRE surveys todate2(Table 3.2, Figure 3.2). Since 1995/96 the use of lipid-lowering drugs has massively increased in Europe.The prescription rate for these drugs has at least doubled in all eight EUROASPIRE populations for which data areavailable. In Italy, the rate has more than tripled, increasing from 25% of patients in 1995/96 to 91% of patientsin 2006/07. There has also been a large increase in the prescription of ACE inhibitors, although in general theprescription rates for these drugs are lower than for lipid-lowering drugs.1 Kotseva K, Wood D, De Backer G, De Bacquer D, Pyorala K, Keil U. EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug thera-pies in coronary patients from 22 European countries. Eur J Cardiovasc Prev Rehabil 2009;16(2):121-37.2 Kotseva K, Wood D, De Backer G, De Bacquer D, Pyorala K, Keil U. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, andIII surveys in eight European countries. Lancet 2009;373(9667):929-40.
  • 48. 46 European Cardiovascular Disease StatisticsCHD hospital patients receiving medicationAnti-platelets(%)Beta-blockers(%)ACEinhibitors (%)Lipidlowering (%)Statins(%)Anti-coagulants (%)Belgium 95.1 83.0 46.0 83.0 83.3 9.0Bulgaria 87.9 82.3 69.9 62.5 65.6 7.8Croatia 97.8 81.5 70.1 80.7 80.9 3.7Cyprus 98.1 60.2 61.0 89.0 89.4 1.4Czech Republic 95.4 87.3 67.4 88.6 90.1 15.0Finland 94.5 94.5 58.6 95.8 95.8 17.7France 98.5 82.7 73.6 88.2 90.9 14.0Germany 98.2 90.7 79.3 89.0 89.4 35.6Greece 98.4 75.4 65.3 81.0 83.5 4.1Hungary 90.0 91.9 71.9 77.6 78.0 6.3Ireland 98.8 84.2 58.9 89.5 90.4 1.2Italy 95.2 81.7 66.0 72.1 72.9 2.7Latvia 88.6 86.5 71.7 83.9 83.9 5.2Lithuania 89.8 78.2 60.7 38.2 38.4 3.5Poland 97.4 89.9 89.7 94.2 95.0 2.8Romania 97.3 91.9 70.1 85.8 85.8 7.3Russian Federation 97.3 89.1 85.7 66.0 66.7 0.5Slovenia 94.3 80.1 76.7 85.5 86.1 9.1Spain 91.9 61.7 48.3 63.1 67.6 3.8The Netherlands 97.9 74.0 61.2 87.2 87.6 12.5Turkey 99.4 83.1 73.6 82.0 82.3 2.7United Kingdom 98.4 74.9 72.8 91.5 92.0 1.6Table 3.1 Reported medication at discharge: hospital patients with established CHD, 2006/07, EUROASPIRE III survey populationsSource: Kotseva K, Wood D, De Backer G, De Bacquer D, Pyorala K, Keil U. EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronarypatients from 22 European countries. Eur J Cardiovasc Prev Rehabil 2009;16(2):121-37.
  • 49. 47European Cardiovascular Disease StatisticsCHD hospital patients receiving medicationAnti-platelettherapy(%)Beta-blockers(%)ACE-inhibitors &AT2 antagonists(%)Lipid loweringdrugs(%)Statins(%)EA1 EA2 EA3 EA1 EA2 EA3 EA1 EA2 EA3 EA1 EA2 EA3 EA1 EA2 EA3Czech Republic 85 88 93 65 74 91 28 47 76 29 57 90 6 39 88Finland 82 82 96 78 88 96 17 31 59 39 64 95 35 63 95France 82 86 98 56 60 74 34 44 79 42 68 92 20 61 89Germany 83 86 92 44 68 85 31 51 73 35 68 87 31 66 85Hungary 72 75 86 58 84 86 46 59 81 22 51 80 7 45 77Italy 86 92 98 49 61 88 32 54 71 25 60 91 7 57 90Netherlands 78 81 96 47 48 75 27 43 67 36 76 92 14 75 91Slovenia 79 82 92 52 66 87 31 63 83 30 58 92 23 56 90Total 81 84 93 56 69 86 31 49 75 32 63 89 18 57 87Table 3.2 Reported medication, hospital patients with established CHD, 1995/96, 1999/2000 and 2006/07, EUROASPIRE survey populationsSource: Kotseva K, Wood D, De Backer G, De Bacquer D, Pyorala K, Keil U. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveysin eight European countries. Lancet 2009;373(9667):929-40.
  • 50. 48 European Cardiovascular Disease StatisticsFigure 3.2 Reported medication use in hospital patients with established CHD, 1995/96, 1999/2000 and 2006/07, EUROASPIRE survey populations100%90%80%70%60%50%40%30%20%10%0%Anti-platelet therapy Beta-blockers ACE-inhibitors &At2 antagonistsLipid lowering drugs StatinsEUROASPIRE I(1995/6)EUROASPIRE II(1999/00)EUROASPIRE III(2006/07)
  • 51. 49European Cardiovascular Disease StatisticsTable3.3RatesofsurgicalproceduresfortreatingCVD,2005to2010,EuropeIn-patientsper100,000inhabitantsEvacuationofsubduralhaematomaandintracranialhaemorrhageTransluminalcoronaryangioplastyBypassanastomosisforheartrevascularization200520062007200820092010200520062007200820092010200520062007200820092010Belgium15.515.115.116.0226.0227.9218.0219.082.080.376.473.1CzechRepublic215.1217.4217.4221.0221.675.770.562.656.856.3Denmark14.514.414.7197.2195.6186.542.942.744.4Germany14.915.516.016.818.0509.0536.5549.9566.8581.5137.8129.2131.7124.0119.8Estonia69.8107.0122.8146.6168.6121.7134.5124.5120.4109.9Ireland7.06.26.66.66.988.591.687.387.683.645.640.340.745.345.3Spain7.77.78.18.38.796.6101.5111.7108.1115.529.728.629.631.129.4France7.47.68.28.48.9179.4185.1185.3189.0194.030.230.030.931.330.2Italy8.58.68.38.38.590.897.2101.3101.7100.941.437.136.234.831.5Cyprus23.615.519.616.2Luxembourg9.28.88.08.38.1176.3187.1146.6174.2192.160.860.562.865.151.9Hungary13.913.713.114.612.7161.5211.2213.7238.2180.9128.9115.598.994.185.5Netherlands2.22.52.82.62.7157.3167.5175.4165.2170.457.258.158.358.357.8Austria228.1230.6231.0229.650.751.550.847.5Poland3.23.12.41.472.770.268.164.750.152.252.139.938.0Portugal9.511.111.711.011.374.185.972.842.022.935.543.643.042.039.7Romania5.15.747.753.219.418.9Slovenia3.92.52.52.51.789.6125.2176.8175.4195.949.852.462.068.764.7Slovakia12.812.613.615.113.525.4Finland18.720.421.222.620.564.680.569.067.666.310.68.67.44.14.5Sweden14.814.714.715.116.3144.4173.1171.5179.2172.550.450.953.346.942.2UnitedKingdom5.25.65.96.06.392.198.191.492.594.139.739.740.136.733.0Iceland12.39.88.57.8208.1201.8236.6197.952.043.651.757.0Switzerland24.022.523.130.327.7156.7160.0158.5162.6159.6Source:EuropeanCommission,Eurostatdatabasehttp://epp.eurostat.ec.europa.eu/portal/page/portal/statistics/search_databaseNotes:Blankcellsindicatedatawerenotavailable.
  • 52. 50 European Cardiovascular Disease StatisticsFigure 3.3a Rates of evacuation of subdural haematoma and intracranial haemorrhage, latest available year, EuropeFigure 3.3b Rates of transluminal coronary angioplasty, latest available year, EuropePolandSloveniaNetherlandsRomaniaUnitedKingdomIrelandIcelandLuxembourgItalySpainFrancePortugalHungarySlovakiaDenmarkBelgiumCyprusSwedenGermanyFinlandSwitzerlandPortugalRomaniaPolandFinlandIrelandUnitedKingdomItalySpainEstoniaNetherlandsSwedenHungaryDenmarkLuxembourgFranceSloveniaIcelandBelgiumCzechRepublicAustriaGermany302520151050Numberofproceduresper100,000inhabitants6005004003002001000Numberofproceduresper100,000inhabitants
  • 53. 51European Cardiovascular Disease StatisticsFigure 3.3c Rates of bypass anastomosis for heart revascularization, latest available year, EuropeFinlandRomaniaSlovakiaSpainFranceItalyUnitedKingdomPolandPortugalSwedenDenmarkIrelandAustriaLuxembourgCzechRepublicIcelandNetherlandsSloveniaBelgiumHungaryEstoniaGermany140120100806040200Numberofproceduresper100,000inhabitants
  • 54. 52 European Cardiovascular Disease Statistics4. SmokingSmoking related mortality and morbidityDespite 50 years of clear evidence of the harms of tobacco smoking, it remains prevalent and is one of the mostimportant modifiable risk factors for premature mortality. Since the landmark ‘Smoking and Health’ report of 1962,it is estimated that over 6 million people per year have died as a result of smoking1.In Europe, about 20% of deaths from CVD in men and about 3% of deaths from CVD in women are due to smoking.The equivalent figures for the 25 countries that made up the EU in 2006 (EU-25) are 16% and 5% respectively.A higher proportion of premature deaths from CVD are due to smoking. In Europe, smoking causes 32% of CVDdeaths in men aged 35 to 69 years and 6% of CVD deaths in women of the same age. In the EU-25 the equivalentfigures are 28% and 13% respectively2.Research from the World Health Organization has estimated the impact of smoking on total disease burden (bothmortality and morbidity) in terms of disability-adjusted life years (DALYs) lost. The World Health Report 2002estimated that in developed countries around 12% of all disease burden and over 20% of CVD is due to smoking3.Prevalence of smokingData from the World Health Organization’s ‘Health for All’ database show that in almost all European countries(excluding Sweden and Norway) the prevalence of smoking is higher in adult men than it is in adult women. Thedifference in the prevalence of smoking between men and women is more marked in Eastern Europe than inWestern Europe. For example, in Armenia, over 50% of men smoke, compared to just 1.5% of women, and inUzbekistan 24% of men smoke compared to only 1% of women (Table 4.1). The highest rates of smoking amongwomen (around 30% in TFYR Macedonia, Germany, Andorra, Bosnia and Herzegovina, Greece and Montenegro)are just half of the highest rates reported among men (around 60% in Albania and the Russian Federation).The prevalence of smoking in men is generally higher in Eastern European and former Soviet countries – of the sixEuropean countries where more than half of men smoke, five were part of the Soviet Union; the sixth is Albania. Incontrast, the male smoking rate in Western and Northern Europe is in general less than 35%, with the exceptionof Germany (37%). This pattern is reversed for women, where smoking rates are very low in former Soviet states(around 6% in in Georgia and Ukraine, less than 2% in Kyrgyzstan and Armenia, less than 1% in Uzbekistan andAzerbaijan), low in Eastern and Central European countries but higher in Western and Northern European countries(Table 4.1 and Figures 4.1a and 4.1b).EuroBarometer survey data published in 2010 showed that the overall smoking rate in the EU in 2009 was 29%4.There was also evidence of substantial inequalities in the prevalence of smoking in the EU, with lower rates ofsmoking among those in high socio-economic positions, and very high rates among unemployed persons (52%,compared to 39% among manual workers and 25% among managers)4. Despite generally narrower gender gapsin smoking prevalence in many EU countries compared to the rest of Europe, there remain substantially more malesmokers than female smokers in the EU (35% vs 25%)4.
  • 55. 53European Cardiovascular Disease StatisticsAmong adolescents, the traditional gender patterns of smoking have tended to be less clearly expressed. The mostrecent data, however, suggest that it is again becoming more common for boys than girls to smoke. In 2001/02,data from the Health Behaviour in School-aged Children survey on smoking among 15 year olds showed that in 22of 32 countries included, a greater proportion of 15 year old girls smoked than did boys. In the most recent survey,collected in 2009/10, however, only 12 of 35 participating European countries showed more 15 year old girls thanboys were regular smokers. The largest excess of female compared to male 15 year old smokers was seen in Spain,Czech Republic, England and Wales. Smoking is more prevalent among 15 year old boys in Eastern European andformer Soviet countries, but the gap between the sexes is less marked than for adults (e.g. Russian Federation, 19%boys vs. 15% girls) (Table 4.2 and Figures 4.2a and 4.2b).Trends in smoking prevalenceOver the past 30 years the prevalence of smoking among men has fallen in almost all European countries for whichdata are available. The main exception to this is the Russian Federation, where the most recent data (2004) showover 60% of men smoking. The prevalence of smoking among women has also fallen in most, but not all, Europeancountries. In many countries where there has been a decline in the prevalence of smoking among women thedecline has been less marked than for men. For example between 1980 and 2005 the prevalence of smoking inNorwegian men fell by half but in Norwegian women it fell by just a third. This has meant that the difference insmoking prevalence between men and women has become less pronounced in recent years (Table 4.1).Trend data on the prevalence of smoking in 15 year olds around Europe show a divergence over the last 15 years,with smoking among adolescents in many countries, particularly those of Northern and Western Europe, decreasingsubstantially between 1993/94 and 2009/10. At the same time, a number of countries, notably Italy and the CzechRepublic, have seen large increases in smoking among 15 year old boys and girls, and the Russian Federation,Latvia, Hungary, Estonia and Slovakia have seen increases particularly among girls (Table 4.2 and Figure 4.2c).Passive smokingThe relationship between passive smoking and various non-communicable diseases has been studied since themid-1970s and a number of relationships between passive smoking and a variety of health problems – includingCVD and cancer – have been observed5. Smokefree policies designed to protect populations from the effects ofpassive smoking are now widespread in Europe.It is estimated that nearly 80,000 people in the EU-25 died from passive smoking in 2002, of which over 32,000died from CHD. Over 25,000 passive smoking deaths were in the United Kingdom or Germany alone (Table 4.3).Smokers tend to live with other smokers, so many of the deaths due to passive smoking are amongst smokers. Butnearly 20,000 non-smokers died of passive smoking in the EU-25 in 2002, over half of which died from CHD (Table4.3).1 World Health Organization. WHO Report on the Global Tobacco Epidemic, 2011: Warning about the dangers of tobacco. http://www.who.int/tobacco/global_re-port/2011/en/. Geneva: WHO, 2011.2 Peto R, Lopez A, Boreham J, Thun M. Mortality from smoking in developed countries 1950-2000. 2nd edition. . Oxford: Oxford University Press, 2003.3 World Health Organization. The World Health Report 2002. Reducing Risks, Promoting Healthy Life. Geneva: WHO, 2002.4 European Commission. Special Eurobarometer 332 ‘Tobacco’ / Wave 72.3 – TNS Opinion & Social. http://ec.europa.eu/public_opinion/index_en.htm. Brussels,Belgium, 2010.5 The Smoke Free Partnership. Lifting the smokescreen. 10 reasons for a smoke free Europe. http://www.smokefreepartnership.eu/Smoke-free-legislation-in-the-EU. Brussels: European Respiratory Society, 2007.
  • 56. 54 European Cardiovascular Disease StatisticsMen1980-841985-891990-941995-992000200120022003200420052006200720082009Albania49.860.0Andorra43.742.0Armenia63.767.559.657.154.754.752.0Austria33.538.838.927.3Azerbaijan40.441.739.941.237.938.638.038.036.3Belarus54.354.053.353.053.254.354.453.252.852.351.9Belgium49.042.833.231.836.034.033.030.028.023.029.025.024.0BosniaandHerzegovina49.2Bulgaria49.049.343.8Croatia34.134.133.8Cyprus28.538.139.2CzechRepublic32.231.530.932.231.129.627.729.624.929.7Denmark39.035.432.033.530.531.029.028.026.028.024.022.0Estonia48.844.944.145.042.040.938.6Finland33.832.831.028.627.029.027.525.727.126.024.425.824.021.9France46.038.035.033.030.630.0Georgia53.253.3Germany43.038.937.1Greece53.049.046.8Hungary44.045.038.236.936.8Iceland33.128.926.523.324.522.225.421.519.521.320.720.315.9Ireland39.033.830.032.527.024.224.224.731.028.0Israel45.539.336.731.830.032.031.932.732.129.032.331.3Italy35.133.831.931.631.331.428.729.228.628.929.9Kazakhstan60.046.540.7Kyrgyzstan60.051.041.441.4Latvia49.451.151.351.147.346.645.0Lithuania43.347.951.543.739.442.143.438.5Luxembourg41.032.033.534.035.039.036.032.029.028.029.028.0Malta40.033.729.925.625.6Montenegro36.7Netherlands45.739.542.538.935.938.937.935.835.135.435.532.032.232.1Norway41.339.736.733.431.329.528.827.227.226.024.021.021.020.0Poland51.043.040.038.042.037.033.5Portugal41.738.738.032.830.8RepublicofMoldova40.038.836.433.632.237.651.1Romania43.936.732.333.232.1RussianFederation47.062.062.260.461.3SanMarino28.0Serbia40.630.7Slovakia32.541.1Slovenia34.731.628.024.021.422.4Spain44.042.839.234.231.631.2Sweden33.828.224.319.216.817.916.316.715.013.912.312.812.0Switzerland33.939.027.031.024.023.0TFYRMacedonia40.0Turkey62.851.150.643.8Ukraine48.558.051.150.152.449.742.0UnitedKingdom38.734.029.328.729.028.027.027.026.025.023.022.021.0Uzbekistan24.1Table4.1Prevalenceofsmoking,adultsaged15yearsandover,bysex,1980to2009,Europe
  • 57. 55European Cardiovascular Disease StatisticsWomen1980-841985-891990-941995-992000200120022003200420052006200720082009Albania7.918.0Andorra28.030.0Armenia1.23.12.12.01.61.61.5Austria17.423.722.619.4Azerbaijan0.30.30.40.30.20.10.10.10.0Belarus4.56.76.36.37.17.28.39.08.79.29.8Belgium27.025.821.824.426.022.025.025.020.016.016.019.018.0BosniaandHerzegovina29.7Bulgaria17.020.323.0Croatia31.626.621.7Cyprus7.610.514.3CzechRepublic21.318.818.122.620.119.419.518.818.618.0Denmark35.030.629.025.526.025.023.024.023.021.022.017.0Estonia19.320.719.917.921.019.517.1Finland17.618.420.019.620.020.019.919.319.518.218.916.617.616.0France17.020.021.021.021.521.2Georgia11.96.3Germany30.030.630.5Greece30.029.029.0Hungary27.024.523.024.626.7Iceland31.928.426.422.522.821.119.618.919.517.418.215.315.7Ireland32.029.828.230.027.023.623.624.727.026.0Israel29.529.025.725.024.018.417.818.019.317.716.014.8Italy16.817.517.417.117.217.616.417.216.616.417.1Kazakhstan7.07.68.8Kyrgyzstan12.04.51.71.7Latvia11.115.718.219.217.818.215.6Lithuania6.311.015.812.814.29.814.513.9Luxembourg25.026.027.526.025.026.026.022.021.022.021.021.0Malta18.014.917.615.815.8Montenegro29.0Netherlands33.331.531.331.429.230.229.228.426.726.326.226.325.024.0Norway32.232.933.332.331.129.729.425.324.824.024.023.021.020.0Poland29.023.525.025.625.023.021.0Portugal6.78.715.08.611.8RepublicofMoldova2.02.02.01.81.83.77.1Romania11.38.710.110.39.0RussianFederation12.010.912.615.515.0SanMarino17.0Serbia26.122.6Slovakia16.314.7Slovenia22.720.420.122.016.015.5Spain20.824.724.622.421.521.3Sweden27.526.524.821.921.019.919.318.317.518.016.714.915.3Switzerland22.828.021.023.020.018.0TFYRMacedonia32.0Turkey24.317.816.611.6Ukraine20.514.06.06.36.35.9UnitedKingdom34.030.527.726.725.025.025.024.023.022.021.019.020.0Uzbekistan0.9Source:WHOEurope.HealthforAllDatabase(HFA-DB)http://data.euro.who.int/hfadb/ Note:Whereyearsaregivenas5yearranges,thefiguresareaveragesovertheperiod.Blankcellsindicatenodatawereavailable. Table4.1continued...
  • 58. 56 European Cardiovascular Disease StatisticsFigure 4.1a Prevalence of smoking, men aged 15 years and over, latest available year, EuropeFigure 4.1b Prevalence of smoking, women aged 15 years and over, latest available year, EuropeSweden[‘08]Icland[‘09]Norway[‘09]UnitedKingdon[‘08]Finland[‘09]Denmark[‘09]Slovenia[‘07]Switzerland[‘07]Belgium[‘07]Uzbekistan[‘02]Malta[‘09]Austria[‘06]Luxembourg[‘09]Ireland[‘08]CzechRepublic[‘09]Italy[‘09]France[‘03]Serbia[‘06]Portugal[‘06]Spain[‘09]Israel[‘08]Romania[‘08]Netherlands[‘09]Poland[‘09]Croatia[‘03]Azerbaijan[‘09]Montenegro[‘08]hungat[‘09]Germany[‘03]Lithuania[‘08]Estonia[‘08]Cyprus[‘08]TFYRMacedonia[‘99]Kazakhstan[‘04]Slovakia[‘98]Kyrgyzstan[‘05]Ukraine[‘08]Andorra[‘02]Turkey[‘08]Bulgaria[‘01]Latvia[‘08]Greece[‘00]Bosnia&Herzegovina[‘02]RepublicofMoldova[‘06]Belarus[‘09]Armenia[‘09]Georgia[‘01]Albania[‘00]RussianFederation[‘04]706050403020100%35302520151050%Azebaijan[‘09]Uzbekistan[‘02]Armenia[‘09]Kyrgyzstan[‘05]Ukraine[‘08]Georgia[‘01]RepublicofMoldova[‘06]Kazakhstan[‘04]Romania[‘08]Belarus[‘09]Turkey[‘08]Portugal[‘06]Lithuania[‘08]Cyprus[‘08]Slovakia[‘98]Israel[‘08]RussianFederation[‘04]Sweden[‘08]Slovenia[‘07]Latvia[‘08]Iceland[‘09]Malta[‘09]Finaland[‘09]Denmark[‘09]Italy[‘09]Estonia[‘08]Switzerland[‘07]Belgium[‘08]CzechRepublic[‘09]Albania[‘00]Austria[‘06]Norway[‘09]UnitedKingdom[‘08]Luxembourg[‘09]Poland[‘09]France[‘03]Spain[‘09]Croatia[‘03]Serbia[‘06]Bulgaria[‘01]Netherlands[‘09]Ireland[‘08]Hungary[‘09]Montenegro[‘08]Greece[‘00]Bosnia&Herzegovina[‘02]Andorra[‘02]Germany[‘03]TFYRMacedonia[99]
  • 59. 57European Cardiovascular Disease StatisticsFigure 4.1c Prevalence of smoking, men, 1980 to 2010, selected countriesFigure 4.1d Prevalence of smoking, women, 1980 to 2010, selected countries6050403020100BelarusEstoniaItalyNorwaySpainSweden1980 1985 1990 1995 2000 2005 2010BelarusEstoniaItalyNorwaySpainSweden40353025201510501980 1985 1990 1995 2000 2005 2010%%
  • 60. 58 European Cardiovascular Disease StatisticsBOYSGIRLS1989/901993/941997/982001/022005/062009/101989/901993/941997/982001/022005/062009/10%%%%%%%%%%%%Armenia111Austria232930262425203136373029Belgium(Flemish)153228231815171828231716Belgium(French)2322141621241717Bulgaria2836Croatia232427252825CzechRepublic16222920221218312328Denmark14201715142428211513Estonia2224302722612181916Finland333025282320322629322119France23282617202531272120Germany21283217152933342215Greece1814171819141613Hungary312536282226201928262126Iceland149137Ireland2520191226212014Israel24171213127Italy92220229252023Latvia33372930321419212322Lithuania1524352634410181821Luxembourg17222119Macedonia,TFYR15141413149Malta17191724Netherlands231615242117Norway212023209923212827128Poland202327261916101320171412Portugal191891114261210Romania20251215RussianFederation19242727191022192115Slovakia192818215181517Slovenia302020301619Spain18202414152727322023Sweden1515181181320192419915Switzerland17252515191825241515Ukraine453431231713UnitedKingdom-England252113933281814UnitedKingdom-NorthernIreland23202528UnitedKingdom-Scotland162122161414182628232315UnitedKingdom-Wales141822161211222729272316Table4.2Prevalenceofsmoking,15yearolds,bysex,1989/90to2009/10,EuropeSource:CurrieCetal.,eds.Socialdeterminantsofhealthandwell-beingamongyoungpeople.HealthBehaviourinSchool-agedChildren(HBSC)study:internationalreportfromthe2009/2010survey.Copenhagen,WHORegionalOfficeforEurope,2012(HealthPolicyforChildrenandAdolescents,No.6)andpreviouseditions. Notes:Smokingdefinedassmokingatleastonceaweek.Datacollectedusingrepresentativenationalsamplesofschoolchildren,withtheexceptionofFrance,GermanyandtheRussianFederation,wherethesamplesweredrawnfromregions.In1993/94and1997/98theseregionswereNancyandToulouse,NorthRhine-Westphalia,andStPetersburgrespectively.In2001/02nationalsampleswerecollectedforFranceandtheRussianFederation,andtheregionalsampleforGermanywascollectedinBerlin,Hessen,NorthRhine-WestphaliaandSaxony.Blankcellsindicatedatawerenotavailable.
  • 61. 59European Cardiovascular Disease StatisticsFigure 4.2a Prevalence of smoking, boys aged 15 years, 2009/10, EuropeFigure 4.2b Prevalence of smoking, girls aged 15 years, 2009/10, EuropeIcelandNorwayUnitedKingdom-EnglandArmeniaPortugalUnitedKingdom-WalesIrelandSwedenDenmarkMacedonia,TFYRUnitedKingdom-ScotlandBelgium(Flemish)GermanyNetherlandsSpainBelgium(French)PolandGreeceRussianFederationSwitzerlandFinlandFranceSloveniaSlovakiaCzechrepublicEstoniaItalyLuxembourgAustriaRomaniaHungaryCroatiaUkraineLatviaLithuania4035302520151050%%35302520151050ArmeniaicelandNorwayMacedonia,TFYRPortugalPolandDenmarkGreeceUkraineUnitedKingdom-EnglandIrelandSwedenUnitedKingdom-ScotlandGermanyRussianFederationSwitzerlandRomaniaUnitedKingdom-WalesBelgium(Flemish)EstoniaNetherlandsBelgium(French)SlovakiaFinlandSloveniaLuxembourgFranceLithuaniaLatviaSpainItalyCroatiaHungaryCzechRepublicAustria
  • 62. 60 European Cardiovascular Disease StatisticsFigure 4.2c Change in smoking rates among 15 year olds, by sex, 1993/94 to 2009/10, Europen Boysn GirlsNorwayGermanyBelgium (Flemish)United Kingdom - WalesUnited Kingdom - ScotlandFinlandDenmarkBelgium (French)SpainPolandFranceSwedenAustriaSwitzerlandRussian FederationLatviaHungaryEstoniaSlovakiaCzech RepublicItaly-25 -20 -15 -10 -5 0 5 10 15 20 25
  • 63. 61European Cardiovascular Disease StatisticsDeaths attributed to passive smokingin all adultsDeaths attributed to passivesmoking in non-smokersCHD Stroke Total CHD Stroke TotalAustria 426 310 1,029 146 69 268Belgium 719 727 2,133 243 164 522Czech Republic 1,455 1,346 3,501 526 313 956Denmark 627 505 1,714 217 114 428Estonia 217 225 499 57 45 108Finland 274 271 659 82 59 159France 1,902 1,997 5,863 510 392 1,114Germany 7,536 4,892 15,609 2,452 1,085 4,000Greece 791 1,282 2,416 238 288 568Hungary 1,766 1,421 3,940 555 313 959Iceland 20 11 40 6 2 9Ireland 294 145 566 89 31 140Italy 2,513 2,788 7,180 835 625 1,778Latvia 703 673 1,507 243 151 414Lithuania 800 420 1,362 240 86 345Luxembourg 30 33 86 10 7 20Malta 31 19 59 11 4 17Netherlands 806 729 2,332 269 161 562Norway 267 188 626 98 46 176Poland 3,390 3,514 8,720 933 692 1,826Portugal 368 939 1,519 145 271 457Slovakia 995 469 1,733 362 109 519Slovenia 108 124 303 37 30 79Spain 2,082 2,328 6,305 680 517 1,498Sweden 267 184 539 91 43 151Switzerland 470 270 1,003 163 62 267United Kingdom 4,950 3,520 10,944 1,526 769 2,690EU-25 32,342 28,591 79,449 10,239 6,279 19,242Table 4.3 Estimated number of deaths attributable to passive smoking, adults aged 20 and over, 2002, EuropeSource: Smoke Free Partnership and the European Heart Network (2006) Lifting the smokescreen. 10 reasons for a smoke free Europe. European Respiratory Society: Brussels. Notes: Estimates based on population attributable proportions applied to routinely collected mortality data for passive smoking-related conditions. See source for details.
  • 64. 62 European Cardiovascular Disease Statistics5. DietDiet is one of the most important modifiable risk factors for cardiovascular disease. Dietary changes can help preventcardiovascular disease (primary prevention) and they can also help to prevent the progression of the disease inpeople who already have symptoms or have been identified as being at high risk (secondary prevention)1. Thereis widespread consensus that significant action is needed to improve population diets to reduce the preventableburden of morbidity and mortality from CVD and other non-communicable diseases2.Key population dietary goals for the prevention of cardiovascular disease include: limiting intake of total dietary fat,particularly saturated and trans fats, limiting intake of salt (sodium), carbohydrate, added sugars, and specificallysugar-sweetened drinks, and increasing intakes of fruit and vegetables and dietary fibre, in addition to limited ormoderate alcohol intake, maintenance of healthy body weight and participation in physical activity1,3.Despite the significance of diet in the prevention of CVD, high quality and comparable data on diets of Europeanpopulations are sparse. Accurate measurement of food intake, and especially of nutrient intake, at the individual levelis hampered by a range of limitations in assessment methods and often relies on individual recall of consumption.National diets and food supply‘Food balance sheet’ data, published by the Food and Agriculture Organization (FAO), is calculated from the foodproduced in and imported into countries minus the food exported, fed to animals, or otherwise not available forhuman consumption. This amount is then divided by the population size. The FAO data thus provide an estimateof average availability per person rather than actual food consumption. It is therefore likely to give figures which arehigher than actual food consumption in wealthy countries where substantial amounts of food are wasted, and togive figures which are lower than actual consumption in countries where people grow crops or raise animals in theirback gardens or smallholdings.At the country level, food balance sheets can be used to give an indication of the food supply available, and allowcomparison between countries. These country-level data show large differences between European countries in thetotal availability of food energy, fats, fruits and vegetables (Table 5.5 to 5.8). Total energy available per person inAustria, for example, was 80% more than in Tajikistan (Table 5.5). The largest quantity of vegetables available was inArmenia (819g per person per day), more than four times more than in Georgia, the Republic of Moldova, Bulgaria,Czech Republic and Iceland (Table 5.6). The largest quantity of fruit per person was available in Luxembourg(520g per person per day), ten times that in Tajikistan, and more than five times that in Kazakhstan and Ukraine(Table 5.7). The FAO recommends that fat should make up between a minimum of 15% and a maximum of 30 to35% of total energy intake for adults4. No countries in Europe with available data showed less than 15% of dietaryenergy from fat, while 19 of 50 countries consumed between 15 and 30% energy from fat, and a further 8 countriesconsume between 30 and 35% of energy from fat (Table 5.8). Fat makes up 40% or more of the total energy in thefood supply of Belgium, Cyprus, Switzerland, Spain and France.
  • 65. 63European Cardiovascular Disease Statistics1 European Heart Network. Diet, Physical Activity and Cardiovascular Disease Prevention in Europe. http://www.ehnheart.org/publications/publications/publication/521-diet-physical-activity-and-cardiovascular-disease-prevention.html. Brussels: European Heart Network, 2011.2 Waxman A. WHO global strategy on diet, physical activity and health. Food Nutr Bull 2004;25(3):292-302.3 Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur HeartJ 2012;33(13):1635-701.4 Food and Agriculture Organization of the United Nations. Fats and fatty acids in human nutrition: Report of an expert consultation. http://foris.fao.org/preview/25553-0ece4cb94ac52f9a25af77ca5cfba7a8c.pdf. Rome: FAO, 2010.Dietary patterns in adultsIn the European Health Interview Survey, adults in 16 countries reported on their usual frequency of fruit and veg-etable consumption. In general, around half to three quarters of respondents reported they consumed vegetables orfruit at least daily, with higher frequency of consumption more common among women (Tables 5.1 and 5.2). Fruitconsumption was most common in Slovenia, where 82% of women and 67% of men reported consuming fruit atleast daily, and lowest in Bulgaria (51% of women and 39% of men). Vegetable consumption was most common inBelgium, where 87% of women and 67% of men reported consuming vegetables at least daily, and lowest in Malta(58% of women and 43% of men).Dietary patterns in children and adolescentsIn the 35 European countries included in the Health Behaviour of School-aged Children survey, only in Portugaland Denmark did more than half of the 11 year old children report eating fruit daily, while for 13 and 15 year olds,fewer than half consumed fruit daily in all countries surveyed (Table 5.4). The situation was similar for vegetableconsumption (Table 5.3).A greater proportion of girls than boys reported daily consumption of both fruits and of vegetables in all countries(Tables 5.3 and 5.4, Figures 5.3 and 5.4). Generally, daily vegetable consumption appeared to decrease slightly withage, from 32% of boys and 40% of girls at age 11, to 26% of boys and 35% of girls at age 15 (Tables 5.3 and 5.4).Trends in dietsFAO data show that over the past twenty years, fruit and vegetable intake has increased across much of Europe.Vegetable consumption has generally stayed relatively stable in Southern Europe (where intakes have historicallybeen very high, as much as double other regions of Europe) and Western Europe. Vegetable consumption inNorthern Europe, while still low, has increased gradually in recent decades, while consumption in Eastern Europeancountries has increased markedly since the mid-1990s, to now equal Europe-wide average consumption (Table 5.6and Figure 5.6).In line with worldwide trends, fruit consumption has increased substantially over the last twenty years in all Europeanregions except Western Europe (Table 5.7 and Figure 5.7). Fruit consumption in the countries of Northern Europehas increased most dramatically, now equalling the high consumption levels of Southern Europe.The amount of fat in the food supply has remained relatively stable in Europe overall in the last decade, generallyshowing small increases over time (Table 5.8). Several countries of Eastern Europe and the former Soviet Union,however, have experienced very large increases in the amount of fat available per person. In Armenia, for instance,there was an increase from 43 to 63 g of fat per person per day in the food supply between 2000 and 2007(Table 5.8). There were similar, but less pronounced trends in the percentage of energy from fat, suggesting thatlarge increases in fat availability have usually been accompanied by concurrent increases in overall dietary energyavailability in the national food supply.
  • 66. 64 European Cardiovascular Disease StatisticsTable 5.1 Frequency of vegetable consumption, adults, by sex, EuropeTwice or morea day(%)Once a day(%)Less than once aday but at least 4times a week (%)Less than 4 timesa week but at leastonce a week (%)Less than oncea week(%)Never(%)MenBelgium 10.2 72.5 6.0 9.8 0.9 0.7Bulgaria 12.5 46.7 11.1 22.6 6.9 0.3Czech Republic 15.5 37.6 15.5 24.8 4.2 2.5Cyprus 18.1 48.3 11.8 18.2 2.8 0.7Estonia * 47.7 27.2 21.9 * 3.2France 44.6 28.8 12.7 9.8 3.0 1.1Greece 15.9 46.4 17.4 15.1 4.2 1.0Hungary 13.2 35.2 19.6 25.4 5.7 0.9Latvia 12.2 46.8 9.4 27.9 3.2 0.5Malta 14.6 28.6 24.9 22.4 5.8 3.8Poland 13.1 46.1 16.1 20.6 3.9 0.3Romania 15.1 36.1 14.1 28.8 5.7 0.3Slovakia 10.4 33.8 18.5 29.5 7.0 0.8Slovenia 17.5 53.8 10.5 14.2 2.8 1.3Spain 12.5 43.5 15.0 23.4 3.7 1.8Turkey 12.2 47.6 14.2 19.3 5.8 1.0WomenBelgium 16.0 71.4 4.4 6.8 1.0 0.3Bulgaria 14.9 44.1 10.9 23.4 6.4 0.3Czech Republic 26.1 39.8 10.9 20.1 2.5 0.7Cyprus 21.9 47.8 10.8 16.5 2.1 0.9Estonia * 55.0 21.7 20.7 * 2.6France 53.5 26.6 9.6 7.5 2.2 0.7Greece 17.8 47.5 13.9 15.6 4.0 1.2Hungary 17.8 38.6 16.3 22.3 4.2 0.9Latvia 17.6 48.8 7.2 24.1 2.2 0.2Malta 22.9 34.6 16.7 19.0 4.4 2.4Poland 17.5 49.0 12.7 18.1 2.6 0.2Romania 18.9 37.5 11.5 27.0 5.0 0.2Slovakia 17.3 41.0 10.7 28.0 2.7 0.4Slovenia 22.2 56.4 6.6 12.0 1.5 1.3Spain 19.0 48.1 9.5 19.7 2.4 1.4Turkey 14.1 48.9 12.7 17.7 5.7 0.9Source: European Commission, Eurostat database, European Health Interview Survey http://epp.eurostat.ec.europa.eu/portal/page/portal/statistics/search_database Notes: Data are self-reported and were collected between 2006 and 2009. *Indicates data are not available.
  • 67. 65European Cardiovascular Disease StatisticsTable 5.2 Frequency of fruit consumption, adults, by sex, EuropeTwice or more aday (%)Once a day(%)Less than once aday but at least 4times a week (%)Less than 4 timesa week but at leastonce a week (%)Less than oncea week(%)Never (%)MenBelgium 21.8 36.1 20.6 7.1 10.2 4.3Bulgaria 7.3 32.1 18.0 28.5 12.9 1.2Czech Republic 20.6 36.7 10.8 25.0 5.8 1.2Cyprus 25.1 38.0 12.7 17.1 5.9 1.2Estonia * 47.7 29.1 17.7 * 5.5France 38.1 21.4 17.3 9.6 9.3 4.3Greece 19.8 39.2 18.5 12.4 7.4 2.8Hungary 25.8 35.5 14.3 18.5 5.4 0.6Latvia 12.8 39.5 12.7 29.6 4.8 0.7Malta 35.7 33.4 11.9 12.4 3.3 3.4Poland 17.0 38.3 19.4 16.9 7.8 0.7Romania 13.9 27.4 18.1 27.1 12.9 0.7Slovakia 15.4 38.4 13.4 26.1 6.1 0.6Slovenia 29.0 37.8 14.8 11.5 5.3 1.6Spain 33.1 32.9 11.1 14.2 5.1 3.7Turkey 9.9 40.8 18.5 19.5 9.6 1.7WomenBelgium 32.8 35.3 15.4 7.1 6.6 2.8Bulgaria 13.2 37.3 15.7 23.9 9.4 0.6Czech Republic 34.8 39.7 6.9 15.4 2.7 0.6Cyprus 29.5 38.8 11.1 14.6 4.6 1.3Estonia * 64.3 16.6 16.3 * 2.9Greece 22.1 40.2 16.6 11.5 7.4 2.3France 50.7 20.7 12.5 7.9 5.2 3.0Latvia 22.6 44.0 8.5 21.3 3.3 0.4Hungary 35.4 39.2 8.0 13.0 4.1 0.4Malta 51.8 26.4 7.9 9.1 2.6 2.2Poland 22.3 44.5 13.3 14.5 4.8 0.6Romania 19.4 29.8 15.4 25.1 9.9 0.4Slovakia 28.5 45.3 7.1 17.3 1.6 0.3Slovenia 44.7 37.6 7.5 7.8 1.9 0.6Spain 43.2 31.3 8.9 10.7 3.5 2.4Turkey 11.5 41.9 16.7 18.5 9.4 2.1Source: European Commission, Eurostat database, European Health Interview Survey http://epp.eurostat.ec.europa.eu/portal/page/portal/statistics/search_database Notes: Data are self-reported and were collected between 2006 and 2009. *Indicates data are not available.
  • 68. 66 European Cardiovascular Disease Statistics11 year olds 13 year olds 15 year oldsBoys (%) Girls (%) Boys (%) Girls (%) Boys (%) Girls (%)Armenia 27 31 26 33 33 37Austria 25 33 20 30 12 23Belgium (Flemish) 50 56 51 65 46 61Belgium (French) 45 45 45 53 46 59Croatia 27 31 21 23 19 23Czech Republic 30 43 27 34 21 36Denmark 41 52 37 41 33 49England 35 45 37 44 34 41Estonia 20 24 20 19 16 21Finland 26 30 19 26 14 35France 47 52 42 47 38 47Germany 21 32 18 31 17 33Greece 33 37 28 36 25 33Hungary 26 33 24 29 20 22Iceland 25 36 21 29 19 27Ireland 39 48 37 44 39 42Italy 20 27 22 27 20 26Latvia 27 31 21 27 16 25Lithuania 28 39 21 26 20 28Luxembourg 36 40 28 33 24 32TFYR Macedonia 38 44 30 41 27 38Netherlands 41 52 39 45 35 42Norway 31 37 27 28 23 33Poland 26 35 23 28 21 30Portugal 30 35 24 29 19 28Romania 35 44 28 36 21 32Russian Federation 33 35 33 30 28 29Scotland 35 43 33 38 31 37Slovakia 31 34 25 29 20 25Slovenia 27 32 20 28 17 26Spain 23 25 18 24 15 24Sweden 36 47 30 36 30 39Switzerland 42 50 38 46 34 45Turkey 26 36 27 36 21 31Ukraine 46 55 40 50 37 44Wales 29 33 30 36 30 34Table 5.3 Daily vegetable consumption, children aged 11, 13 and 15 years, by sex, 2009/10, EuropeSource: Currie C et al., eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).
  • 69. 67European Cardiovascular Disease Statistics11 year olds 13 year olds 15 year oldsBoys (%) Girls (%) Boys (%) Girls (%) Boys (%) Girls (%)Armenia 44 49 44 54 49 51Austria 43 55 36 49 23 37Belgium (Flemish) 31 38 26 35 17 29Belgium (French) 49 50 49 50 43 50Croatia 41 46 32 38 24 29Czech Republic 42 55 39 46 29 40Denmark 51 60 42 50 34 56England 34 46 37 43 33 40Estonia 29 32 25 29 17 27Finland 25 33 20 26 15 29France 43 44 36 43 31 38Germany 36 48 30 43 23 40Greece 37 41 34 37 26 28Hungary 36 50 33 41 25 27Iceland 35 46 28 38 23 35Ireland 41 46 32 38 28 35Italy 44 51 39 43 33 39Latvia 28 35 24 33 16 26Lithuania 26 34 21 28 18 29Luxembourg 41 47 34 40 32 40TFYR Macedonia 45 52 43 48 29 44Netherlands 38 46 27 35 20 30Norway 40 53 36 46 29 49Poland 33 45 25 36 20 25Portugal 44 57 44 46 34 39Romania 43 52 36 44 29 40Russian Federation 35 41 33 34 27 30Scotland 42 50 31 35 26 34Slovakia 45 47 33 38 27 31Slovenia 42 57 32 46 25 38Spain 43 46 36 39 31 35Sweden 31 41 23 27 22 26Switzerland 46 54 38 48 30 41Turkey 39 46 32 40 23 37Ukraine 36 44 32 41 24 29Wales 36 39 30 34 25 30Table 5.4 Daily fruit consumption, children aged 11, 13 and 15 years, by sex, 2009/10, EuropeSource: Currie C et al., eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).
  • 70. 68 European Cardiovascular Disease StatisticsFigure 5.3 Daily vegetable consumption, 15 year olds, by sex, 2009/10, EuropeFigure 5.4 Daily fruit consumption, 15 year olds, by sex, 2009/10, EuropeArmeniaBelgium(French)DenmarkNorwayEnglandTFYRMacedoniaPortugalItalyLuxembourgSwitzerlandFranceRomaniaCzechRepublicspainSloveniaIrelandGermanyScotlandTurkeyAustriaIcelandSlovakiaRussianFederationWalesGreeceCroatiaUkraineHungaryNetherlandsSwedenLithuaniaBelgium(Flemish)PolandFinlandEstoniaLatvia6050403020100Belgium(Flemish)Belgium(French)FranceDenmarkUkraineIrelandSwitzerlandEnglandNetherlandsArmeniaScotlandSwedenTFYRMacedoniaWalesGreeceRussianFederationCzechRepublicLuxembourgNorwayRomaniaPolandicelandItalySlovakiaSloveniaCroatiaHungaryLatviaSpainAustriaEstonia706050403020100%%n Boysn Girlsn Boysn Girls
  • 71. 69European Cardiovascular Disease StatisticsQuantity(kCalperpersonperday)1970-741975-791980-841985-891990-941995-9920002001200220032004200520062007Albania2,4282,6912,7402,6352,6982,8472,8322,8612,8652,8382,8492,9172,9152,880Armenia1,8832,0862,1332,1502,1512,2952,1502,2702,2002,280Austria3,2413,2243,3633,4233,5463,6723,8093,8173,7443,7143,7163,7013,7603,819Azerbaijan2,2072,1852,4062,4802,6482,7472,8953,0013,0272,961Belarus3,1613,2022,9893,0402,9692,7782,8982,9533,1583,146Belgium3,7163,7203,7283,7223,7263,7023,6753,694BosniaandHerzegovina2,5672,8602,7072,8732,8642,9443,0763,0913,0823,078Bulgaria3,4883,5553,6283,6503,0082,8052,8152,7732,7722,7742,7682,7682,7492,766Croatia2,3732,5262,5352,6772,7922,8852,9702,9922,9782,990Cyprus2,8992,6202,8983,0013,1663,2343,2073,1933,2033,1883,2013,2143,2023,181CzechRepublic3,0173,2313,0803,1663,2453,3133,3793,3663,3243,260Denmark3,1043,0143,0803,1903,2523,3573,3293,3653,4023,3783,4423,3723,4043,416Estonia2,6203,0213,0643,0453,0253,0423,0603,1073,1273,154Finland3,1543,0893,0473,0423,0933,1083,1613,1783,1543,1543,1853,2073,2173,221France3,2763,3263,4223,5203,5303,5563,6033,6443,6653,5993,5693,5863,5413,532Georgia1,7212,3542,3742,5292,6092,7092,8282,8552,7252,859Germany3,1713,2243,3653,4733,3513,3633,4333,4783,5213,4953,4963,5243,5193,547Greece3,2453,3373,3903,4963,5603,5603,6203,6723,6913,6803,7133,6973,6783,725Hungary3,3213,3923,5043,6633,5133,2923,3813,3943,4043,4013,4603,3873,4633,465Iceland2,9863,0743,2103,1853,0983,1023,1533,1393,2253,2633,3113,3093,3193,362Ireland3,4793,5193,5713,5943,5983,6463,7243,7223,5773,5913,5463,4333,5523,612Israel3,2013,1623,1993,3523,3843,4523,4943,5453,6343,5733,5573,5733,5193,527Italy3,4793,4383,4493,4933,5323,5893,7093,6913,6933,6753,7063,6753,6493,646Kazakhstan3,2472,8302,3972,5792,9222,9713,0333,2143,3723,490Kyrgyzstan2,4972,5062,3962,4492,4712,6122,7272,7442,6292,644Latvia3,2742,9302,7992,8983,0702,9382,9633,0543,0412,962Lithuania2,8763,0793,3493,3623,3423,3513,4423,4083,4133,436Luxembourg3,6133,6073,6993,6953,7213,7053,6703,681Malta3,1453,2903,1943,1783,2583,4873,4603,4593,4963,4863,5803,5713,5943,611Montenegro2,4432,447Netherlands3,1393,1323,1513,1623,2583,2693,2153,2353,2333,1813,2203,2323,2183,278Norway3,1383,2373,2923,2523,2483,3153,3633,3853,4423,4253,4583,4813,4213,464Poland3,4653,5783,3903,4443,3403,3333,4093,4103,4223,3843,3543,3773,3943,421Portugal3,0262,9392,8163,2073,4343,5203,5863,5723,5683,5573,5983,5913,5743,584RepublicofMoldova3,0612,6442,5442,7102,7972,7342,8362,9433,0082,771Romania3,0373,2273,0932,9622,9913,0913,1783,2763,3653,4253,4193,5143,5623,455RussianFederation2,9622,8782,8842,9983,0473,1083,1433,2263,2133,376Serbia2,7482,710Slovakia2,9172,9382,7962,8012,7862,7722,8152,8582,9042,893Slovenia2,8042,9783,0523,0583,0793,1063,1823,2263,2123,223Spain2,8383,0143,0573,1673,3233,3373,3783,3623,3733,3473,3453,3083,2323,272Sweden2,8792,9622,9952,9553,0383,0843,1003,1213,1133,1143,1043,1263,1123,110Switzerland3,4783,3693,4543,3973,3513,3143,4353,3733,4053,4123,3943,3693,4283,465Tajikistan2,0491,9401,9121,8531,9452,0472,0982,0812,1812,118TFYRMacedonia2,5012,7282,8062,7002,8072,8232,9712,8692,9743,105Turkey3,0573,1663,2523,5313,5863,4863,4813,4403,4303,4133,4343,4343,4953,517Turkmenistan2,6292,5602,6052,6092,6722,7272,7492,7612,7712,731Ukraine3,1972,8302,8972,9893,0483,0523,1913,2163,2513,224UnitedKingdom3,2103,1423,1193,2193,2343,3093,3703,4163,4343,4183,4513,4313,4373,458Uzbekistan2,6722,5832,3812,2732,2982,3592,3922,4772,5162,581Europe3,2703,3103,3303,3773,2583,2093,2493,2983,3273,3253,3523,3723,3693,406EuropeanUnion3,2233,2603,2893,3673,3513,3743,4333,4573,4763,4553,4653,4663,4553,466Table5.5Totalenergyconsumption,1970to2007,EuropeSource:FoodandAgricultureOrganizationoftheUnitedNations(FAO)FAOstat.orghttp://faostat3.fao.org/home/index.html Notes:Dietaryenergyconsumptionperpersonreferstotheamountoffood,expressedinkilocalories(kcal)perday,availableforeachindividualinthetotalpopulationduringthereferenceperiod.Caloriccontentisderivedbyapplyingtheappropriatefoodcompositionfactorstothequantitiesofthecommodities.Perpersonsuppliesarederivedfromthetotalamountoffoodavailableforhumanconsumptionbydividingtotalcaloriesbytotalpopulationactuallypartakingofthefoodsuppliesduringthereferenceperiod.However,perpersonfiguresrepresentonlytheaveragesupplyavailableforthepopulationasawholeanddonotnecessarilyindicatewhatisactuallyconsumedbyindividuals.Theactualfoodconsumptionmaybelowerthanthequantityshownasfoodavailabilitydependingonthemagnitudeofwastageandlossesoffoodinthehousehold,e.g.duringstorage,inpreparationandcooking,asplate-wasteorquantitiesfedtodomesticanimalsandpets,thrownorgivenaway.Where5-yearrangesaregiven,valuesareaveragesofavailabledataforthe5years.Blankcellsindicatedatawerenotavailable.
  • 72. 70 European Cardiovascular Disease StatisticsFigure 5.5a Total energy consumption, 1970 to 2007, by region, EuropeFigure 5.5b Total energy consumption, 2007, EuropeTotal energy consumption(kCal per capita per day)3,500 to 4,0003,250 to 3,5003,000 to 3,2502,750 to 3,000<2,750no dataSouthern EuropeEastern EuropeWestern EuropeNorthern EuropeEuropeWorld1970kCalperpersonperday20101975 1980 1985 1990 1995 2000 200540003800360034003200300028002600240022002000
  • 73. 71European Cardiovascular Disease StatisticsTable5.6Vegetableconsumption,1970to2007,EuropeQuantity(gperpersonperday)1970-741975-791980-841985-891990-941995-9920002001200220032004200520062007Albania208221230187346453460476498531523523528507Armenia334353329386400463589630753819Austria199221215186186221222255246249279255257260Azerbaijan155199271326375424430444446411Belarus214239257271285296326353372383Belgium320309334345334331326320BosniaandHerzegovina388495476482493490564559580539Bulgaria284325360368318377386312285370298175233203Croatia182273277309334285219197241252Cyprus376300293360391446435452449427416435422411CzechRepublic190211208205200194192216211203Denmark126142176218204221244246257268279266271266Estonia157174186214211268225222219263Finland5880101140166189194192197197205214203216France332314310336327293298293298296309285266268Georgia189236205219225227230249156164Germany170181194207209232246255252246255238244257Greece640669723715736745791772723789827717649657Hungary268275254260251271315312318315329307350301Iceland4556728899129140145145156167178197205Ireland125197199182212203200222222219203197216216Israel458423420463531647638611632605630531485487Italy433432467474477486531444408479534496427413Kazakhstan148169244315359400413438424427Kyrgyzstan162211353389293361361361405375Latvia222217194263257304290298301293Lithuania186225263255233277287315238263Luxembourg222241230246222233241235Malta275320342334341489542539534526605561597605Montenegro474446Netherlands220214197211214215257274230203271235255282Norway132134155157159168164186186203203200205214Poland271290303318334336348323271293326312309356Portugal354364327388434485482504449430504463405465RepublicofMoldova0000254238205279246268233285372186Romania289375474423331399408452446534545507528413RussianFederation202217241246252263277290298309Serbia339282Slovakia194231225211189203222205233244Slovenia163196205189203211227238238211Spain439476459484494434449424446424444430405424Sweden106120135157179192203211211216233233246241Switzerland222233262249249261274266268257260238241246Tajikistan281197170200225257279296329298TFYRMacedonia447477517542438435408386392430Turkey426468485527560624654627660649624646624611Turkmenistan257250279235326356356381386359Ukraine240255279287298315318334370326UnitedKingdom209209221228239233238260244252246263255249Uzbekistan379301296318323356339353430465Europe265278295300285295312307301315331323320318EuropeanUnion286298313325322324339329318331350331318320Source:FoodandAgricultureOrganizationoftheUnitedNations(FAO)FAOstat.orghttp://faostat3.fao.org/home/index.html Notes:Theactualfoodconsumptionmaybelowerthanthequantityshownasfoodavailabilitydependingonthemagnitudeofwastageandlossesoffoodinthehousehold,e.g.duringstorage,inpreparationandcooking,asplate-wasteorquantitiesfedtodomesticanimalsandpets,thrownorgivenaway.Where5-yearrangesaregiven,valuesareaveragesofavailabledataforthe5years.Blankcellsindicatedatawerenotavailable.
  • 74. 72 European Cardiovascular Disease StatisticsFigure 5.6a Vegetable consumption, 1970 to 2007, by region, EuropeFigure 5.6b Vegetable consumption, 2007, EuropeVegetable consumption(g per person per day)>550450 to 550350 to 450250 to 350<250no dataSouthern EuropeEastern EuropeWestern EuropeNorthern EuropeEuropeWorld1970gperday20101975 1980 1985 1990 1995 2000 20056005004003002001000
  • 75. 73European Cardiovascular Disease StatisticsQuantity(gperpersonperday)1970-741975-791980-841985-891990-941995-9920002001200220032004200520062007Albania11412412310986136205238249257260279296312Armenia143148131131118120126274252260Austria301320330360406299348356329383383392394427Azerbaijan226180164170159162120172192197Belarus111817193142112142145178178Belgium197192194205238189241230BosniaandHerzegovina6888828582164304287252252Bulgaria30224622921718015214013712012011290101159Croatia184235219227222246189200260277Cyprus518485613375336350359315304268312323315326CzechRepublic179204192172205219255219197192Denmark176180140197194221282255468397389392361307Estonia92175227216194194205189175214Finland158221225195212189225246227249260257244255France209176181205231239266263277263290312304318Georgia153165140129101148110151115115Germany289284278308310281315282282268246271233241Greece337290388406452407449465454419515471444449Hungary181180182177185167225203200203260230287233Iceland141162168208236228271293312290293312372402Ireland139140165182187178181219301367329301301383Israel569429492411408374372419427378435507381381Italy335302316329363341400367392367424419416394Kazakhstan32234436444466746893Kyrgyzstan4425748582779393123112Latvia105122162148164142142156151167Lithuania96146189186167159162181219249Luxembourg594580649646556509548520Malta165173183208253279304268266290296318263266Montenegro192194Netherlands226264289302394355329331392361350364397372Norway221234250278268279296296331339356359367389Poland7910810279102128129145131129134140140137Portugal198151135202274313323318318296339318323320RepublicofMoldova220208397192205145123129129110Romania83105145138148133142142137189194205192159RussianFederation1009199107123129145164178194Serbia274296Slovakia125183178153153162140178164178Slovenia180318433318405383446424370329Spain221230252291319286301304326304260293309241Sweden229235216234246244268277296312309298301320Switzerland373379362346325302249238238216208200200216Tajikistan73645538361444415249TFYRMacedonia206239315219189252279263293271Turkey342326344321318296301277279301271312293301Turkmenistan7976101112123134131123126115Ukraine9688827779999911010793UnitedKingdom167151168194212226230252268315318348378348Uzbekistan74829910410485101110145153Europe225216225243264252274266279277285296296285EuropeanUnion176177184194207204219216230233244252257252Table5.7Fruitconsumption,1970to2007,EuropeSource:FoodandAgricultureOrganizationoftheUnitedNations(FAO)FAOstat.orghttp://faostat3.fao.org/home/index.html Notes:Theactualfoodconsumptionmaybelowerthanthequantityshownasfoodavailabilitydependingonthemagnitudeofwastageandlossesoffoodinthehousehold,e.g.duringstorage,inpreparationandcooking,asplate-wasteorquantitiesfedtodomesticanimalsandpets,thrownorgivenaway.Where5-yearrangesaregiven,valuesareaveragesofavailabledataforthe5years.Blankcellsindicatedatawerenotavailable.
  • 76. 74 European Cardiovascular Disease StatisticsFigure 5.7a Fruit consumption, 1970 to 2007, by region, EuropeFigure 5.7b Fruit consumption, 2007, EuropeFruit consumption(g per person per day)>375300 to 375225 to 300150 to 225<150no data4003503002502001501005001970Southern EuropeEastern EuropeWestern EuropeNorthern EuropeEuropeWorldgperday20101975 1980 1985 1990 1995 2000 2005
  • 77. 75European Cardiovascular Disease StatisticsSource:WHOEurope.HealthforAllDatabase(HFA-DB)http://data.euro.who.int/hfadb/ Notes:Blankcellsindicatedatawerenotavailable. Valuesareaveragesoftheyearslistedincolumnheaders.NodataavilableforAndorra,MonacoorSanMarino. Fatavailableperpersonperday(ing)Percentageoftotalenergyavailablefromfat1970-741975-791980-841985-891990-941995-992000-042005-071970-741975-791980-841985-891990-941995-992000-042005-07Albania49586160728285921820202124262728Armenia3139475915171924Austria1281351501531591631631623638404040403939Azerbaijan3538445214151516Belarus97999710928283032Belgium1631633940BosniaandHerzegovina3954647314172021Bulgaria88101110120989194982326273029293032Croatia66718810725252932Cyprus105951081211251281311443333343636363740CzechRepublic11011211413433313236Denmark1361281291301341341351353938383737363636Estonia8395959029282826Finland1271311301261251281261283638383736373636France1281381491581631651681633537394042424241Georgia3142606716162121Germany1281301371411431451431423636373638393736Greece1161221271361421461431503233343536373536Hungary1141241351481451341421483133353637373839Iceland1201261361291201201361443637383735353839Ireland1261281391391301351351313233353533333333Israel1041071101161161221371452931313131323537Italy1151181291441471511571583031343737383839Kazakhstan8067819922212627Kyrgyzstan6352515723191819Latvia909310511925283235Lithuania80799810625232628Luxembourg1581603939Malta961081091121091131111142729313230292929Montenegro6724Netherlands1301281331331361421371363737383838393838Norway1451491451381361351411394241403838373736Poland1081181091161111111131132830293030303030Portugal8289881031221281361382427282932333435RepublicofMoldova6350526319171720Romania789591888987971092326272727252628RussianFederation8278819125242425Serbia11939Slovakia10310510210932323334Slovenia10110311612133313434Spain931061181301441481511503032353739404041Sweden1151211231231241271231233637373737373536Switzerland1501521571551511471511543941414141404041Tajikistan5446496024212226TFYRMacedonia64769311423253034Turkey727677879092941022122212223242526Turkmenistan7172676824252222Ukraine8472799124232325UnitedKingdom1391331341371391401381443938393839383638Uzbekistan7371656924252524Europe343535353536EuropeanUnion353637373737Table5.8Totalfatconsumptionperpersonperdayandpercentageoftotalenergyavailablefromfat,1970to2007,Europe
  • 78. 76 European Cardiovascular Disease StatisticsFigure 5.8 Percentage of energy available from fat, 2001, EuropePercentage of total energyavailable from fat40 to 4535 to 4030 to 3525 to 30<25no data
  • 79. 77European Cardiovascular Disease Statistics6. Physical activityParticipation in regular physical activity and/or aerobic exercise training is associated with a decrease in cardiovascularmortality1.A lack of physical activity also increases the risk of other chronic diseases and may impact on quality of life.In 2010, the World Health Organization published its most recent recommendations on physical activity and health.For children and adolescents, the WHO recommended participation in at least 60 minutes of moderate to vigorousintensity physical activity daily. For adults, the recommendation is for at least 2.5 hours of moderate physical activityor 75 minutes of vigorous physical activity per week, with additional health benefits to participation in higher levelsof intensity, longer duration of activity and specific muscle-strengthening activities2. The 2012 European Guidelineson cardiovascular disease prevention in clinical practice also recommend at least 2.5 hours of at least moderateintensity activity, or 1 to 2.5 hours of vigorous intensity exercise1.Physical activity has an important role in many aspects of health, including most of the major non-communicablediseases which make the largest contribution to ill health worldwide3. Recent estimates have suggested that physicalinactivity may be responsible for up to 9% of all premature mortality worldwide and causes 6% of the total burdenof disease from coronary heart disease3.Prevalence of physical activity and inactivityThe most recent multi-country data on physical activity among adults was the 2009 Eurobarometer survey onphysical activity, which asked respondents to indicate how often they exercised or played sport and how often theyparticipated in non-sport physical activities including active transport and incidental leisure time physical activity4.Participation in exercise or sport was relatively low across the EU, with 39% of adults overall reporting that they neverparticipate in these activities and 21% participating three times per week or more. More than half of respondentsreported never exercising in five countries (Greece, Bulgaria, Portugal, Italy and Hungary). The highest rates ofregular participation in exercise were in the Scandinavian countries and Ireland (Table 6.1 and Figure 6.1).Participation in less formal physical activity was also quite low across the EU. When asked ‘How often do you engagein a physical activity outside sport such as cycling or walking from a place to another, dancing, gardening…?’, 14%of adults in the EU responded ‘Never’ (Table 6.2). Those in Southern Europe tended to be less likely to participatein informal physical activity and more than a quarter of respondents in Cyprus, Greece, Italy, Portugal and Romaniareported never doing any physical activity. Informal physical activity was highest in the Netherlands, Sweden, Latvia,Denmark and Slovenia (Table 6.2 and Figure 6.2).There were some differences between men and women in sport participation in the EU, with 43% of men, but just37% of women reporting participating in sports at least once per week, and 49% of men and 57% of women reportingparticipation less than once per month. Participation in non-sport physical activity (walking, cycling, gardening etc.),however, showed no appreciable gender difference, with 27% of both men and women reporting regularly doing thissort of physical activity and 34% reporting rarely or never participating4.
  • 80. 78 European Cardiovascular Disease StatisticsPhysical activity and sedentary behaviours among childrenAmong children and adolescents in Europe, levels of physical activity vary widely by age, gender and country (Table6.4, Figures 6.4a to 6.4c). In general, physical activity appears to decrease between 11 and 15 years of age, and isgenerally higher among boys than girls.In many countries, particularly among 13 and 15 year olds, more than double the percentage of boys compared to girlsparticipate in more than one hour of moderate to vigorous physical activity (MVPA) per day (Figures 6.4b and 6.4c).The proportion of children watching two or more hours of television per day, an indicator of sedentary lifestyles, showsmuch less difference by gender and age, however wide variation between countries is evident (Table 6.5 and Figures6.5a to 6.5c). The lowest rates of excess television viewing were in Switzerland, where between 27% (11 year oldchildren) and 42% (15 year olds) exceeded 2 hours of television per day. In a large number of countries, however,more than two-thirds of all 11, 13 and 15 year olds reported that they watch more than 2 hours of television per dayon weekdays.1 Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur HeartJ 2012;33(13):1635-701.2 World Health Organization. Global recommendations on physical activity for health. http://www.who.int/dietphysicalactivity/publications/9789241599979/en/index.html. Geneva: WHO, 2010.3 Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis ofburden of disease and life expectancy. Lancet 2012;380(9838):219-29.4 European Commission. Special Eurobarometer 332 ‘Physical Activity’ / Wave 72.3 – TNS Opinion & Social. http://ec.europa.eu/public_opinion/index_en.htm.Brussels, Belgium, 2010.
  • 81. 79European Cardiovascular Disease Statistics5 times per weekor more (%)3 to 4 timesper week (%)1 to 2 timesper week (%)1 to 3 timesper month (%)Less often (%) Never (%)Austria 5 11 22 12 21 29Belgium 15 10 24 7 16 28Bulgaria 3 2 8 5 23 58Cyprus 16 13 12 2 10 46Czech Republic 5 4 19 10 25 37Denmark 15 18 31 7 11 18Estonia 7 9 18 8 17 41Finland 17 27 27 9 13 7France 13 12 23 8 10 34Germany 9 15 25 6 14 31Greece 3 7 8 3 12 67Hungary 5 7 11 6 18 53Ireland 23 18 17 4 11 26Italy 3 9 17 4 12 55Latvia 8 6 13 8 21 44Lithuania 14 8 14 4 16 44Luxembourg 12 16 23 5 12 32Malta 17 15 16 4 10 38Netherlands 5 16 35 8 8 28Poland 6 7 13 6 18 48Portugal 9 10 14 4 7 55Romania 8 6 7 8 20 49Slovakia 5 8 17 10 25 35Slovenia 13 15 24 7 18 23Spain 12 15 12 4 15 42Sweden 22 22 28 8 13 6United Kingdom 14 14 17 7 15 33EU 9 12 19 6 15 39Table 6.1 Frequency of exercising or playing sport, adults, 2009, EUSource: European Commission, Eurobarometer 72.3 Special Eurobarometer 334 http://ec.europa.eu/public_opinion/archives/ebs/ebs_334_en.pdfNotes: Some percentages do not add to 100% due to a small proportion of ‘don’t know’ responses in some countries.Question: ‘How often do you exercise or play sport?’
  • 82. 80 European Cardiovascular Disease Statistics5 times perweek or more (%)3 to 4 timesper week (%)1 to 2 timesper week (%)1 to 3 timesper month (%)Lessoften (%)Never(%)Austria 15 21 33 14 12 5Belgium 21 14 22 10 14 19Bulgaria 25 17 23 8 19 3Cyprus 20 14 17 4 13 32Czech Republic 17 13 21 13 23 13Denmark 43 18 24 7 4 4Estonia 40 16 21 7 8 8Finland 29 23 26 9 9 4France 33 17 25 9 6 10Germany 28 24 26 8 8 6Greece 15 14 19 10 15 27Hungary 41 15 16 6 11 11Ireland 33 22 19 5 8 12Italy 7 9 21 14 16 33Latvia 44 17 15 7 7 9Lithuania 39 15 13 6 13 14Luxembourg 37 17 22 7 9 8Malta 32 13 17 4 9 24Netherlands 42 20 22 7 4 5Poland 26 15 19 9 10 17Portugal 17 15 16 5 10 36Romania 19 11 13 8 18 27Slovakia 27 18 22 9 16 8Slovenia 39 21 20 5 10 5Spain 33 22 16 7 12 10Sweden 40 21 23 7 7 2United Kingdom 37 15 21 7 9 11EU 27 17 21 9 11 14Table 6.2 Frequency of participating in informal physical activity, adults, 2009, EUSource: European Commission, Eurobarometer 72.3 Special Eurobarometer 334 http://ec.europa.eu/public_opinion/archives/ebs/ebs_334_en.pdfNotes: Some percentages do not add to 100% due to a small proportion of ‘don’t know’ responses in some countries.Question: ‘How often do you engage in a physical activity outside sport such as cycling or walking from a place to another, dancing, gardening…?’
  • 83. 81European Cardiovascular Disease StatisticsFigure 6.1 Prevalence of adults who do no moderate intensity physical activity in a typical week, 2009, EUFigure 6.2 Prevalence of adults who participate in physical activity (excluding sport) at least 5 times per week, 2009, EUItalyGreeceCzechrepublicportugalRomaniaCyprusBelgiumBulgariapolandSlovakiaGermanyFinlandMaltaIrelandSpainfranceLuxembourgUnitedKingdomLithuaniaSloveniaEstoniaSwedenHungaryNetherlandsDenmarkLatviaEUSwedenFinlandDenarkSloveniaIrelandBelgiumNetherlandsaustriaGermanyLuxembourgUnitedKingdomFranceSlovakiaCzechRepublicMaltaEstoniaSpainLatviaLithuaniaCyprusPolandRomaniaHungaryItalyPortugalBulgariaGreeceEU50454035302520151050%80706050403020100%
  • 84. 82 European Cardiovascular Disease StatisticsMale (%) Female (%) Total (%)Austria 30 39 35Belgium 40 45 43Bosnia and Herzegovina 30 37 34Bulgaria 25 29 27Croatia 26 21 24Cyprus 48 63 55Czech Republic 28 22 25Denmark 35 35 35Estonia 16 19 17Finland 41 35 38France 28 37 33Georgia 21 24 22Germany 28 29 28Greece 17 15 16Hungary 26 26 26Ireland 48 59 53Italy 50 60 55Kazakhstan 32 31 32Latvia 28 36 32Lithuania 20 25 23Luxembourg 50 46 48Malta 71 73 72Netherlands 21 15 18Norway 43 45 44Poland 24 32 28Portugal 48 54 51Romania 31 46 39Russian Federation 23 19 21Serbia 63 73 68Slovakia 23 21 22Slovenia 27 34 30Spain 47 53 50Sweden 44 44 44Turkey 50 63 56Ukraine 20 16 18United Kingdom 58 69 63Table 6.3 Prevalence of insufficently active adults, aged 15 years and older, by sex, 2008, EuropeSource: WHO Global Health Observatory http://www.who.int/gho/database/en/ Notes: Percent of defined population attaining less than 5 times 30 minutes of moderate activity per week, or less than 3 times 20 minutes of vigorous activity per week, or equivalent. Based on self-reported physical activity captured using the GPAQ (Global Physical Activity Questionnaire), the IPAQ (International Physical Activity Questionnaire) or a similar questionnaire (agestandardized estimates).
  • 85. 83European Cardiovascular Disease StatisticsBoys 2005/06 2009/1011 year olds (%) 13 year olds (%) 15 year olds (%) 11 year olds (%) 13 year olds (%) 15 year olds (%)Armenia 34 27 29Austria 29 27 13 40 34 20Belgium (Flemish) 20 21 17 25 18 17Belgium (French) 31 27 24 30 20 15Bulgaria 39 32 24Croatia 36 31 20 31 31 22Czech Republic 25 28 27 28 30 25Denmark 31 23 20 16 12 14England 27 23 18 33 27 25Estonia 24 22 18 19 17 13Finland 48 24 15 38 32 17France 24 20 14 21 17 14Germany 25 19 16 25 21 13Greece 25 21 16 21 21 18Hungary 28 29 19 30 25 21Iceland 29 24 16 25 20 15Ireland 51 39 27 43 36 28Israel 30 24 13Italy 23 23 16 10 10 12Latvia 30 27 26 26 25 22Lithuania 27 22 19 23 18 18Luxembourg 18 19 19 32 32 24Malta 27 20 19Netherlands 30 24 18 24 24 19Norway 27 15 13 27 18 12Poland 24 21 21 31 22 23Portugal 30 21 15 23 19 14Romania 29 24 16 32 28 16Russian Federation 20 18 12 17 18 13Scotland 40 28 21 24 19 13Slovakia 51 51 46 30 30 27Slovenia 25 22 19 31 25 20Spain 32 21 19 41 27 25Sweden 23 21 11 19 14 13Switzerland 19 16 13 20 16 12TFYR Macedonia 29 30 21 32 28 22Turkey 29 22 16 27 23 18Ukraine 33 32 21 34 29 24Wales 35 27 21 29 23 21Table 6.4 Prevalence of children who participate in at least one hour of moderate to vigorous physical activity per day, by sex, 2005/06 and 2009/10, Europe
  • 86. 84 European Cardiovascular Disease StatisticsGirls 2005/06 2009/1011 year olds (%) 13 year olds (%) 15 year olds (%) 11 year olds (%) 13 year olds (%) 15 year olds (%)Armenia 21 17 14Austria 23 14 10 30 17 9Belgium (Flemish) 15 10 11 15 11 10Belgium (French) 23 20 21 18 12 9Bulgaria 26 19 16Croatia 26 15 10 19 15 8Czech Republic 19 17 16 23 19 14Denmark 26 18 16 10 10 8England 18 14 9 20 15 12Estonia 21 13 9 16 11 9Finland 37 15 9 25 17 10France 12 5 5 9 6 5Germany 20 13 10 20 14 9Greece 16 12 7 12 8 5Hungary 19 13 11 22 11 9Iceland 23 14 9 17 11 9Ireland 38 23 13 31 20 12Israel 15 12 6Italy 13 9 7 7 5 5Latvia 23 17 16 18 18 13Lithuania 20 13 13 17 12 11Luxembourg 13 11 11 18 16 13Malta 18 14 13Netherlands 20 20 15 19 15 13Norway 17 14 7 17 6 9Poland 19 12 10 23 14 10Portugal 12 8 5 14 7 6Romania 16 11 6 20 13 7Russian Federation 12 10 7 11 9 7Scotland 25 15 9 16 10 8Slovakia 43 35 29 22 15 12Slovenia 21 10 9 20 15 10Spain 24 14 12 26 15 8Sweden 20 14 10 17 11 9Switzerland 11 10 10 11 8 6TFYR Macedonia 26 18 11 28 15 13Turkey 21 17 12 19 12 9Ukraine 22 16 11 25 17 9Wales 21 12 9 19 13 9Source: Currie C et al., eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6) and previous editions.Table 6.4 continued...
  • 87. 85European Cardiovascular Disease StatisticsFigure 6.4a Prevalence of 11 year olds participating in 1 hour or more of MVPA per day, by sex, 2009Figure 6.4b Prevalence of 13 year olds participating in 1 hour or more of MVPA per day, by sex, 2009Figure 6.4c Prevalence of 15 year olds participating in 1 hour or more of MVPA per day, by sex, 2009ItalyDenmarkRussianFederationEstoniaSwedenSwitzerlandFranceGreeceLithuaniaPortugalNetherlandsScotlandBelgium(Flemish)GermanyIcelandLatviaNorwayTurkeyCzechRepublicWalesBelgium(French)HungarySlovakiaCroatiaPolandSloveniaLuxembourgRomaniaTFYRMacedoniaEnglandArmeniaUkraineFinlandAustriaSpainIrelandn Boysn Girls454035302520151050%ItalyDenmarkFranceNorwaySwitzerlandSwedenPortugalRusianFederationEstoniaBelgium(Flemish)GreeceScotlandLithuaniaIcelandBelgium(French)GermanyTurkeyHungaryPolandWalesNetherlandsSloveniaRomaniaEnglandSpainLatviaTFYRMacedoniaArmeniaSlovakiaCroatiaUkraineLuxembourgCzechRepublicFinlandAustriaIreland35302520151050%n Boysn GirlsItalySwitzerlandFrancePortugalRussianFederationNorwayScotlandDenmarkEstoniaGermanySwedenGreeceRomaniaBelgium(Franch)IcelandBelgium(Flemish)FinlandTurkeyAustriaLithuaniaCroatiaHangarySloveniaWalesNetherlandsPolandSpainUkraineLatviaTFYRMacedoniaEnglandLuxembourgCzechRepublicSlovakiaIrelandArmenia302520151050%n Boysn Girls
  • 88. 86 European Cardiovascular Disease StatisticsBoys 2005/06 2009/1011 year olds (%) 13 year olds (%) 15 year olds (%) 11 year olds (%) 13 year olds (%) 15 year olds (%)Armenia 66 74 79Austria 55 65 70 46 61 63Belgium (Flemish) 64 69 69 58 61 65Belgium (French) 49 60 60 43 55 58Bulgaria 80 82 78Croatia 74 80 76 69 76 71Czech Republic 70 76 71 61 72 63Denmark 64 73 69 64 65 69England 58 66 63 64 74 71Estonia 74 80 71 69 74 66Finland 55 62 62 61 60 55France 53 63 61 49 59 54Germany 50 66 67 44 65 68Greece 68 77 75 69 73 71Hungary 57 68 64 50 64 64Iceland 62 72 62 49 60 52Ireland 63 66 65 55 56 60Israel 72 75 78Italy 56 66 69 48 59 62Latvia 77 82 75 70 74 68Lithuania 75 82 77 69 72 72Luxembourg 45 55 59 42 56 63Netherlands 65 76 79 69 71 71Norway 50 59 66 47 59 64Poland 66 74 69 64 68 67Portugal 68 76 77 61 72 67Romania 79 81 82 65 77 69Russian Federation 71 74 71 67 67 63Scotland 69 73 74 61 66 69Slovakia 76 84 85 71 75 73Slovenia 65 70 63 63 67 54Spain 53 64 67 48 60 65Sweden 55 67 61 60 66 63Switzerland 31 39 51 29 35 45TFYR Macedonia 55 67 66 52 63 61Turkey 63 63 70 60 67 68Ukraine 77 83 77 69 76 69Wales 62 76 75 62 71 73Table 6.5 Prevalence of children who watch television for two or more hours per day on weekdays, by sex, 2005/06 and 2009/10, Europe
  • 89. 87European Cardiovascular Disease StatisticsGirls 2005/06 2009/1011 year olds (%) 13 year olds (%) 15 year olds (%) 11 year olds (%) 13 year olds (%) 15 year olds (%)Armenia 61 75 82Austria 42 65 62 37 55 60Belgium (Flemish) 62 70 67 55 64 65Belgium (French) 42 54 51 40 49 54Bulgaria 81 86 84Croatia 70 83 70 69 77 67Czech Republic 65 71 67 56 69 59Denmark 57 70 69 58 68 67England 51 57 61 60 68 64Estonia 75 79 72 68 75 63Finland 55 58 57 58 59 50France 50 58 57 42 55 48Germany 42 64 68 43 59 64Greece 70 82 77 64 74 70Hungary 50 67 59 48 65 57Iceland 50 64 61 41 52 46Ireland 56 63 61 48 52 56Israel 78 85 74Italy 52 66 65 42 60 61Latvia 73 78 70 65 73 68Lithuania 79 83 78 69 75 70Luxembourg 37 50 53 40 52 58Netherlands 63 70 76 64 69 69Norway 48 69 72 42 61 66Poland 63 73 64 61 67 65Portugal 67 82 78 60 75 64Romania 73 80 74 64 75 68Russian Federation 73 76 73 69 71 65Scotland 64 69 69 58 67 68Slovakia 74 82 83 66 78 72Slovenia 63 68 48 55 64 46Spain 45 62 69 45 54 63Sweden 48 66 59 56 67 60Switzerland 29 38 42 24 34 38TFYR Macedonia 51 70 66 47 70 65Turkey 59 62 68 53 65 67Ukraine 77 83 79 71 76 69Wales 66 72 72 56 69 67Source: Currie C et al., eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6) and previous editions. Table 6.5 continued...
  • 90. 88 European Cardiovascular Disease StatisticsFigure 6.5a Prevalence of 11 year olds watching 2 or more hours of television per day, by sex, 2009, EuropeFigure 6.5b Prevalence of 13 year olds watching 2 or more hours of television per day, by sex, 2009, EuropeFigure 6.5c Prevalence of 15 year olds watching 2 or more hours of television per day, by sex, 2009, Europe9080706050403020100SwitzerlandLuxembourgAustriaBelgium(Franch)GermanyNorwayicelandItalyFranceSpainHungaryTFYRMacedoniairelandbelgium(Flemish)TurkeySwedenCzechRepublicSloveniaWalesFinlandScotlandPortugalDenmarkEnglandPolandArmeniaRomaniaGreeceNetherlandsLatviaRussianFederationEstoniaSlovakiaCroatiaLithuaniaUkraine%n Boysn GirlsSwitzerlandBelgium(Franch)IrelandLuxembourgIcelandFranceSpainAustriaFinlandItalyNorwayGermanyBelgium(Flemish)HungarySloveniaturkeySwedenTFYRMacedoniaDenmarkScoltlandPolandRussianFederationWalesNetherlandsCzechRepublicEnglandPortugalLatviaGreeceLthuaniaEstoniaArmeniaRomaniaUkraineCroatiaSlovakian Boysn Girls9080706050403020100%SwitzerlandIcelandSloveniaFranceFinlandBelgium(French)IrelandLuxembourgHungaryCzechRepublicAustriaItalySwedenTFYRMacedoniaSpainRussianFederationEstoniaNorwayBelgium(Flemish)PortugalGermanyPolandTurkeyEnglandDenmarkLatviaScotlandRomaniaUkraineCroatiaWalesNetherlandsGreeceLithuaniaSlovakiaArmenian Boysn Girls9080706050403020100%
  • 91. 89European Cardiovascular Disease Statistics7. AlcoholMortality and morbidity attributable to alcohol consumptionWhile moderate alcohol consumption (one or two drinks a day) reduces the risk of CVD, at high levels of intake– particularly when consumed in episodes of very heavy consumption – the risk of CVD is increased. Alcoholconsumption also increases the risk of liver cirrhosis, injuries and some forms of cancer. On balance, the positiveeffects of alcohol on the health of populations beyond very low levels of consumption are generally outweighed byits negative effects1.Levels of alcohol consumption and recent trendsLevels of recorded alcohol consumption vary considerably across Europe2. Data from 2007, the most recentcomparable year, show that the amount of recorded alcohol consumption ranges from less than half a litre peradult per year in Tajikistan and San Marino, to over 15 litres per adult in the Czech Republic, Estonia, Luxembourgand the Republic of Moldova. There is a wide regional spread of countries with an above average level of alcoholconsumption, including Northern (Estonia), Western (Ireland and Germany), Southern (France and Spain), Central(Czech Republic and Hungary) and Eastern (Republic of Moldova) countries (Table 7.1, Figure 7.1a).There has been a steady decrease in levels of alcohol consumption in several Southern and Western Europeancountries, particularly France, Italy and Luxembourg, which all recorded decreases in consumption of more than1.5 litres of pure alcohol per adult between 2000 and 2007. In a number of countries in Eastern Europe, however,there were very large increases in consumption over the same period of time. Estonia, notably, recorded a doublingof per capita consumption between 2000 and 2007, although more recent data show that the levels have begun todecline since 2007 (Table 7.1 and Figure 7.1b).1 Nichols M, Scarborough P, Allender S, Rayner M. What is the optimal level of population alcohol consumption for chronic disease prevention in England? Model-ling the impact of changes in average consumption levels. BMJ Open 2012;2(3).2 Levels of actual alcohol consumption may vary less than levels of recorded consumption because there is probably much unrecorded consumption in countrieswith low recorded rates. For example, estimates from WHO suggest that unrecorded alcohol consumption is twice that of recorded consumption in Latvia andis four times that of recorded consumption in TFYR Macedonia. For more details see: Rehn N, with Room R and Edwards G (2001) Alcohol in the EuropeanRegion – consumption, harm and policies. www.who.dk/document/E76240.pdf
  • 92. 90 European Cardiovascular Disease StatisticsRecordedconsumption(litresofpurealcohol)19701975198019851990199520002001200220032004200520062007200820092010Albania1.81.41.51.62.02.94.04.53.94.34.44.95.05.2Andorra17.015.913.612.811.8Armenia3.23.02.52.53.13.33.43.63.63.73.63.5Austria13.914.513.812.114.914.213.712.812.912.612.512.712.812.912.412.2Azerbaijan2.51.21.41.41.41.31.31.31.41.5Belarus13.211.47.78.910.810.712.111.111.211.012.513.8Belgium11.713.013.512.912.111.110.310.39.99.99.89.79.711.210.8BosniaandHerzegovina11.98.59.08.68.59.89.510.311.511.413.5Bulgaria8.710.511.211.211.79.79.710.710.210.610.610.110.010.210.510.0Croatia15.910.912.713.113.212.411.810.510.711.410.510.1Cyprus4.84.76.27.99.59.68.28.88.89.910.19.38.99.38.78.4CzechRepublic10.711.812.512.311.212.515.315.415.515.615.215.415.315.515.315.0Denmark8.711.711.712.111.612.112.712.511.912.311.711.911.711.311.110.7Estonia9.98.37.99.210.411.613.213.815.016.014.313.212.5Finland5.88.07.98.09.58.38.69.09.29.39.910.010.110.510.310.0France21.621.219.216.815.814.213.613.913.813.513.213.211.811.612.312.3Georgia4.83.44.13.63.94.04.15.05.76.96.16.0Germany13.314.414.012.912.613.412.912.512.311.911.812.212.412.112.011.7Greece7.17.013.211.310.710.58.58.68.18.78.99.28.89.09.38.2Greenland13.919.212.018.510.39.710.711.611.711.711.311.7Hungary11.512.716.916.716.212.612.313.213.313.313.313.213.412.811.811.5Iceland3.84.04.34.45.24.86.16.36.56.56.77.17.27.5Ireland8.611.210.59.710.411.913.713.814.213.413.513.413.413.412.411.311.9Israel4.34.92.82.61.81.52.72.62.52.32.22.42.32.4Italy19.718.316.713.211.09.69.39.18.68.68.38.07.87.87.46.9Kazakhstan11.94.95.65.45.65.96.16.46.67.0Kyrgyzstan7.14.51.74.14.14.64.54.54.64.75.5Latvia13.010.97.39.98.88.39.010.09.511.011.712.313.2Lithuania11.67.16.19.910.211.011.312.113.213.813.213.112.212.6Luxembourg12.913.513.714.714.714.317.916.717.017.417.717.716.316.216.515.3Malta6.96.95.85.85.96.36.36.36.77.67.67.7Montenegro6.87.37.48.48.3Netherlands7.811.911.310.69.99.810.110.09.79.69.69.59.49.39.39.2Norway4.75.55.95.25.04.85.75.55.96.06.26.46.56.66.86.7Poland7.69.611.59.48.38.18.47.78.09.19.29.09.710.310.710.1Portugal14.518.514.917.016.114.712.312.212.012.912.312.211.911.4RepublicofMoldova12.016.614.213.914.311.211.313.716.721.120.6Romania8.510.210.910.110.911.310.29.810.310.911.79.912.713.513.912.7RussianFederation8.97.87.97.47.111.29.810.010.311.310.911.011.111.511.5SanMarino0.10.20.00.10.20.10.00.10.0Serbia7.47.57.07.37.47.37.97.97.87.3Slovakia11.513.413.712.712.410.311.110.710.89.910.010.810.311.511.811.4Slovenia15.113.813.49.910.211.111.512.313.514.312.812.711.9Spain16.119.518.515.013.611.411.111.19.910.210.410.010.012.212.011.4Sweden7.27.66.76.16.46.26.06.06.97.06.56.66.86.96.97.4Switzerland14.013.513.413.513.011.511.311.110.910.910.610.210.310.510.310.2Tajikistan1.80.40.90.60.40.40.40.40.40.3TFYRMacedonia6.65.04.53.85.45.65.84.34.34.23.7Turkey0.91.31.21.00.81.51.51.51.51.41.41.31.31.31.31.3Turkmenistan2.02.92.32.32.32.32.32.32.3Ukraine7.88.06.65.73.77.17.48.48.07.88.59.19.8UnitedKingdom6.78.99.68.910.09.710.810.611.111.511.711.811.511.411.510.7Uzbekistan1.91.61.51.51.51.61.8EuropeanUnion14.012.411.811.211.010.911.011.011.110.911.0Europe11.910.710.010.310.210.210.410.610.610.510.7Table7.1Alcoholconsumption,adultsaged15yearsandover,1970to2010,EuropeSource:EuropeanInformationSystemonAlcoholandHealth(Individualcountryestimates)andWHOHFA-DB(EUandEuropeaggregatedestimates)http://apps.who.int/ghodata/?theme=GISAH&region=euro-http://data.euro.who.int/hfadb/ Notes:Recordedalcoholconsumptionpercapitaisdefinedastherecordedamountofalcoholconsumedperadult(15+years)overacalendaryearinacountry,inlitresofpurealcohol.Theindicatoronlytakesintoaccounttheconsumptionwhichisrecordedfromproduction,import,export,andsalesdata,oftenviataxation.Blankcellsindicatethatdatawerenotavailable.
  • 93. 91European Cardiovascular Disease StatisticsFigure 7.1a Alcohol consumption, adults aged 15 years and over, 2007, EuropeFigure 7.1b Alcohol consumption, adults aged 15 years and over, 1970 to 2010, selected countriesSanMarinoTajikistanTurkeyAzerbaijanTurkmenistanIsraelArmeniaTFYRMacedoniaAlbaniaKyrgyzstanNorwayGeorgiaSwedenKazakhstanMontenegroIcelandMaltaItalySerbiaGreeceCyprusNetherlandsUkraineBulgariaPolandFinlandSwitzerlandEuropeEUBelgiumDenmarkUnitedKingdomBosniaandHerzegovinaCroatiaPortugalRussianFederationSlovakiaFranceGreenlandGermanySpainLatviaHungarySloveniaAustriaLithuaniaIrelandRomaniaBelarusCzechRepublicEstoniaLuxembourgRepublicofMoldova2520151050Litres/person/year1970AlbaniaCroatiaIrelandItalyRepublic of MoldovaSwedenUkraine1975 1980 1985 1990 1995 2000 2005 20102520151050Litres/person/year
  • 94. 92 European Cardiovascular Disease Statistics8. Blood pressureRisk of CVD is directly related to both systolic and diastolic blood pressure levels1. Lifestyle changes - particularlyweight loss, an increase in physical activity, and a reduction in salt and alcohol intake – and drug treatment caneffectively lower blood pressure.The World Health Report 2002 estimates that around 11% of all disease burden in developed countries is caused byraised blood pressure and that over 50% of CHD and almost 75% of stroke in developed countries is due to systolicblood pressure levels in excess of the theoretical minimum (115 mmHg)2.The INTERHEART case-control study estimated that 22% of heart attacks in Western Europe and 25% of heartattacks in Central and Eastern Europe are due to a history of high blood pressure (hypertension) and that thosewith a history of hypertension are at just under twice the risk of a heart attack compared to those with no history ofhypertension3.The WHO Global Health Observatory provides national estimates of both hypertension prevalence and mean systolicblood pressure for men and women. Using as the definition of hypertension a systolic blood pressure greaterthan 140 or a diastolic blood pressure greater than 90, or blood pressure lowering medication use, there were noEuropean countries in 2008 with age-standardized prevalence of hypertension below one third of the population.WHO estimates of systolic blood pressure for the European region for 2008 show that among men aged 25 or overmean systolic blood pressure ranges between 124 mmHg (Turkey) and 138 mmHg (Estonia). Among women aged25 or over WHO data suggest that the mean systolic blood pressure ranges between 118 mmHg (Iceland) and 133mmHg (Armenia and Bosnia and Herzegovina) (Table 8.2). Trends in mean systolic blood pressure since 1980show that among both men and women, average blood pressure levels have decreased in most countries. Thelargest decreases appear to have occurred in higher-income western and northern European countries, while levelshave remained relatively stable in many eastern European countries (Table 8.2).1 Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data forone million adults in 61 prospective studies. Lancet 2002;360(9349):1903-13.2 World Health Organization. The World Health Report 2002. Reducing Risks, Promoting Healthy Life. Geneva: WHO, 2002.3 Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries(the INTERHEART study): case-control study. Lancet 2004;364(9438):937-52.
  • 95. 93European Cardiovascular Disease StatisticsAge-standardized estimate of prevalence of raised bloodpressure (SBP≥140 OR DBP≥90 OR on medication)Men (%) Women (%) Total (%)Albania 48.0 42.0 44.9Andorra 42.6 30.9 36.7Armenia 49.8 46.0 47.8Austria 42.6 33.4 38.0Azerbaijan 46.0 41.1 43.4Belarus 51.2 42.3 46.6Belgium 39.3 30.4 34.8Bosnia and Herzegovina 47.2 46.6 47.1Bulgaria 48.1 40.9 44.5Croatia 49.8 43.4 46.7Cyprus 42.4 32.0 37.0Czech Republic 47.6 37.6 42.7Denmark 40.6 28.4 34.5Estonia 52.9 42.2 47.3Finland 47.4 36.3 41.9France 42.3 29.3 35.7Georgia 49.9 43.5 46.5Germany 44.8 34.3 39.7Greece 39.4 32.7 36.1Hungary 50.0 41.0 45.5Iceland 40.2 27.3 33.8Ireland 47.0 34.2 40.6Israel 37.4 29.9 33.6Italy 42.2 33.6 37.9Kazakhstan 48.5 41.4 44.8Kyrgyzstan 47.1 42.8 45.0Latvia 51.2 42.2 46.6Lithuania 52.1 43.4 47.7Luxembourg 42.1 31.3 36.7Malta 43.3 33.8 38.6Montenegro 49.6 42.0 45.6Netherlands 42.4 30.8 36.6Norway 46.3 35.2 40.9Poland 49.3 42.4 46.0Portugal 46.5 37.4 41.9Republic of Moldova 48.4 43.3 45.9Romania 47.1 41.7 44.5Russian Federation 46.2 41.3 43.8Serbia 50.1 43.0 46.6Slovakia 49.6 42.0 45.8Slovenia 50.4 42.3 46.4Spain 41.5 31.7 36.7Sweden 43.1 32.5 37.9Switzerland 41.6 28.2 34.8Tajikistan 46.4 43.3 44.8TFYR Macedonia 48.0 42.6 45.4Turkey 36.2 35.8 36.1Turkmenistan 47.0 42.2 44.6Ukraine 52.2 44.6 48.3United Kingdom 42.2 32.8 37.5Uzbekistan 41.5 36.5 39.1Table 8.1 Prevalence of raised blood pressure or blood pressure medication use, adults aged 25 years and over, by sex, 2008, EuropeSource: WHO Global Health Observatory http://www.who.int/gho/database/en/Notes: Age standardized estimates
  • 96. 94 European Cardiovascular Disease StatisticsFigure 8.1 Prevalence of raised blood pressure, adults aged 25 years and over, by sex, 2008, EuropeIsraelIcelandDenmarkBelgiumSwitzerlandFranceGreeceTurkeyNetherlandsAndorraLuxembourgSpainCyprusUnited KingdomItalySwedenAustriaMaltaUzbekistanGermanyIrelandNorwayFinlandPortugalCzech RepublicAzerbaijanRussian FederationBulgariaRomaniaTurkmenistanKazakhstanTajikistanAlabaniaKyrgystanTFYR MacedoniaHungaryMontenegorSlovakiaRepublic of MoldovaPolandSloveniaGeorgiaBelarusLatviaSerbiaCroatiaBosnia and HerzegovinaEstoniaLithuaniaArmeniaUkraine0% 10% 20% 30% 40% 50% 60%n Menn Women
  • 97. 95European Cardiovascular Disease StatisticsMen 1980 1985 1990 1995 2000 2001 2002 2003 2004 2005 2006 2007 2008Albania 133 134 133 132 132 132 132 133 133 133 133 133 134Andorra 141 137 136 134 133 133 132 132 132 132 132 132 131Armenia 136 136 136 134 134 134 134 134 134 134 135 135 135Austria 139 136 135 134 133 133 132 132 132 132 132 132 131Azerbaijan 135 135 134 132 131 131 131 131 131 132 132 132 132Belarus 138 138 137 136 135 135 135 135 136 136 136 136 136Belgium 136 134 133 133 131 131 131 130 130 130 129 129 129Bosnia and Herzegovina 132 133 133 132 132 132 132 132 133 133 133 133 133Bulgaria 135 136 136 135 134 134 134 134 134 134 134 134 134Croatia 138 138 138 137 136 136 135 135 135 135 135 135 135Cyprus 135 133 133 133 132 132 132 132 132 132 131 131 131Czech Republic 137 137 136 135 134 134 134 133 133 133 133 133 133Denmark 137 134 133 132 131 131 131 131 131 130 130 130 130Estonia 141 140 139 138 137 137 137 137 138 138 138 138 138Finland 143 140 138 136 135 135 135 135 135 135 135 135 135France 139 136 135 134 133 133 132 132 132 132 132 131 131Georgia 138 139 138 136 135 135 135 135 135 135 135 135 135Germany 140 138 138 138 137 136 136 135 135 134 134 133 133Greece 134 131 130 130 129 129 129 129 129 129 129 129 129Hungary 138 139 139 137 136 136 136 136 136 136 136 135 135Iceland 138 134 132 130 130 130 130 130 130 130 130 130 129Ireland 140 137 136 136 136 136 136 136 136 136 135 135 135Israel 133 131 130 129 128 128 128 127 127 127 127 127 127Italy 137 135 135 134 132 132 132 132 131 131 131 131 131Kazakhstan 137 137 136 134 133 133 133 134 134 134 134 134 134Kyrgyzstan 134 134 133 132 132 132 132 132 132 132 133 133 133Latvia 139 138 138 136 135 135 135 136 136 136 136 136 136Lithuania 140 140 139 137 136 136 136 136 136 136 137 137 137Luxembourg 140 137 136 135 133 133 132 132 132 132 131 131 131Malta 137 134 133 133 133 133 133 132 132 132 132 132 132Montenegro 137 137 137 135 135 135 135 135 135 135 135 135 135Netherlands 139 136 134 133 132 132 132 132 132 132 131 131 131Norway 142 139 137 136 135 135 135 135 135 135 135 135 135Poland 137 137 136 134 134 134 134 134 134 134 134 135 135Portugal 138 136 136 135 135 135 135 135 135 135 135 135 135Republic of Moldova 136 136 135 133 132 132 132 133 133 133 133 134 134Romania 135 136 136 134 133 133 133 133 133 133 133 133 133Russian Federation 135 135 134 132 131 131 131 131 131 132 132 132 132Serbia 138 139 139 137 136 136 136 136 136 136 135 135 135Slovakia 137 138 137 136 135 135 135 135 135 135 135 135 135Slovenia 138 139 138 137 136 136 136 136 136 136 136 136 136Spain 137 133 132 131 130 130 130 130 130 130 130 130 130Sweden 139 136 134 133 133 133 133 133 133 132 132 132 132Switzerland 139 136 134 132 131 131 131 131 131 131 131 131 131Tajikistan 134 134 134 132 131 131 131 131 131 132 132 132 132TFYR Macedonia 136 136 136 134 133 133 133 133 133 133 134 134 134Turkey 126 126 126 126 126 126 125 125 125 125 124 124 124Turkmenistan 135 135 134 132 132 132 132 132 132 132 133 133 133Ukraine 140 139 138 136 135 135 135 136 136 136 137 137 137United Kingdom 137 136 137 136 135 134 134 134 133 133 132 132 131Uzbekistan 130 130 129 127 127 127 127 127 127 128 128 128 128Table 8.2 Mean systolic blood pressure, adults aged 25 and over, by sex, 1980 to 2008, Europe
  • 98. 96 European Cardiovascular Disease StatisticsWomen 1980 1985 1990 1995 2000 2001 2002 2003 2004 2005 2006 2007 2008Albania 133 132 131 130 129 129 129 129 129 129 129 129 129Andorra 137 133 131 128 126 125 125 124 124 123 123 122 122Armenia 136 136 135 133 133 133 133 133 133 133 133 133 133Austria 134 132 130 129 127 126 126 126 125 125 125 124 124Azerbaijan 132 132 131 130 129 129 129 129 129 129 129 129 129Belarus 135 134 133 131 130 130 130 130 130 130 130 130 130Belgium 131 129 129 128 126 125 125 124 124 123 123 122 122Bosnia and Herzegovina 132 133 133 133 133 133 133 133 133 133 133 133 133Bulgaria 136 134 133 131 130 129 129 129 129 129 129 128 128Croatia 136 135 134 133 132 132 131 131 131 131 131 131 130Cyprus 131 130 129 127 126 125 125 124 124 124 123 123 123Czech Republic 136 134 133 130 128 127 127 127 127 126 126 126 126Denmark 130 128 126 125 123 122 122 122 121 121 120 120 119Estonia 138 136 134 131 130 130 130 130 130 130 129 129 129Finland 138 136 134 132 130 129 129 128 128 128 127 127 127France 132 130 128 126 124 123 123 122 122 122 121 121 120Georgia 135 135 134 132 131 131 131 131 131 131 131 131 131Germany 135 134 133 131 129 129 128 128 127 126 126 125 125Greece 132 130 128 127 125 125 125 124 124 124 124 123 123Hungary 135 134 133 131 130 130 130 129 129 129 129 129 128Iceland 132 128 125 124 121 121 121 120 120 119 119 119 118Ireland 131 129 129 128 127 126 126 126 126 125 125 125 125Israel 130 129 128 127 125 124 124 123 123 122 122 121 121Italy 136 133 131 129 126 126 126 125 125 125 124 124 124Kazakhstan 134 134 132 131 130 129 129 129 129 129 129 129 129Kyrgyzstan 131 130 130 129 129 129 129 129 129 130 130 130 130Latvia 137 136 134 131 130 130 130 130 130 130 130 130 129Lithuania 138 137 135 132 132 131 131 131 131 131 131 131 131Luxembourg 134 131 130 128 126 126 125 125 124 124 123 123 122Malta 135 133 131 130 128 127 127 126 126 126 125 125 124Montenegro 135 134 133 131 130 130 130 130 130 130 129 129 129Netherlands 132 130 128 127 125 124 124 124 123 123 122 122 122Norway 137 134 132 131 129 128 128 128 127 127 127 126 126Poland 138 135 133 131 130 130 130 130 130 130 130 130 130Portugal 135 134 133 132 130 130 129 129 129 128 128 128 127Republic of Moldova 133 132 132 131 130 130 130 130 130 130 130 130 130Romania 134 134 133 131 130 130 130 129 129 129 129 129 129Russian Federation 134 134 132 130 129 129 128 128 128 128 129 129 129Serbia 137 136 135 133 131 131 131 131 131 130 130 130 130Slovakia 136 135 134 132 131 130 130 130 130 130 130 130 129Slovenia 136 135 134 132 131 131 131 130 130 130 130 130 130Spain 134 130 128 126 124 124 124 123 123 123 123 122 122Sweden 133 131 129 128 126 126 125 125 124 124 124 123 123Switzerland 131 129 127 125 123 122 122 121 121 121 120 120 120Tajikistan 130 130 130 129 129 129 129 129 130 130 130 130 130TFYR Macedonia 135 134 133 132 131 131 131 130 130 130 130 130 130Turkey 127 128 128 128 127 127 126 126 126 125 125 124 124Turkmenistan 132 132 131 130 129 129 129 129 129 129 129 129 129Ukraine 136 136 134 133 131 131 131 131 131 132 132 132 132United Kingdom 131 131 132 131 129 128 128 127 127 126 125 125 124Uzbekistan 127 126 125 124 124 124 124 124 124 124 124 124 125Source: WHO Global Health Observatory http://www.who.int/gho/database/en/ Notes: Age standardized estimates Table 8.2 continued...
  • 99. 97European Cardiovascular Disease Statistics9. Blood cholesterolRisk of CVD is directly related to blood cholesterol levels. Blood cholesterol levels can be reduced by physical activityand by dietary changes – in particular a reduction in the consumption of saturated fat – and drugs.Research from the World Health Organization highlights the importance of raised blood cholesterol as a risk factorfor CHD. The World Health Report 2002 estimates that around 8% of all disease burden in developed countries iscaused by raised blood cholesterol and that over 60% of CHD and around 40% of ischaemic stroke in developedcountries is due to total blood cholesterol levels in excess of the theoretical minimum (3.8 mmol/L)1.The WHO Global Health Observatory provides national estimates of the prevalence of raised blood cholesterol levels(both the proportion of the population in excess of 5.0mmol/L and in excess of 6.2mmol/L) and trends in meanblood cholesterol levels for men and women. The highest rates of raised cholesterol levels were seen in the highincome countries of Northern and Western Europe, while the lowest rates were seen in countries of the formerSoviet Union (Table 9.1). The population with the lowest proportion of adults aged 25 years and older with raisedblood cholesterol levels was Tajikistan, where 24% of the population had levels above 5.0mmol/L and less than 5%had levels above 6.2mmol/L. In contrast, Iceland had 70% of the population with blood cholesterol levels above5.0mmol/L and 29% with levels above 6.2mmol/L. In high income countries with high proportions of the populationwith raised cholesterol levels, the proportion of men with raised cholesterol generally exceeded that of women. Incountries with low rates of raised cholesterol, more women than men were affected.The WHO estimates of mean total cholesterol for men aged 25 years and over in Europe show that in 2008 mean totalcholesterol ranged from 4.5 mmol/L or lower in Tajikistan, Uzbekistan, Kyrgyzstan, Azerbaijan and Turkmenistan to5.5mmol/L or over in Denmark, Andorra, Germany, Luxembourg and Iceland. Among women aged 25 or over WHOdata suggest that the mean total cholesterol was at or below 4.5 mmol/L in Tajikistan, Uzbekistan and Kyrgyzstan(Turkey) and 5.5mmol/L or greater in Andorra, Luxembourg and Iceland (Table 9.2).Over the period 1980 to 2008, estimated mean population total cholesterol levels reduced in all countries for whichestimates were available for both men and women, with the exception of Poland, where levels were stable over theperiod (Table 9.2).1 World Health Organization. The World Health Report 2002. Reducing Risks, Promoting Healthy Life. Geneva: WHO, 2002.
  • 100. 98 European Cardiovascular Disease StatisticsAge-standardized estimate of prevalence ofraised blood cholesterol (≥5.0mmol/L)Age-standardized estimate of prevalence ofraised blood cholesterol (≥6.2mmol/L)Men (%) Women (%) Total (%) Men (%) Women (%) Total (%)Albania 46.3 44.3 45.3 11.3 12.6 12.0Andorra 69.7 64.1 67.1 26.7 24.1 25.5Armenia 39.6 41.5 40.8 8.9 11.0 10.1Austria 61.3 57.7 59.7 19.6 18.9 19.4Azerbaijan 33.1 36.0 34.8 6.7 8.7 7.8Belarus 50.5 50.8 51.1 13.9 15.8 15.3Belgium 64.6 59.9 62.4 22.2 20.8 21.6Bosnia and Herzegovina 38.5 39.5 39.2 8.5 10.1 9.4Bulgaria 50.3 49.0 49.9 13.5 14.5 14.2Croatia 49.4 49.7 49.8 13.1 14.9 14.3Cyprus 58.7 55.5 57.1 17.8 17.7 17.7Czech Republic 54.4 52.7 53.9 14.7 15.7 15.5Denmark 68.3 61.8 65.2 26.0 24.6 25.5Estonia 56.0 56.7 56.7 17.0 19.3 18.5Finland 57.5 59.3 59.0 16.4 21.7 19.7France 63.5 60.2 62.0 20.2 20.7 20.6Georgia 35.6 38.0 37.1 7.5 9.5 8.7Germany 69.6 61.4 65.6 27.1 21.9 24.6Greece 50.1 45.9 48.2 12.7 12.8 12.8Hungary 55.4 54.0 55.2 16.5 18.5 17.9Iceland 72.5 67.0 69.8 30.2 27.7 29.1Ireland 65.5 59.5 62.6 22.9 20.4 21.7Israel 51.8 54.8 53.5 13.3 15.5 14.5Italy 62.3 61.6 62.2 19.0 20.8 20.1Kazakhstan 45.0 45.6 45.7 11.0 12.9 12.3Kyrgyzstan 28.3 31.2 30.1 5.3 7.0 6.3Latvia 55.3 55.2 55.7 16.6 18.6 18.0Lithuania 54.9 54.0 54.8 16.1 17.2 17.0Luxembourg 69.5 64.1 66.9 26.5 24.3 25.6Malta 60.7 56.9 59.0 19.2 18.9 19.2Montenegro 48.4 47.9 48.3 12.6 13.9 13.4Netherlands 62.5 58.2 60.5 20.4 19.6 20.1Norway 64.2 59.3 61.9 21.8 20.3 21.2Poland 59.9 53.8 57.1 18.3 16.5 17.6Portugal 57.2 54.3 55.9 16.7 16.5 16.7Republic of Moldova 35.2 36.9 36.5 7.5 9.3 8.6Romania 46.0 45.2 45.8 11.4 12.6 12.1Russian Federation 47.3 52.1 50.6 12.3 17.1 15.4Serbia 47.4 52.0 49.8 11.9 14.9 13.5Slovakia 52.7 51.7 52.5 14.8 16.1 15.7Slovenia 56.8 55.3 56.3 17.3 18.4 18.1Spain 58.9 52.9 56.1 17.1 15.4 16.4Sweden 56.1 47.0 51.8 16.3 13.2 14.8Switzerland 61.1 56.9 59.2 18.7 18.5 18.8Tajikistan 22.5 25.3 24.0 3.8 5.3 4.6TFYR Macedonia 42.4 43.7 43.2 10.0 11.8 11.0Turkey 38.1 41.0 39.7 7.8 10.0 9.0Turkmenistan 33.8 35.8 35.1 6.9 8.7 7.9Ukraine 43.1 44.7 44.4 10.4 12.7 11.9United Kingdom 65.2 61.3 63.4 21.6 21.3 21.7Uzbekistan 24.2 28.9 26.8 4.1 6.5 5.4Table 9.1 Prevalence of raised blood cholesterol, adults aged 25 years and over, by sex, 2008, EuropeSource: WHO Global Health Observatory http://www.who.int/gho/database/en/ Notes: Age standardized estimates
  • 101. 99European Cardiovascular Disease StatisticsFigure 9.1 Prevalence of raised cholesterol (≥6.2mmol/L), by sex, 2008, Europen Menn WomenTajikistanUzbekistanKyrgyzstanAzerbaijanTurmenistanRepublic of MoldovaGeorgiaTurkeyBosnia and HerzegovinaArmeniaTFYR MacedoniaUkraineAlbaniaRomaniaKazakhstanGreeceMontenegroSerbiaBulgariaCroatiaIsraelSwedenBelarusRussian FederationCzech RepublicSlovakiaSpainPortugalLithuaniaPolandCyprusHungaryLatviaSloveniaEstoniaSwitzerlandMaltaAustriaFinlandItalyNetherlandsFranceNorwayBelgiumIrelandUnited KingdomGermanyAndorraDenmarkLuxembourgIceland0% 5% 10% 15% 20% 25% 30% 35%
  • 102. 100 European Cardiovascular Disease StatisticsMen Age-standardized estimate of mean blood cholesterol levels (mmol/L)1980 1985 1990 1995 2000 2001 2002 2003 2004 2005 2006 2007 2008Albania 5.0 5.0 5.0 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.9Andorra 6.2 6.0 5.9 5.8 5.7 5.7 5.6 5.6 5.6 5.6 5.6 5.6 5.6Armenia 5.2 5.1 5.0 4.8 4.7 4.7 4.7 4.7 4.7 4.7 4.7 4.7 4.7Austria 5.9 5.8 5.7 5.6 5.5 5.5 5.4 5.4 5.4 5.4 5.3 5.3 5.3Azerbaijan 5.1 5.1 5.0 4.7 4.5 4.5 4.5 4.5 4.5 4.5 4.5 4.5 4.5Belarus 5.4 5.3 5.3 5.2 5.1 5.1 5.1 5.1 5.0 5.0 5.0 5.0 5.0Belgium 6.1 6.0 5.9 5.7 5.6 5.6 5.5 5.5 5.5 5.5 5.5 5.4 5.4Bosnia and Herzegovina 4.9 4.9 4.9 4.6 4.7 4.7 4.7 4.7 4.7 4.7 4.7 4.7 4.7Bulgaria 5.3 5.3 5.3 5.2 5.1 5.1 5.1 5.0 5.0 5.0 5.0 5.0 5.0Croatia 5.4 5.4 5.3 5.2 5.1 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0Cyprus 5.5 5.4 5.4 5.4 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.2Czech Republic 6.0 5.9 5.8 5.7 5.5 5.4 5.4 5.3 5.3 5.2 5.2 5.2 5.1Denmark 5.9 5.8 5.8 5.7 5.7 5.6 5.6 5.6 5.6 5.6 5.6 5.5 5.5Estonia 5.6 5.5 5.5 5.3 5.2 5.2 5.2 5.2 5.2 5.2 5.2 5.2 5.2Finland 6.2 6.0 5.8 5.5 5.4 5.3 5.3 5.3 5.3 5.2 5.2 5.2 5.2France 6.0 5.9 5.8 5.7 5.6 5.5 5.5 5.5 5.5 5.4 5.4 5.4 5.4Georgia 5.2 5.2 5.1 4.8 4.6 4.6 4.6 4.6 4.6 4.6 4.6 4.6 4.6Germany 5.8 5.9 5.9 5.9 5.8 5.7 5.7 5.7 5.7 5.6 5.6 5.6 5.6Greece 5.5 5.4 5.3 5.2 5.1 5.1 5.1 5.0 5.0 5.0 5.0 5.0 5.0Hungary 5.3 5.3 5.3 5.2 5.2 5.2 5.2 5.2 5.2 5.2 5.2 5.2 5.2Iceland 6.1 6.1 6.0 5.9 5.8 5.8 5.7 5.7 5.7 5.7 5.7 5.7 5.7Ireland 6.0 5.8 5.7 5.6 5.6 5.6 5.6 5.5 5.5 5.5 5.5 5.5 5.4Israel 5.8 5.7 5.5 5.4 5.3 5.2 5.2 5.2 5.1 5.1 5.1 5.1 5.0Italy 5.7 5.5 5.4 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3Kazakhstan 5.3 5.2 5.1 5.0 4.8 4.8 4.8 4.8 4.8 4.8 4.9 4.9 4.9Kyrgyzstan 5.0 4.9 4.8 4.6 4.5 4.5 4.5 4.4 4.4 4.4 4.4 4.4 4.4Latvia 5.6 5.5 5.4 5.3 5.2 5.1 5.1 5.1 5.1 5.1 5.1 5.1 5.1Lithuania 5.8 5.7 5.6 5.5 5.2 5.2 5.2 5.2 5.2 5.2 5.1 5.1 5.1Luxembourg 6.2 6.1 6.0 5.9 5.7 5.7 5.7 5.7 5.6 5.6 5.6 5.6 5.6Malta 5.9 5.8 5.7 5.5 5.5 5.4 5.4 5.4 5.4 5.4 5.3 5.3 5.3Montenegro 5.3 5.3 5.3 5.1 5.1 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0Netherlands 5.9 5.8 5.7 5.6 5.5 5.5 5.5 5.4 5.4 5.4 5.4 5.4 5.3Norway 6.0 5.9 5.7 5.6 5.5 5.5 5.5 5.5 5.5 5.4 5.4 5.4 5.4Poland 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3Portugal 5.5 5.4 5.3 5.3 5.3 5.3 5.3 5.3 5.2 5.2 5.2 5.2 5.2Republic of Moldova 5.3 5.2 5.1 4.9 4.6 4.6 4.6 4.6 4.6 4.6 4.6 4.6 4.6Romania 5.3 5.2 5.2 5.1 5.0 5.0 4.9 4.9 4.9 4.9 4.9 4.9 4.9Russian Federation 5.6 5.5 5.3 5.2 5.0 5.0 4.9 4.9 4.9 4.9 4.9 4.9 4.9Serbia 5.1 5.1 5.0 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.9Slovakia 5.4 5.3 5.3 5.2 5.2 5.2 5.1 5.1 5.1 5.1 5.1 5.1 5.1Slovenia 5.4 5.4 5.4 5.3 5.3 5.3 5.3 5.2 5.2 5.2 5.2 5.2 5.2Spain 5.6 5.5 5.5 5.4 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.2 5.2Sweden 6.0 5.9 5.7 5.5 5.4 5.3 5.3 5.3 5.3 5.2 5.2 5.2 5.2Switzerland 6.0 5.9 5.8 5.6 5.5 5.4 5.4 5.4 5.4 5.4 5.3 5.3 5.3Tajikistan 5.0 4.9 4.8 4.5 4.2 4.2 4.2 4.2 4.2 4.2 4.2 4.2 4.2TFYR Macedonia 5.3 5.3 5.2 5.0 4.9 4.9 4.9 4.8 4.8 4.8 4.8 4.8 4.8Turkey 4.8 4.8 4.8 4.8 4.8 4.8 4.7 4.7 4.7 4.7 4.7 4.7 4.7Turkmenistan 5.1 5.0 4.9 4.7 4.5 4.5 4.5 4.5 4.5 4.5 4.5 4.5 4.5Ukraine 5.5 5.4 5.3 5.1 4.9 4.9 4.8 4.8 4.8 4.8 4.8 4.8 4.8United Kingdom 6.2 6.1 5.9 5.7 5.6 5.5 5.5 5.5 5.5 5.5 5.4 5.4 5.4Uzbekistan 5.0 4.9 4.8 4.5 4.4 4.4 4.3 4.3 4.3 4.3 4.3 4.3 4.3Table 9.2 Mean blood cholesterol levels, by sex, 1980 to 2008, Europe
  • 103. 101European Cardiovascular Disease StatisticsWomen Age-standardized estimate of mean blood cholesterol levels (mmol/L)1980 1985 1990 1995 2000 2001 2002 2003 2004 2005 2006 2007 2008Albania 5.1 5.0 5.0 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.9Andorra 6.1 6.0 5.8 5.7 5.6 5.6 5.5 5.5 5.5 5.5 5.5 5.5 5.5Armenia 5.3 5.3 5.1 4.9 4.8 4.8 4.8 4.8 4.8 4.8 4.8 4.8 4.8Austria 5.9 5.8 5.7 5.5 5.4 5.4 5.4 5.4 5.3 5.3 5.3 5.3 5.3Azerbaijan 5.3 5.2 5.1 4.9 4.7 4.7 4.7 4.7 4.7 4.6 4.7 4.7 4.7Belarus 5.5 5.5 5.4 5.3 5.2 5.2 5.2 5.1 5.1 5.1 5.1 5.1 5.1Belgium 6.0 5.9 5.8 5.6 5.5 5.5 5.5 5.4 5.4 5.4 5.4 5.4 5.3Bosnia and Herzegovina 5.0 5.0 4.9 4.7 4.7 4.8 4.8 4.8 4.8 4.8 4.8 4.8 4.8Bulgaria 5.3 5.4 5.3 5.2 5.1 5.1 5.1 5.1 5.1 5.0 5.0 5.0 5.0Croatia 5.4 5.4 5.3 5.2 5.1 5.1 5.1 5.1 5.1 5.1 5.1 5.1 5.0Cyprus 5.5 5.5 5.4 5.4 5.3 5.3 5.3 5.3 5.2 5.2 5.2 5.2 5.2Czech Republic 5.9 5.9 5.8 5.7 5.5 5.5 5.4 5.4 5.3 5.3 5.2 5.2 5.1Denmark 6.0 5.8 5.7 5.6 5.5 5.5 5.5 5.5 5.5 5.5 5.4 5.4 5.4Estonia 5.7 5.6 5.6 5.5 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.2Finland 6.2 6.0 5.8 5.6 5.5 5.5 5.4 5.4 5.4 5.4 5.4 5.4 5.4France 6.0 5.9 5.7 5.6 5.5 5.5 5.4 5.4 5.4 5.4 5.4 5.4 5.3Georgia 5.4 5.3 5.2 4.9 4.7 4.7 4.7 4.7 4.7 4.7 4.7 4.7 4.7Germany 5.8 5.8 5.8 5.8 5.7 5.6 5.6 5.6 5.5 5.5 5.4 5.4 5.4Greece 5.6 5.4 5.3 5.1 5.0 5.0 5.0 5.0 5.0 4.9 4.9 4.9 4.9Hungary 5.3 5.3 5.3 5.2 5.2 5.2 5.2 5.2 5.2 5.2 5.2 5.2 5.2Iceland 6.2 6.1 6.0 5.8 5.7 5.7 5.7 5.6 5.6 5.6 5.6 5.6 5.6Ireland 5.9 5.8 5.6 5.5 5.5 5.4 5.4 5.4 5.4 5.4 5.4 5.3 5.3Israel 5.9 5.8 5.6 5.5 5.4 5.3 5.3 5.3 5.3 5.2 5.2 5.2 5.2Italy 5.6 5.5 5.4 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.4Kazakhstan 5.4 5.3 5.2 5.1 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.9Kyrgyzstan 5.2 5.1 5.0 4.8 4.6 4.6 4.6 4.6 4.6 4.6 4.5 4.5 4.5Latvia 5.7 5.6 5.5 5.4 5.3 5.2 5.2 5.2 5.2 5.2 5.2 5.2 5.2Lithuania 5.8 5.8 5.8 5.6 5.4 5.3 5.3 5.3 5.3 5.2 5.2 5.2 5.2Luxembourg 6.2 6.1 5.9 5.8 5.6 5.6 5.6 5.5 5.5 5.5 5.5 5.5 5.5Malta 6.1 5.9 5.7 5.5 5.4 5.4 5.3 5.3 5.3 5.3 5.3 5.3 5.3Montenegro 5.4 5.3 5.3 5.2 5.1 5.1 5.1 5.1 5.0 5.0 5.0 5.0 5.0Netherlands 5.9 5.8 5.6 5.5 5.4 5.4 5.4 5.4 5.3 5.3 5.3 5.3 5.3Norway 6.0 5.8 5.7 5.6 5.5 5.4 5.4 5.4 5.4 5.4 5.3 5.3 5.3Poland 5.4 5.3 5.3 5.3 5.2 5.2 5.2 5.2 5.2 5.2 5.2 5.2 5.2Portugal 5.6 5.5 5.4 5.3 5.3 5.3 5.2 5.2 5.2 5.2 5.2 5.2 5.2Republic of Moldova 5.4 5.4 5.3 5.0 4.8 4.8 4.7 4.7 4.7 4.7 4.7 4.7 4.7Romania 5.3 5.3 5.3 5.1 5.0 5.0 5.0 5.0 5.0 4.9 4.9 4.9 4.9Russian Federation 5.8 5.7 5.6 5.4 5.2 5.2 5.2 5.1 5.1 5.1 5.1 5.1 5.1Serbia 5.2 5.1 5.1 5.0 5.0 5.0 5.0 5.1 5.1 5.1 5.1 5.1 5.1Slovakia 5.4 5.4 5.4 5.3 5.2 5.2 5.2 5.2 5.1 5.1 5.1 5.1 5.1Slovenia 5.5 5.4 5.4 5.4 5.3 5.3 5.3 5.3 5.3 5.2 5.2 5.2 5.2Spain 5.6 5.5 5.4 5.3 5.2 5.2 5.2 5.2 5.2 5.2 5.1 5.1 5.1Sweden 6.1 6.0 5.8 5.5 5.3 5.2 5.2 5.1 5.1 5.1 5.0 5.0 5.0Switzerland 6.0 5.9 5.7 5.6 5.4 5.4 5.3 5.3 5.3 5.3 5.3 5.3 5.2Tajikistan 5.2 5.1 5.0 4.7 4.4 4.4 4.4 4.4 4.4 4.3 4.3 4.3 4.3TFYR Macedonia 5.4 5.3 5.2 5.1 5.0 5.0 4.9 4.9 4.9 4.9 4.9 4.9 4.9Turkey 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.8 4.8 4.8 4.8 4.8 4.8Turkmenistan 5.3 5.2 5.1 4.9 4.7 4.7 4.7 4.7 4.7 4.7 4.7 4.7 4.7Ukraine 5.5 5.5 5.4 5.2 5.0 5.0 5.0 4.9 4.9 4.9 4.9 4.9 4.9United Kingdom 6.2 6.0 5.9 5.7 5.5 5.5 5.5 5.4 5.4 5.4 5.4 5.4 5.4Uzbekistan 5.2 5.1 4.9 4.7 4.6 4.5 4.5 4.5 4.5 4.5 4.5 4.4 4.4Source: WHO Global Health Observatory - http://www.who.int/gho/database/en/ Notes: Age standardized estimates Table 9.2 continued...
  • 104. 102 European Cardiovascular Disease Statistics10. Overweightand obesityOverweight and obesity increase the risk of CVD. As well as being an independent risk factor, obesity is also a majorrisk factor for high blood pressure, raised blood cholesterol, diabetes and impaired glucose tolerance1.Prevalence of overweight and obesityThere is relatively little comparable international data on the prevalence of overweight and obesity. Data on theprevalence of overweight and obesity in Europe are usually taken from national health surveys and there arelimitations to how comparable the data are, due to differences in the survey designs (sampling frames, age rangeetc.) and methods (measured or self-reported height and weight values).The International Obesity Task Force (IOTF) collates up-to-date data on national and regional surveys of obesityprevalence (Table 10.1 and Figures 10.1a and 10.1b). These data show that the combined prevalence of overweightand obesity among adult men ranges from 31% in Kyrgyzstan to 83% in Luxembourg. In 34 of 40 countries withavailable data, more than half of adult men were affected by overweight and obesity (Table 10.1).Among women the lowest prevalence of overweight and obesity was in Turkmenistan (24%), while the highest wasin Luxembourg (63%). More than half of women were affected by overweight and obesity in 21 of 45 countries withavailable data.WHO data from 2008, which estimate mean Body Mass Index (BMI) by sex at a national level, show that nationalmean BMI levels for both men and women across Europe vary between around 24 and 28 kg/m2, well above theoptimum mean BMI value for the health of a population (21kg/m2)1. The highest mean BMI among men was inthe Czech Republic. Other countries with high mean BMI values for men were mostly from Southern and WesternEurope. The lowest mean BMI for men was in Tajikistan, and the next 8 lowest values were all in former Soviet Unioncountries. Mean BMIs were lower for women than men in most (38 of 51) countries. Among women the lowestmean BMI was again found in Tajikistan, however the other lower values were more geographically mixed than formen. Switzerland, France and Italy all feature among the five countries with the lowest mean BMI value for women,alongside Turkmenistan. The highest mean BMI values for women were in the Russian Federation, Armenia, Israel,Azerbaijan and Turkey.Trends in BMIThe WHO data show consistent increases in population mean BMI from 1980 to 2008 in almost all countries,particularly among men, although there was a small dip around the end of the 1990s in many of the former Sovietcountries (Table 10.2). The largest overall increases in mean BMI for both men and women were in Israel, Turkeyand the United Kingdom. In these countries, mean BMI increased by more than two units (kg/m2) between 1980and 2008.
  • 105. 103European Cardiovascular Disease StatisticsOverweight and obesity in childrenData on childhood overweight and obesity are even more difficult to compare across countries and surveys thanfor adults. Body composition changes rapidly through childhood and adolescence which means that classificationof overweight and obesity must be age- and sex-specific. There are several definitions in common use, based onage- and sex-specific BMI cut-offs, including the recently released WHO Child Growth Standards (from birth to 5years)2and Growth Reference (from 5 to 19 years)3. The most common system used for international comparisonin currently published studies, however, is that developed by Cole et al and supported by the IOTF, which providesage and sex-specific BMI cut-off values that correspond to a BMI of 25 (the adult cut-off for overweight) and 30(adult cut-off for obesity)4, 5.In addition to issues of defining overweight and obesity, inter-country comparisons of the most recent data on theprevalence of childhood obesity in Europe is hampered by widely varying age groups in survey samples and differingmethods of data collection. Bearing these limitations in mind, however, the results suggest that the highest levels ofchildhood obesity among boys in Europe are consistently found in Southern European countries (Table 10.3). Morethan 30% of boys are overweight (including obesity) in Greece, Spain, Italy, Malta and Cyprus, and 45% in Creteare overweight. The lowest rates of overweight and obesity among boys were in Latvia, Turkey, Estonia, Norway andFrance. The lowest rates of overweight among girls were all seen in countries where data had been self-reported:Latvia, Estonia, Romania and Luxembourg. The highest overweight rates for girls were again found in SouthernEurope, with more than 30% of girls in Crete, Italy and Spain overweight.In response to this important gap, the WHO European region has established the Childhood Obesity SurveillanceInitiative (COSI) in fifteen countries. The system aims to routinely measure trends in overweight and obesity among6 to 9 year old children, in order to understand the progress of the obesity epidemic in this population group and topermit inter-country comparisons within the European Region6.1 World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health OrganTechRepSer 2000;894:i-xii, 1-253.2 WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards based on length/height, weight and age. Acta PaediatrSuppl 2006;450:76-85.3 de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. BullWorld Health Organ 2007;85(9):660-7.4 Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. British MedicalJournal 2000;320(7244):1240-3.5 Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes 2012.6 Wijnhoven T, et al. WHO European Childhood Obesity Surveillance Initiative 2008: weight, height and body mass index in 6–9-year-old children. Pediatr Obes2012;in press.
  • 106. 104 European Cardiovascular Disease StatisticsMales FemalesYear Overweight (%) Obese (%) Overweight (%) Obese (%)Albania 2008-09 44.8 8.5 29.6 9.7Armenia 2005 26.9 15.5Austria 2005-06 42.3 23.3 32.4 20.8Azerbaijan 2006 35.8 4.3 29.5 17.9Belgium 2002-04 41.4 10.7 29.8 10.2Bosnia & Herzegovina 2002 17 25Bulgaria 2004 39.6 13.4 32.2 19.2Croatia 2003 46.7 21.6 38.7 22.7Cyprus 1999-00 46 26.6 34.3 23.7Czech Republic 2008 42.8 23.9 29.2 22.3Denmark*† 2005 41.4 11.8 25.6 11.8England 2010 42 26 32 26Estonia* 2004 32 13.7 25.7 14.9Finland* 2005 44.8 14.9 26.7 13.5France 2006 41 16.1 23.8 17.6Germany 2005-07 45.5 20.5 29.5 21.1Greece† 2001-03 50.8 27.9 29.3 25.6Hungary* 2004 41.8 17.1 31.3 18.2Iceland 1991-06 47.3 17 35.2 18.3Israel 1999-01 45.8 19.9 33.1 25.7Ireland 2008-10 43.8 25.8 30.9 21.3Ireland (Northern) 2005-06 39 25 30 23Italy* 2005 42.5 10.5 26.1 9.1Kazakhstan 1999 19.9 12.6Kyrgystan 1993 26.4 4.2 24.3 10.7Lithuania* 2006 35.7 20.6 29.7 19.2Luxembourg 2007 62 21 44 19Malta* 2003 46.5 22.9 34.3 16.9Moldova 2005 23.3 18.2Netherlands 1998-02 43.5 10.4 28.5 10.1Norway† 1995-97 53.2 15.5 40 21Poland 2003-07 40.3 20.8 28.4 23.8Portugal 2003-05 45.2 15 34.4 13.4Romania* 2000 38.1 7.7 28.6 9.5Russia 2000 30.7 10.3 27.4 21.6Scotland 2010 39.5 26.6 32.2 28.1Serbia 2000 43 14.3 31 20Slovakia 2007 39.5 18.1 24.4 15.9Slovenia* 2001 50 16.5 30.9 13.8Spain 2008-10 46.4 24.4 32.5 21.4Sweden† 2002 43.5 14.8 26.6 11Switzerland* 2007 37.8 8.6 20.9 7.7Turkey† 2001-02 46.5 16.5 28.6 29.4Turkmenistan 2000 16 7.8Uzbekistan 2002 26.5 5.4 20.6 7.1Wales* 2009 41 21 31 21Table 10.1 Prevalence of overweight and obesity, by sex, latest available year, EuropeSource: IOTF Global Prevalence of Adult Obesity http://www.iaso.org/site_media/uploads/Prevalence_of_Adult_Obesity_19th_January_2012.pdfNotes: Overweight defined as BMI between 25 and 29.9kg/m2, Obesity defined as BMI>30kg/m2. Specific age group of study samples varies. See source for details. Blank cells indicate datawere not available* Indicates height and weight data were self-reported.† Indicates a sub-national (regional) sample.
  • 107. 105European Cardiovascular Disease StatisticsFigure 10.1a Prevalence of obesity among adult men, latest available year, EuropeFigure 10.1b Prevalence of obesity among adult women, latest available year, EuropeKyrgystanAzerbaijanUzbekistanRomaniaAlbaniaSwitzerlandRussiaNetherlandsItalyBelgiumDenmarkBulgariaEstoniaSerbiaSwedenFinlandPortugalNorwayFranceSloveniaTurkeyBosnia&HerzegovinaIcelandHungarySlovakiaIsraelGermanyLithuaniapolandLuxembourgWalesCroatiaMaltaAustriaCzechRepublicSpainIreland(Northern)IrelandEnglandCyprusScotlandGreeceUzbekistanSwitzerlandTurkmenistanItalyRomaniaAlbaniaNetherlandsBelgiumKyrgystanSwedenDenmarkKazakstanPortugalFinlandSloveniaEstoniaArmeniaSlovakiaMaltaFranceAzerbaijanHungaryMoldovaIcelandLuxembourgBulgariaLithuaniaSerbiaAustriaNorwayWalesGermanyIrelandSpainRussiaCzechRepublicCroatiaIreland(Northern)CyprusPolandBosnia&HerzegovinaGreeceIsraelEnglandScotlandTurkey302520151050%302520151050%
  • 108. 106 European Cardiovascular Disease StatisticsMen Age standardised estimate of mean BMI (kg/m2)1980 1985 1990 1995 2000 2005 2006 2007 2008Albania 25.0 25.1 25.2 25.2 25.5 26.2 26.3 26.5 26.6Andorra 25.7 25.8 26.1 26.4 26.8 27.3 27.4 27.5 27.6Armenia 23.8 24.0 24.2 24.0 24.2 24.8 25.0 25.2 25.4Austria 24.8 25.0 25.3 25.6 25.8 26.2 26.3 26.4 26.4Azerbaijan 24.4 24.6 24.8 24.6 24.5 25.1 25.3 25.5 25.6Belarus 24.8 24.9 25.0 25.1 25.3 25.8 25.9 26.1 26.2Belgium 25.1 25.2 25.5 25.8 26.2 26.5 26.6 26.7 26.8Bosnia and Herzegovina 25.1 25.3 25.3 25.0 25.5 26.3 26.5 26.6 26.8Bulgaria 25.1 25.4 25.6 25.7 25.8 26.2 26.4 26.5 26.6Croatia 25.1 25.3 25.5 25.5 25.9 26.4 26.5 26.6 26.8Cyprus 25.2 25.5 25.9 26.3 26.8 27.2 27.3 27.4 27.5Czech Republic 26.2 26.5 26.7 27.0 27.3 27.7 27.8 27.9 28.0Denmark 24.6 24.6 24.7 25.0 25.3 25.8 25.9 26.0 26.1Estonia 24.6 24.7 24.8 24.8 25.2 25.9 26.0 26.2 26.3Finland 25.4 25.5 25.7 25.9 26.1 26.5 26.6 26.7 26.8France 24.7 24.8 25.0 25.2 25.4 25.7 25.7 25.8 25.9Georgia 24.6 24.8 25.0 24.6 24.6 25.2 25.3 25.4 25.6Germany 25.4 25.7 25.9 26.3 26.7 27.0 27.0 27.1 27.2Greece 24.7 24.9 25.1 25.4 25.7 26.1 26.2 26.3 26.4Hungary 25.2 25.6 25.9 26.1 26.4 26.9 27.1 27.2 27.3Iceland 24.8 25.2 25.5 25.8 26.3 26.9 27.0 27.1 27.2Ireland 25.8 25.9 26.1 26.4 27.0 27.4 27.5 27.6 27.7Israel 24.7 25.0 25.3 25.7 26.3 26.8 26.9 27.0 27.1Italy 25.4 25.4 25.5 25.7 25.9 26.3 26.4 26.4 26.5Kazakhstan 24.5 24.8 24.9 24.9 25.0 25.7 25.9 26.1 26.3Kyrgyzstan 24.3 24.4 24.5 24.3 24.2 24.5 24.6 24.7 24.8Latvia 25.1 25.2 25.3 25.3 25.5 26.1 26.2 26.4 26.5Lithuania 26.0 26.0 26.0 25.8 26.0 26.5 26.7 26.8 26.9Luxembourg 25.0 25.2 25.6 26.2 26.6 27.1 27.2 27.3 27.4Malta 25.6 25.9 26.1 26.6 27.1 27.5 27.6 27.6 27.7Montenegro 25.3 25.5 25.7 25.6 25.9 26.4 26.5 26.6 26.8Netherlands 24.0 24.2 24.4 24.8 25.2 25.6 25.7 25.8 25.9Norway 24.7 24.9 25.2 25.6 26.1 26.6 26.7 26.8 27.0Poland 25.0 25.2 25.3 25.5 25.9 26.4 26.5 26.6 26.7Portugal 25.0 25.0 25.3 25.7 26.1 26.5 26.5 26.6 26.7Republic of Moldova 24.6 24.6 24.6 24.2 23.9 24.0 24.1 24.2 24.3Romania 24.6 24.7 24.8 24.6 24.7 25.2 25.3 25.5 25.6Russian Federation 25.0 25.0 25.0 25.0 25.0 25.6 25.7 25.9 26.0Serbia 25.6 25.8 26.0 26.0 26.3 26.8 26.9 27.1 27.2Slovakia 25.4 25.6 25.9 26.0 26.4 26.8 26.9 27.0 27.1Slovenia 25.6 25.8 26.0 26.2 26.7 27.3 27.4 27.5 27.6Spain 25.3 25.4 25.7 26.1 26.6 27.2 27.3 27.4 27.5Sweden 24.7 24.9 25.1 25.4 25.8 26.1 26.2 26.3 26.4Switzerland 25.1 25.2 25.4 25.6 25.8 26.0 26.1 26.2 26.2Tajikistan 24.0 24.2 24.2 23.7 23.3 23.5 23.6 23.7 23.8TFYR Macedonia 25.2 25.4 25.5 25.5 25.8 26.2 26.3 26.5 26.6Turkey 23.5 23.9 24.5 25.1 25.7 26.3 26.4 26.6 26.7Turkmenistan 24.3 24.4 24.5 24.3 24.3 24.8 24.9 25.0 25.2Ukraine 24.8 24.9 25.0 24.9 24.7 25.1 25.2 25.3 25.5United Kingdom 24.7 25.0 25.6 26.1 26.7 27.1 27.2 27.3 27.4Uzbekistan 24.5 24.7 24.7 24.7 24.7 25.0 25.1 25.2 25.3Table 10.2 Mean BMI, adults aged 20 years and over, by sex, 1980 to 2008, Europe
  • 109. 107European Cardiovascular Disease StatisticsWomen Age standardised estimate of mean BMI (kg/m2)1980 1985 1990 1995 2000 2005 2006 2007 2008Albania 25.2 25.2 25.1 24.9 25.1 25.4 25.5 25.6 25.6Andorra 25.6 25.6 25.7 25.9 26.0 26.3 26.3 26.3 26.4Armenia 25.9 26.2 26.3 26.0 26.3 26.9 27.0 27.2 27.3Austria 23.9 24.1 24.3 24.5 24.7 24.9 25.0 25.0 25.1Azerbaijan 26.2 26.5 26.7 26.5 26.4 27.1 27.3 27.5 27.7Belarus 26.3 26.2 26.1 26.0 26.0 26.3 26.4 26.6 26.7Belgium 25.0 24.9 25.0 25.1 25.1 25.2 25.2 25.2 25.2Bosnia and Herzegovina 25.0 25.3 25.4 25.2 25.8 26.2 26.2 26.3 26.4Bulgaria 25.6 25.7 25.7 25.4 25.2 25.3 25.4 25.4 25.5Croatia 25.2 25.2 25.0 24.6 24.6 25.0 25.1 25.1 25.2Cyprus 23.8 24.3 24.7 25.2 25.5 25.8 25.8 25.9 25.9Czech Republic 26.7 26.7 26.6 26.4 26.5 26.5 26.5 26.6 26.6Denmark 23.4 23.7 23.9 24.3 24.6 24.9 25.0 25.1 25.1Estonia 26.0 25.6 25.2 24.7 24.8 25.1 25.2 25.2 25.3Finland 25.0 25.0 25.2 25.3 25.4 25.5 25.6 25.6 25.6France 24.1 24.2 24.4 24.5 24.7 24.8 24.8 24.8 24.8Georgia 25.8 26.0 26.1 25.5 25.7 26.2 26.3 26.4 26.5Germany 24.7 24.9 25.1 25.3 25.5 25.6 25.6 25.7 25.7Greece 24.1 24.3 24.4 24.5 24.7 24.9 24.9 24.9 25.0Hungary 25.1 25.3 25.5 25.4 25.4 25.7 25.8 25.9 25.9Iceland 24.1 24.7 24.8 25.0 25.4 25.7 25.8 25.9 26.0Ireland 24.7 24.9 25.2 25.5 26.0 26.4 26.4 26.5 26.6Israel 24.4 24.9 25.4 26.0 26.5 27.0 27.1 27.2 27.3Italy 25.2 25.0 24.9 24.8 24.8 24.8 24.8 24.8 24.8Kazakhstan 25.3 25.6 25.8 25.8 25.8 26.3 26.5 26.6 26.8Kyrgyzstan 25.2 25.4 25.6 25.3 25.3 25.5 25.6 25.7 25.8Latvia 25.6 25.5 25.4 25.1 25.0 25.4 25.5 25.6 25.6Lithuania 27.0 26.6 26.3 25.7 25.7 26.0 26.0 26.1 26.1Luxembourg 24.2 24.5 24.8 25.3 25.6 25.9 26.0 26.0 26.1Malta 25.9 26.0 26.1 26.4 26.8 27.0 27.0 27.0 27.1Montenegro 26.0 26.0 25.8 25.4 25.4 25.5 25.5 25.6 25.7Netherlands 24.0 24.1 24.3 24.6 24.8 25.1 25.1 25.2 25.2Norway 23.7 24.1 24.4 24.7 25.2 25.6 25.6 25.7 25.7Poland 25.9 25.7 25.6 25.5 25.7 25.8 25.9 25.9 25.9Portugal 24.8 24.8 25.2 25.6 25.9 26.1 26.2 26.2 26.2Republic of Moldova 27.0 27.0 27.0 26.7 26.4 26.7 26.9 27.0 27.0Romania 25.4 25.4 25.3 25.0 24.9 25.1 25.2 25.2 25.3Russian Federation 26.8 26.7 26.6 26.4 26.5 26.9 27.0 27.1 27.2Serbia 26.1 26.1 25.9 25.4 25.2 25.2 25.3 25.3 25.4Slovakia 26.1 26.2 26.2 26.0 26.1 26.2 26.2 26.3 26.3Slovenia 26.4 26.4 26.3 26.2 26.3 26.5 26.5 26.6 26.6Spain 25.1 25.2 25.5 25.7 26.0 26.2 26.3 26.3 26.3Sweden 24.4 24.5 24.6 24.8 24.9 25.1 25.1 25.1 25.2Switzerland 23.7 23.8 23.9 24.0 24.0 24.1 24.1 24.1 24.1Tajikistan 24.3 24.4 24.4 23.8 23.4 23.6 23.7 23.8 23.9TFYR Macedonia 25.4 25.4 25.3 25.1 25.1 25.2 25.3 25.3 25.4Turkey 26.0 26.5 27.0 27.5 27.8 28.1 28.1 28.2 28.3Turkmenistan 24.1 24.2 24.3 24.1 24.0 24.4 24.5 24.6 24.7Ukraine 26.4 26.3 26.3 26.0 25.6 26.0 26.1 26.2 26.3United Kingdom 24.2 24.6 25.2 25.7 26.2 26.7 26.8 26.9 27.0Uzbekistan 24.2 24.5 24.7 24.7 24.9 25.2 25.3 25.4 25.5Source: WHO Global Health Observatory http://www.who.int/gho/database/en/ Notes: Age standardized estimates. Table 10.2 continued...
  • 110. 108 European Cardiovascular Disease StatisticsMean BMI>2827 to 2826 to 2725 to 26<25no dataFigure 10.2a Mean BMI, men aged 20 years and over, 2008, EuropeFigure 10.2b Mean BMI, women aged 20 years and over, 2008, EuropeMean BMI>2827 to 2826 to 2725 to 26<25no data
  • 111. 109European Cardiovascular Disease StatisticsPrevalence of overweightincluding obesity (%)Year Age group (years) Boys GirlsAustria 2003 8 to 12 22.5 16.7Belgium 1998-09 5 to 15 27.3 26.7Bulgaria 2004 5 to 17 22.0 17.9Crete 2005-06 10 to 12 45.0 37.0Cyprus 2003 11 30.2 28.8Czech Republic 2005 6 to 17 24.6 16.8Denmark 1996-07 5 to 16 14.1 15.3England 2009 5 to 17 21.8 26.1Estonia* 2005-06 11, 13 & 15 12.7 7.0Finland 2005-06 11, 13 & 15 18.7 13.0France 2006-07 3 to 17 13.1 14.9Germany 2008 4 to 16 22.6 17.7Greece 2003 13 to 17 27.8 16.0Hungary 2005 7 to 14 25.5 25.9Iceland 1998 9 22.0 25.5Italy † 2008 8 to 9 35.9† 35.9†Latvia* 2005-06 11, 13 & 15 10.0 5.7Luxembourg* 2005-07 11, 13 & 15 15.0 10.0Malta* 2005-06 11, 13 & 15 31.0 28.0Netherlands 2003 5 to 16 14.7 17.9Northern Ireland 2005 2 to 15 27.0 25.0Norway 2003-06 5 to 15 12.9 14.7Poland 2000 7 to 17 16.3 12.4Portugal 2008 10 to 18 23.5 21.6Poland 2000 7 to 17 16.3 12.4Romania* 2005-06 11, 13 & 15 14.7 8.7Russian Federation 2005 7 to 11 17.3 16.9Slovakia 2001 7 to 17 17.5 16.2Slovenia 2007 6 to 17 28.7 24.4Spain 1999-00 5 to 17 32.9 22.9Sweden 2000 10 17.0 19.5Switzerland 2007 6 to 13 16.7 13.1Turkey 2001 12 to 17 11.3 10.3Source: IOTF Global Childhood Overweight http://www.iaso.org/site_media/uploads/Global_Childhood_Overweight_May_2012.pdf Notes: All studies used IOTF definitions for childhood overweight and obesity, except Austria and Belgium, which used 90th and 85th centiles of reference populations. * indicates self-reported data. † Italy: study did not provide results by gender, therefore results for all children combined are presented. Table 10.3 Prevalence of childhood overweight, by sex, latest available year, Europe
  • 112. 110 European Cardiovascular Disease Statistics11. DiabetesDiabetes mellitus not only substantially increases the risk of CVD but also magnifies the effect of other risk factorsfor CVD such as raised cholesterol levels, raised blood pressure, smoking and obesity.The INTERHEART case-control study estimated that people with diagnosed diabetes are at three times the risk of aheart attack compared to those without1.The most recent data from the WHO’s European Health for All Database, which compiles data from national diabetesregisters, where available, or from routine reporting systems, show diabetes prevalence of less than 1% in sixcountries: Albania, Greece, Iceland, Tajikistan, Turkmenistan, Uzbekistan and Kyrgyzstan. The highest prevalencerates (>6% of the population) were in Slovakia, Malta, Portugal and the Czech Republic (Table 11.1). Among 25countries with data available for comparison, 21 showed an increase in diabetes prevalence after 2000 (Table 11.1and Figure 11.1b). There was an almost doubling in rates (from a low starting prevalence) in Romania, Latvia andAzerbaijan between 2000 and 2009 and a further seven countries showed increases of more than 50% on 2000prevalence. The most recent estimates of diabetes prevalence show a much higher rate in the EU (4.1%) comparedwith Europe as a whole (2.8%) (Figure 11.1a).There is strong evidence, however, that diagnosis rates of diabetes may vary substantially between countries andthat the true rate of diabetes is generally much higher than the diagnosed rates of disease. The WHO’s estimatesof prevalence of raised fasting glucose, an indicator of diabetes risk, show substantially greater proportions of thepopulation at risk (Table 11.2). Seventeen countries had a prevalence of raised fasting glucose of more than one inten, including many countries with very low rates of diagnosed diabetes. No countries had an estimated prevalenceof raised fasting glucose less than 5% of the adult population. Over time, estimates of mean fasting blood glucoselevels in European countries have generally showed small increases since 1980 (Table 11.3).1 Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries(the INTERHEART study): case-control study. Lancet 2004;364(9438):937-52.
  • 113. 111European Cardiovascular Disease Statistics1980-84 1985-89 1990-94 1995-99 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009Albania 0.1 0.1 0.1Armenia 0.6 0.8 1.1 1.1 1.1 1.1 1.1 1.0 1.1 1.1 1.2 1.3 1.4 1.5Austria 4.7Azerbaijan 0.6 0.5 0.5 0.6 0.6 0.6 0.6 0.6 0.8 0.9 1.1 1.2Belarus 1.2 1.2 1.3 1.4 1.5 1.5 1.6 1.7 1.8 1.9 1.9 2.1Belgium 2.9 3.2 2.8 3.5 3.6Bosnia & Herzegovina 0.5 0.6 0.7 1.3 1.2 1.1 1.1 1.2 1.3 1.7 1.6 1.5 1.3Bulgaria 1.0 1.2 1.2 1.6 1.7Czech Republic 3.4 4.1 4.8 5.8 6.4 6.4 6.5 6.7 7.0 7.2 7.3 7.3 7.4 7.5Denmark 2.4 2.4 2.8 3.0 3.2 3.5 3.8 4.0 4.2 4.4 4.7Estonia 2.9Finland 1.8 1.9 2.1 2.3 2.6 2.7 2.8 2.9 3.1 3.3 3.4 3.5 3.7 4.0France 0.6 2.8 3.0Georgia 1.0 1.1 1.0 1.1 1.1 1.1 1.2 1.3 1.3 1.4 1.5 1.6GermanyGreece 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.1 0.2 0.2 0.2Hungary 4.4Iceland 0.1 0.1 0.2 0.2Israel 2.6 3.0 3.2 3.7 3.9 4.1 4.7Italy 3.7 4.2 4.5 4.6 4.8 4.8Kazakhstan 0.7 0.6 0.7 0.6 0.8 0.9 0.8 0.9 0.9 1.0 1.2 1.1Kyrgyzstan 0.2 0.4 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.5 0.5 0.5 0.6Latvia 1.1 1.1 1.1 1.5 1.5 1.5 1.7 1.7 2.1 2.3 2.6 2.8 3.0Lithuania 0.8 0.9 1.0 1.2 1.5 1.5 1.7 2.0 2.1 2.2 1.7 1.8 2.0 2.2Malta 5.2 6.5 6.6 6.8 7.1 7.6 6.4Netherlands 2.0 1.9 2.0 3.8Norway 2.9 2.0Portugal 6.1 4.8 6.5Republic Moldova 0.6 0.9 1.0 0.9 0.9 0.7 0.8 1.0 1.1 1.2 1.3 1.4 1.5 1.5Romania 0.6 0.7 1.1 1.4 1.6 1.8 1.9 2.1 2.2 2.0 2.7 3.0 2.7Russian Federation 1.0 1.3 1.3 1.4 1.5 1.5 1.6 1.7 1.8 1.9Slovakia 2.8 3.3 3.8 4.2 4.7 4.9 5.1 5.2 5.3 5.3 5.5 5.7 5.6 6.2Slovenia 2.5 2.8 3.4Spain 5.0 5.1Sweden 3.0 2.9Tajikistan 0.3 0.2 0.3 0.2 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.3TFYR Macedonia 1.1 0.8 1.0 1.0 1.1 1.1 1.3 1.3 1.4Turkey 1.9Turkmenistan 0.4 0.3 0.4 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3Ukraine 1.0 1.3 1.7 1.8 1.9 1.9 1.9 2.0 2.1 2.2 2.3 2.4 2.5 2.6United Kingdom 3.5 3.7 3.9 4.1 4.3Uzbekistan 0.4 0.4 0.5 0.4 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.6Table 11.1 Prevalence of diabetes, adults, 1980 to 2009, EuropeSource: WHO Europe. Health for All Database (HFA-DB) http://data.euro.who.int/hfadb/ Notes: Where years are given as 5-year ranges, values are the averages of available data for the 5 years. Blank cells indicate data were not available.
  • 114. 112 European Cardiovascular Disease StatisticsFigure 11.1a Prevalence of diabetes, latest available year, EuropeFigure 11.1b Prevalence of diabetes, 1980 to 2009, selected countriesAlbaniaGreeceIcelandTajikistanTurkmenistanKyrgyzstanUzbekistanKazakhstanAzerbaijanBosnia&HerzegovinaArmeniaRepublicofMoldovaTFYRMacedoniaGeorgiaBulgariaRussianFederationTurkeyNorwayBelarusLithuaniaUkraineRomaniaEuropeSwedenEstoniaLatviaFranceSloveniaBelgiumNetherlandsFinlandEUUnitedKingdomHungaryDenmarkIsraelAustriaItalySpainSlovakiaMaltaPortugalCzechRepublic876543210%8.07.06.05.04.03.02.0.010.01980Year1985 1990 1995 2000 2005 2010TajikistanGreeceCzech RepublicSlovakiaFinlandRepublic of MoldovaRomania%
  • 115. 113European Cardiovascular Disease StatisticsTable 11.2 Prevalence of raised blood glucose, adults aged 25 and over, 2008, EuropeAge standardized prevalence estimate of raised fasting blood glucose(≥ 7.0 mmol/L or on medication) (%)Males Females TotalNetherlands 6.1 4.1 5.1France 7.2 4.3 5.7Austria 7.1 4.6 5.8Portugal 7.5 5.7 6.6United Kingdom 7.8 5.7 6.7Ireland 8.4 5.6 7.0Sweden 8.1 6.0 7.0Italy 8.8 5.4 7.1Switzerland 9.3 5.3 7.2Denmark 8.8 5.9 7.3Poland 8.2 6.9 7.6Belgium 9.3 6.4 7.8Germany 9.8 6.3 8.0Finland 10.3 6.3 8.1Luxembourg 9.9 6.7 8.3Cyprus 10.2 6.8 8.4Estonia 9.0 7.8 8.4Andorra 10.4 7.0 8.6Greece 9.5 7.9 8.7Iceland 10.9 6.9 8.9Montenegro 9.8 8.4 9.1Norway 10.6 7.7 9.1Serbia 10.3 8.2 9.2Croatia 10.2 8.4 9.3Israel 10.2 8.7 9.4Romania 10.0 8.9 9.4Hungary 10.6 8.5 9.5Albania 10.3 9.0 9.6TFYR Macedonia 10.4 8.8 9.6Bulgaria 10.4 8.9 9.7Latvia 10.4 9.0 9.7Slovakia 10.6 9.2 9.9Slovenia 10.7 8.8 9.7Spain 11.0 8.8 9.9Turkey 10.1 9.8 10.0Belarus 10.4 10.0 10.2Tajikistan 10.7 9.7 10.2Ukraine 10.2 10.2 10.2Czech Republic 11.5 9.1 10.3Lithuania 11.2 9.7 10.4Malta 11.8 8.9 10.4Republic of Moldova 9.5 11.1 10.4Russian Federation 10.5 10.7 10.6Kyrgyzstan 11.1 10.4 10.7Bosnia and Herzegovina 11.4 10.4 10.9Turkmenistan 12.0 10.1 11.0Armenia 11.5 11.5 11.5Georgia 11.9 11.1 11.5Kazakhstan 12.5 10.8 11.5Uzbekistan 12.6 10.9 11.7Azerbaijan 12.1 12.3 12.2Source: WHO Global Health Observatory http://www.who.int/gho/database/en/
  • 116. 114 European Cardiovascular Disease StatisticsMen Age-standardized estimate of mean fasting blood glucose levels (mmol/L)1980 1985 1990 1995 2000 2005 2006 2007 2008Albania 5.4 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5Andorra 5.4 5.4 5.5 5.5 5.5 5.6 5.6 5.6 5.6Armenia 5.4 5.5 5.5 5.5 5.6 5.6 5.6 5.7 5.7Austria 4.9 4.9 5.0 5.1 5.2 5.3 5.4 5.4 5.4Azerbaijan 5.5 5.5 5.6 5.6 5.6 5.7 5.7 5.7 5.7Belarus 5.4 5.4 5.4 5.4 5.4 5.5 5.5 5.5 5.5Belgium 5.3 5.3 5.4 5.4 5.4 5.5 5.5 5.5 5.6Bosnia and Herzegovina 5.4 5.5 5.5 5.6 5.7 5.7 5.7 5.7 5.7Bulgaria 5.4 5.4 5.5 5.5 5.5 5.5 5.5 5.5 5.5Croatia 5.3 5.4 5.4 5.4 5.4 5.5 5.5 5.5 5.5Cyprus 5.4 5.4 5.4 5.5 5.5 5.6 5.6 5.6 5.6Czech Republic 5.3 5.5 5.6 5.6 5.7 5.7 5.7 5.7 5.7Denmark 5.3 5.3 5.3 5.4 5.4 5.5 5.5 5.5 5.5Estonia 5.3 5.3 5.3 5.2 5.3 5.3 5.3 5.3 5.4Finland 5.7 5.7 5.6 5.6 5.6 5.6 5.7 5.7 5.7France 5.4 5.4 5.5 5.5 5.5 5.5 5.5 5.5 5.5Georgia 5.5 5.6 5.6 5.6 5.6 5.7 5.7 5.7 5.7Germany 5.5 5.5 5.6 5.6 5.6 5.6 5.6 5.6 5.6Greece 5.4 5.4 5.5 5.5 5.5 5.6 5.6 5.6 5.6Hungary 5.3 5.4 5.5 5.5 5.5 5.5 5.6 5.6 5.6Iceland 5.4 5.5 5.5 5.5 5.6 5.6 5.6 5.7 5.7Ireland 5.4 5.4 5.4 5.5 5.5 5.5 5.5 5.5 5.5Israel 5.5 5.5 5.5 5.6 5.6 5.6 5.6 5.7 5.7Italy 5.3 5.3 5.3 5.3 5.4 5.5 5.5 5.6 5.6Kazakhstan 5.5 5.5 5.6 5.7 5.7 5.7 5.7 5.8 5.8Kyrgyzstan 5.5 5.5 5.6 5.6 5.6 5.6 5.6 5.6 5.6Latvia 5.4 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5Lithuania 5.5 5.5 5.5 5.5 5.5 5.6 5.6 5.6 5.6Luxembourg 5.3 5.3 5.4 5.4 5.5 5.6 5.6 5.6 5.6Malta 5.4 5.5 5.5 5.6 5.7 5.7 5.8 5.8 5.8Montenegro 5.4 5.4 5.4 5.4 5.4 5.4 5.4 5.5 5.5Netherlands 5.3 5.3 5.3 5.3 5.2 5.3 5.3 5.3 5.3Norway 5.4 5.4 5.5 5.5 5.6 5.6 5.6 5.7 5.7Poland 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3Portugal 5.3 5.3 5.3 5.3 5.3 5.4 5.4 5.4 5.4Republic of Moldova 5.4 5.4 5.4 5.4 5.3 5.4 5.4 5.4 5.4Romania 5.3 5.4 5.4 5.4 5.4 5.5 5.5 5.5 5.5Russian Federation 5.4 5.4 5.4 5.4 5.4 5.5 5.5 5.5 5.5Serbia 5.4 5.4 5.5 5.5 5.5 5.5 5.5 5.5 5.5Slovakia 5.4 5.4 5.5 5.5 5.5 5.5 5.6 5.6 5.6Slovenia 5.4 5.5 5.5 5.5 5.5 5.5 5.6 5.6 5.6Spain 5.1 5.2 5.2 5.4 5.5 5.6 5.7 5.7 5.7Sweden 5.4 5.4 5.4 5.4 5.4 5.5 5.5 5.5 5.5Switzerland 5.3 5.3 5.4 5.4 5.5 5.5 5.6 5.6 5.6Tajikistan 5.5 5.5 5.5 5.5 5.5 5.5 5.6 5.6 5.6TFYR Macedonia 5.4 5.4 5.5 5.5 5.5 5.5 5.5 5.5 5.5Turkey 5.3 5.4 5.5 5.5 5.6 5.5 5.5 5.5 5.5Turkmenistan 5.5 5.5 5.6 5.6 5.6 5.7 5.7 5.7 5.7Ukraine 5.4 5.4 5.4 5.4 5.4 5.5 5.5 5.5 5.5United Kingdom 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5 5.5Uzbekistan 5.6 5.6 5.7 5.7 5.8 5.8 5.8 5.8 5.8Table 11.3 Trends in mean blood glucose levels, by sex, 1980 to 2008, Europe
  • 117. 115European Cardiovascular Disease StatisticsWomen Age-standardized estimate of mean fasting blood glucose levels (mmol/L)1980 1985 1990 1995 2000 2005 2006 2007 2008Albania 5.3 5.3 5.4 5.3 5.3 5.3 5.3 5.3 5.3Andorra 5.2 5.2 5.3 5.3 5.3 5.3 5.3 5.3 5.3Armenia 5.3 5.4 5.5 5.5 5.6 5.6 5.6 5.6 5.6Austria 4.8 4.8 4.9 4.9 5.0 5.0 5.1 5.1 5.1Azerbaijan 5.4 5.4 5.5 5.5 5.6 5.7 5.7 5.7 5.7Belarus 5.4 5.4 5.4 5.4 5.4 5.4 5.4 5.4 5.4Belgium 5.1 5.1 5.2 5.2 5.2 5.2 5.2 5.2 5.2Bosnia and Herzegovina 5.2 5.3 5.4 5.5 5.6 5.5 5.5 5.5 5.5Bulgaria 5.2 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3Croatia 5.1 5.2 5.2 5.2 5.2 5.2 5.2 5.2 5.2Cyprus 5.1 5.2 5.2 5.2 5.2 5.3 5.3 5.3 5.3Czech Republic 5.2 5.3 5.4 5.4 5.4 5.4 5.4 5.3 5.3Denmark 5.0 5.1 5.1 5.1 5.1 5.1 5.1 5.2 5.2Estonia 5.3 5.3 5.2 5.1 5.1 5.1 5.1 5.1 5.1Finland 5.2 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3France 5.1 5.2 5.2 5.2 5.2 5.2 5.2 5.1 5.1Georgia 5.3 5.4 5.4 5.4 5.5 5.5 5.6 5.6 5.6Germany 5.2 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3Greece 5.2 5.3 5.3 5.3 5.3 5.4 5.4 5.4 5.4Hungary 5.1 5.1 5.2 5.2 5.2 5.2 5.2 5.2 5.2Iceland 5.1 5.2 5.2 5.2 5.2 5.2 5.3 5.3 5.3Ireland 5.1 5.1 5.2 5.2 5.2 5.2 5.2 5.2 5.2Israel 5.3 5.3 5.4 5.5 5.5 5.5 5.5 5.5 5.5Italy 5.2 5.1 5.1 5.1 5.1 5.1 5.1 5.1 5.1Kazakhstan 5.3 5.3 5.4 5.5 5.5 5.5 5.5 5.5 5.5Kyrgyzstan 5.3 5.3 5.4 5.4 5.5 5.5 5.5 5.5 5.5Latvia 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3Lithuania 5.4 5.4 5.4 5.3 5.4 5.4 5.4 5.4 5.4Luxembourg 5.0 5.1 5.1 5.1 5.2 5.2 5.2 5.2 5.3Malta 5.3 5.4 5.4 5.4 5.5 5.5 5.5 5.5 5.5Montenegro 5.2 5.3 5.3 5.2 5.2 5.2 5.2 5.2 5.2Netherlands 5.2 5.1 5.1 5.0 5.0 4.9 4.9 4.9 4.9Norway 5.1 5.2 5.3 5.3 5.3 5.4 5.4 5.4 5.4Poland 5.1 5.2 5.2 5.1 5.1 5.1 5.0 5.0 5.0Portugal 5.2 5.2 5.2 5.2 5.1 5.1 5.1 5.1 5.1Republic of Moldova 5.4 5.4 5.5 5.5 5.5 5.5 5.5 5.6 5.6Romania 5.2 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3Russian Federation 5.4 5.4 5.4 5.4 5.5 5.5 5.5 5.5 5.5Serbia 5.2 5.3 5.3 5.3 5.2 5.2 5.2 5.2 5.2Slovakia 5.2 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3Slovenia 5.2 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3Spain 5.0 5.0 5.1 5.2 5.3 5.5 5.5 5.5 5.5Sweden 5.4 5.4 5.4 5.3 5.3 5.2 5.2 5.2 5.2Switzerland 5.0 5.0 5.1 5.1 5.1 5.2 5.2 5.2 5.2Tajikistan 5.2 5.2 5.3 5.3 5.3 5.4 5.4 5.4 5.4TFYR Macedonia 5.2 5.2 5.3 5.3 5.3 5.3 5.3 5.3 5.3Turkey 5.2 5.3 5.4 5.4 5.5 5.5 5.5 5.5 5.5Turkmenistan 5.2 5.2 5.3 5.3 5.4 5.4 5.4 5.4 5.4Ukraine 5.4 5.4 5.4 5.4 5.4 5.4 5.4 5.4 5.4United Kingdom 5.2 5.2 5.3 5.3 5.3 5.3 5.3 5.3 5.3Uzbekistan 5.2 5.3 5.4 5.5 5.5 5.6 5.6 5.6 5.6Source: WHO Global Health Observatory http://www.who.int/gho/database/en/ Table 11.3 continued...
  • 118. 116 European Cardiovascular Disease Statistics12. Economic costsTotal costsCVD has major economic costs as well as human costs for Europe.1Overall CVD is estimated to cost the EU economyalmost €196 billion a year. Of the total cost of CVD in the EU, around 54% is due to direct health care costs, 24%to productivity losses and 22% to the informal care of people with CVD (Table 12.1).CHD is estimated to cost the EU economy €60 billion a year: 31% of the overall cost of CVD. Of the total cost of CHDin the EU, around 33% is due to direct health care costs, 29% to productivity losses and 38% to the informal careof people with CHD (Table 12.1).Stroke is estimated to cost the EU economy over €38 billion a year: around one-fifth of the overall cost of CVD. Ofthe total cost of stroke in the EU, around 50% is due to direct health care costs, 22% to productivity losses and 29%to the informal care of people with stroke (Table 12.1).Health care costsCVD cost the health care systems of the EU just over €106 billion in 2009.2This represents a cost per capita of€212 per annum, around 9% of the total health care expenditure across the EU. The cost of inpatient hospital carefor people who have CVD accounted for about 49% of these costs, and that of drugs for about 29% (Table 12.2 andFigure 12.1).The amount spent on health care for people with CVD varies widely across the EU. Cost per capita varied ten-fold in2009, from €37 in Romania to €374 in Germany. Percentage of total health care expenditure spent on CVD variedfrom 4% in Luxembourg to 17% in Estonia, Latvia and Poland (Table 12.2).Around one-fifth (19%) of health care expenditure on CVD in the EU is due to CHD (Tables 12.2 and 12.3). CHDcost the health care systems of the EU just under €20 billion in 2009. Inpatient hospital care for people who haveCHD accounted for 56% of these costs and drugs accounted for 20% (Table 12.3).Almost one-fifth (18%) of health care expenditure on CVD in the EU is due to stroke (Tables 12.2 and 12.4). Strokecost the health care systems of the EU €19 billion in 2009. Inpatient hospital care for people who have strokesaccounted for about 72% of these costs and drugs accounted for about 7% (Table 12.4).Non health-care costsLooking only at the cost of CVD to the health care systems of the EU grossly underestimates the true cost of CVD.Production losses from death and illness in those of working age and from the informal care of people with thedisease contribute greatly to the overall financial burden. Informal care costs are equivalent to the opportunity costof unpaid care. This opportunity cost is a measure of the amount of money that carers forgo to provide unpaid carefor their spouses, friends or relatives suffering from CVD, CHD or stroke.
  • 119. 117European Cardiovascular Disease StatisticsIn 2009, production losses due to mortality and morbidity associated with CVD cost the EU almost €46 billion, with59% of this cost due to death (€27 billion) and 41% due to illness (€19 billion) in those of working age (Table 12.5).Just under half (45%) of the production losses due to mortality from CVD and 29% of the cost of production lossesdue to morbidity were due to CHD. In 2009, production losses due to mortality and morbidity associated with CHDcost the EU €18 billion (Table 12.5).Stroke accounted for 18% of the production losses due to mortality from CVD and 18% of the cost of productionlosses due to morbidity. In 2009, production losses due to mortality and morbidity associated with stroke cost theEU €8 billion (Table 12.5).The cost of informal care for people with CVD in the EU is another important non-health care cost. In 2009, the totalcost of providing this care was just under €44 billion. Just over half of these costs were due to CHD (€23 billion)and over one-quarter were due to stroke (€11 billion) (Table 12.5).This Chapter should be referenced as: Leal J, Luengo-Fernandez R, Gray A. Economic Costs. In: Nichols M, Townsend N, Scarborough P, Rayner M et al. EuropeanCardiovascular Disease Statistics 2012. European Heart Network, Brussels, European Society of Cardiology, Sophia Antipolis.1 The figures for this section are from a new cost of illness study by researchers at the Health Economics Research Centre, Department of Public Health, Universityof Oxford. The analysis was carried out for the year 2009, and costs calculated for individual Member States and the EU as a whole.2 Due to lack of data across the EU, this figure does not include the money spent on non-clinical activities concerned with the primary prevention of CVD, for ex-ample, public anti-smoking campaigns, nutrition education etc. However, the cost of drugs prescribed in primary care for both primary and secondary preventionare included.
  • 120. 118 European Cardiovascular Disease StatisticsCVD CHD Cerebrovascular disease€ thousands % of total € thousands % of total € thousands % of totalDirect health carecosts106,156,940 54% 19,867,875 33% 19,102,868 50%Productivity loss dueto mortality26,963,326 14% 12,014,249 20% 4,812,409 13%Productivity loss dueto morbidity18,873,665 10% 5,530,552 9% 3,329,282 9%Informal care costs 43,560,202 22% 22,812,144 38% 11,115,782 29%Total 195,554,133 60,224,820 38,360,340Table 12.1 Total cost of CVD, CHD and cerebrovascular diseases, 2009, EU
  • 121. 119European Cardiovascular Disease StatisticsCountryPrimarycareOutpatientcareA&EInpatientcareMedicationsTotalhealthcarecostsCostpercapitaPercentageoftotalhealthcareexpenditureAustria€54,246€87,906€36,341€1,510,046€650,078€2,338,617€2808%Belgium€177,452€57,286€9,007€1,232,872€898,200€2,374,817€2216%Bulgaria€24,959€29,616€7,432€107,855€178,015€347,877€4613%Cyprus€3,210€10,282€2,708€12,425€38,125€66,750€847%CzechRep.€65,706€148,065€32,699€826,796€494,368€1,567,633€15014%Denmark€51,595€58,393€31,313€852,000€251,102€1,244,403€2265%Estonia€12,081€22,645€13,395€84,302€34,034€166,457€12417%Finland€40,419€63,569€32,805€1,602,803€219,156€1,958,752€36812%France€590,209€910,328€99,969€6,927,755€4,203,000€12,731,261€1986%Germany€2,450,304€5,832,696€130,517€16,315,575€5,950,067€30,679,159€37411%Greece€108,174€241,064€48,125€824,182€1,578,000€2,799,545€24911%Hungary€46,043€54,948€8,822€281,589€607,358€998,760€10014%Ireland€52,444€49,066€21,005€501,797€301,235€925,547€2086%Italy€1,148,231€1,056,688€272,339€6,863,073€5,148,000€14,488,331€24110%Latvia€12,356€19,409€6,291€113,328€51,972€203,355€9017%Lithuania€27,107€26,682€12,631€87,205€97,288€250,913€7512%Luxembourg€7,027€12,399€986€69,429€43,204€133,045€2704%Malta€1,777€2,353€995€15,060€28,326€48,511€11711%Netherlands€493,132€707,649€31,226€3,458,479€1,107,333€5,797,817€3528%Poland€246,162€840,684€34,263€1,687,006€1,349,535€4,157,650€10917%Portugal€79,746€70,673€51,046€264,403€749,523€1,215,392€1146%Romania€18,230€143,334€6,212€343,317€291,471€802,565€3712%Slovakia€65,260€162,234€7,890€178,269€181,200€594,854€11010%Slovenia€13,554€11,844€8,242€109,612€120,100€263,352€1308%Spain€1,737,135€760,823€464,684€1,812,847€3,160,000€7,935,489€1738%Sweden€318,028€540,650€127,274€1,112,638€331,711€2,430,301€2638%UK€1,247,279€1,140,361€171,810€4,843,730€2,232,610€9,635,790€1566%TOTALEU€9,091,864€13,061,647€1,670,027€52,038,391€30,295,010€106,156,940€2129%Table12.2HealthcarecostsofCVD(€thousands)bycountry,2009,EU
  • 122. 120 European Cardiovascular Disease StatisticsFigure 12.2 Percentage of total healthcare expenditure on CVD in the EU, 2009, by resource use categoryPrimary care 9%Outpatient care 12%A&E 2%Inpatient care 49%Medications 29%
  • 123. 121European Cardiovascular Disease StatisticsCountryPrimarycareOutpatientcareA&EInpatientcareMedicationsTotalhealthcarecostsCostpercapitaPercentageoftotalhealthcareexpenditureAustria€13,681€22,171€9,166€358,227€86,365€489,609€592%Belgium€53,831€17,378€2,732€302,511€119,329€495,780€461%Bulgaria€5,586€6,628€1,663€18,751€23,650€56,279€72%Cyprus€990€3,172€835€3,694€5,065€13,757€171%CzechRep.€16,799€37,856€8,360€143,887€65,678€272,581€262%Denmark€15,484€17,524€7,917€197,869€33,360€272,154€491%Estonia€3,454€6,473€3,829€22,433€4,522€40,711€304%Finland€15,475€16,414€8,470€335,313€29,116€404,787€763%France€52,893€81,581€8,959€1,067,922€470,640€1,681,994€261%Germany€312,094€742,906€34,542€3,669,570€654,425€5,413,538€662%Greece€37,525€83,624€16,694€236,781€209,642€584,266€522%Hungary€10,073€12,021€1,930€58,523€80,689€163,236€162%Ireland€16,637€15,565€6,663€118,280€40,020€197,165€441%Italy€280,668€258,292€66,569€1,282,952€683,928€2,572,409€432%Latvia€4,768€7,489€2,427€38,810€6,905€60,399€275%Lithuania€8,302€8,171€3,868€25,145€12,925€58,412€173%Luxembourg€1,960€3,459€275€13,594€5,740€25,029€511%Malta€527€698€295€3,768€3,763€9,051€222%Netherlands€118,045€169,396€7,475€924,795€370,915€1,590,626€962%Poland€72,507€247,623€10,092€414,306€179,290€923,819€244%Portugal€19,007€16,844€12,166€43,670€99,577€191,263€181%Romania€2,318€18,224€790€43,363€38,723€103,417€52%Slovakia€19,754€49,108€2,388€49,364€24,073€144,687€273%Slovenia€2,800€2,446€1,702€18,913€15,956€41,817€211%Spain€398,724€174,632€106,659€362,949€419,816€1,462,780€321%Sweden€99,019€168,333€39,627€249,859€44,069€600,907€652%UK€120,364€399,865€58,518€1,122,043€296,609€1,997,400€321%TotalEU€1,703,282€2,587,894€424,615€11,127,295€4,024,789€19,867,875€402%Table12.3HealthcarecostsofCHD(€thousands)bycountry,2009,EU
  • 124. 122 European Cardiovascular Disease StatisticsTable12.4Healthcarecostsofcerebrovasculardiseases(€thousands)bycountry,2009,EUCountryPrimarycareOutpatientcareA&EInpatientcareMedicationsTotalhealthcarecostsCostpercapitaPercentageoftotalhealthcareexpenditureAustria€7,864€12,745€5,269€389,985€27,851€443,714€531%Belgium€23,484€7,581€1,192€189,615€38,481€260,353€241%Bulgaria€5,063€6,008€1,508€25,246€7,627€45,451€62%Cyprus€602€1,928€508€2,716€1,633€7,387€91%CzechRep.€12,253€27,611€6,098€283,717€21,180€350,859€343%Denmark€8,174€9,252€5,624€201,556€10,758€235,364€431%Estonia€2,436€4,567€2,701€26,743€1,458€37,906€284%Finland€10,814€12,229€6,311€701,725€9,389€740,468€1395%France€43,044€66,390€7,291€1,240,771€172,532€1,530,027€241%Germany€491,658€1,170,342€19,842€4,016,170€264,919€5,962,931€732%Greece€17,943€39,985€7,982€429,643€67,606€563,158€502%Hungary€12,087€14,425€2,316€77,699€26,021€132,548€132%Ireland€7,356€6,882€2,946€30,539€12,906€60,628€140%Italy€218,466€201,049€51,816€2,014,216€220,555€2,706,102€452%Latvia€2,809€4,412€1,430€32,711€2,227€43,589€194%Lithuania€5,438€5,352€2,534€18,335€4,168€35,826€112%Luxembourg€542€957€76€9,315€1,851€12,742€260%Malta€160€212€90€2,004€1,214€3,680€91%Netherlands€67,231€96,478€4,257€1,152,323€44,976€1,365,266€832%Poland€34,680€118,436€4,827€333,710€57,818€549,471€142%Portugal€15,705€13,918€10,053€83,027€32,112€154,814€151%Romania€3,445€27,083€1,174€74,273€12,487€118,462€62%Slovakia€11,666€29,002€1,410€43,133€7,763€92,974€172%Slovenia€1,556€1,360€946€26,615€5,145€35,622€181%Spain€294,340€128,914€78,736€429,299€135,383€1,066,672€231%Sweden€58,694€99,781€23,489€371,646€14,211€567,822€612%UK€44,438€180,121€35,278€1,623,543€95,651€1,979,031€321%TotalEU€1,401,949€2,287,019€285,703€13,830,274€1,297,923€19,102,868€382%
  • 125. 123European Cardiovascular Disease StatisticsTable12.5Nonhealth-carecosts(€thousands)ofCVD,CHDandcerebrovasculardiseasesbycountry,2009,EUCVDCHDCerebrovasculardiseasesCountryProductionlossesduetomortalityProductionlossesduetomorbidityInformalcareProductionlossesduetomortalityProductionlossesduetomorbidityInformalcareProductionlossesduetomortalityProductionlossesduetomorbidityInformalcareAustria€442,022€233,822€980,348€234,216€50,799€501,081€74,215€33,761€226,305Belgium€610,318€776,671€802,999€256,243€201,880€487,018€116,889€151,119€186,695Bulgaria€209,616€43,427€162,079€52,801€7,550€79,916€44,379€10,165€41,581Cyprus€51,559€9,083€48,667€34,739€7,670€18,451€5,555€3,073€9,211CzechRep.€364,212€276,622€522,289€170,234€41,695€275,098€56,505€21,830€113,095Denmark€510,395€445,050€225,752€190,882€102,680€125,811€127,713€107,634€81,864Estonia€81,373€56,546€74,219€31,322€15,076€36,673€12,287€17,990€18,951Finland€457,302€253,653€209,244€201,652€34,115€45,598€80,758€135,540€70,836France€2,049,415€2,482,111€3,153,216€690,355€904,073€2,200,702€418,162€456,197€858,606Germany€7,584,053€5,659,342€14,500,758€3,332,466€1,380,995€7,491,747€1,124,157€693,771€4,120,745Greece€885,590€149,385€563,646€570,513€97,578€293,502€148,642€177,057€115,323Hungary€345,178€80,905€491,856€169,274€18,785€245,885€63,068€20,995€127,035Ireland€388,271€381,287€213,073€227,120€143,465€93,065€62,522€49,634€64,501Italy€2,097,533€181,741€6,864,506€861,572€43,359€3,468,716€392,183€45,942€1,551,716Latvia€144,340€33,480€100,459€65,822€9,577€49,170€26,582€8,178€25,419Lithuania€143,894€66,516€127,149€70,231€18,980€61,958€26,485€16,531€32,000Luxembourg€31,511€27,131€47,212€13,087€5,954€20,294€5,481€4,401€11,818Malta€6,429€1,471€18,097€3,770€533€6,864€1,490€246€3,448Netherlands€1,181,306€2,323,857€1,359,953€441,322€770,506€757,049€210,329€407,466€364,542Poland€1,416,633€648,536€1,910,185€424,684€181,603€1,320,857€279,825€133,746€588,684Portugal€532,412€189,725€593,333€177,566€45,219€235,078€200,299€37,363€118,530Romania€776,777€135,605€522,035€330,163€17,128€251,533€215,070€29,337€129,465Slovakia€182,335€143,936€237,672€89,291€22,123€111,908€33,356€11,703€56,943Slovenia€78,569€83,595€206,266€34,599€24,243€102,726€19,476€10,449€53,188Spain€1,369,038€939,852€4,898,748€588,440€243,536€2,242,211€263,699€210,992€859,550Sweden€556,789€534,619€511,146€278,335€119,656€374,236€100,903€180,663€167,374UK€4,466,456€2,715,698€4,215,296€2,473,550€1,021,775€1,915,000€702,379€353,501€1,118,357TotalEU€26,963,326€18,873,665€43,560,202€12,014,249€5,530,552€22,812,144€4,812,409€3,329,282€11,115,782
  • 126. 124 European Cardiovascular Disease Statistics2010 Mid-year malepopulation2010 Mid-year femalepopulationAlbania 1,605,000 1,600,000Andora 42,500 42,500Armenia 1,439,000 1,653,000Austria 4,096,000 4,298,000Azerbaijan 4,544,000 4,644,000Belarus 4,462,000 5,133,000Belgium 5,251,000 5,462,000Bosnia Herzegovina 1,807,000 1,953,000Bulgaria 3,623,000 3,872,000Croatia 2,120,000 2,284,000Cyprus 563,000 540,000Czech Republic 5,147,000 5,346,000Denmark 2,752,000 2,799,000Estonia 618,000 723,000Finland 2,632,000 2,732,000France 30,549,000 32,239,000Georgia 2,050,000 2,302,000Germany 40,341,000 41,962,000Greece 5,620,000 5,740,000Hungary 4,740,000 5,244,000Iceland 161,000 159,000Ireland 2,236,000 2,233,000Israel 3,661,000 3,758,000Italy 29,616,000 30,935,000Kazakhstan 7,695,000 8,332,000Kyrgyzstan 2,632,000 2,702,000Latvia 1,036,000 1,216,000Lithuania 1,544,000 1,779,000Luxembourg 252,000 255,000Malta 207,000 210,000Monaco 17,500 17,500Montenegro 310,000 322,000Netherlands 8,243,000 8,370,000Norway 2,443,000 2,440,000Poland 18,467,000 19,810,000Portugal 5,171,000 5,504,000Republic of Moldova 1,695,000 1,878,000Romania 10,434,143 10,997,155Russian Federation 66,135,000 76,824,000San Marino 16,000 16,000Serbia 4,878,000 4,979,000Slovakia 2,656,000 2,806,000Slovenia 993,000 1,037,000Spain 22,748,000 23,329,000Sweden 4,671,000 4,709,000Switzerland 3,767,000 3,897,000Tajikistan 3,385,000 3,494,000TFYR Macedonia 1,032,000 1,028,000Turkey 36,285,000 36,467,000Turkmenistan 2,483,000 2,559,000Ukraine 20,914,000 24,535,000United Kingdom 30,516,000 31,520,000Uzbekistan 13,641,000 13,804,000European Region 433,866,144 462,414,144EU 244,722,144 255,667,152Member states of the WHO European RegionAPPENDIXSource: WHO Europe Health for All DatabaseFor Andorra, Monaco and San Marino, only whole population figures were available, data presented here assume equal male and female populations
  • 127. 125European Cardiovascular Disease StatisticsNote:*MemberoftheEuropeanUnionFRANCE*GERMANY*ITALY*GREECE*SPAIN*TURKEYFINLAND*ICELANDUNITEDKINGDOM*IRELAND*PORTUGAL*NIGERIAGAMBIAGUINEA-BISSAUPOLAND*ROMANIA*BULGARIA*KYRGYZSTANKAZAKHSTANMALTA*BELARUSUKRAINEGUINEATAJIKISTANUZBEKISTANTURKMENISTANNORWAYSWEDEN*CHADBURKINAFASOSENEGALNETHERLANDS*BELGIUM*CYPRUS*RUSSIANFEDERATIONCZECHREP.*SLOVAKIA*AUSTRIA*SWITZERLANDDENMARK*ESTONIA*LATVIA*LITHUANIA*ALBANIASLOVENIA*CROATIABOSNIA-HERZEGOVINASERBIATFYRMACEDONIAMONTENEGROLUXEMBOURG*GEORGIAAZERBAIJANARMENIAHUNGARY*ISRAELREP.MOLDOVA

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