European Society of Cardiology: the 2023 Atlas of Cardiovascular Disease Statistics
Authors: Timmis Adam , Aboyans Victor , Vardas Panos , Townsend Nick , Torbica Aleksandra , Kavousi Maryam , Boriani Giuseppe , Huculeci Radu , Kazakiewicz Denis , Scherr Daniel , Karagiannidis Efstratios , Cvijic Marta , Kapłon-Cieślicka Agnieszka , Ignatiuk Barbara , Raatikainen Pekka , De Smedt Delphine , Wood Angela , Dudek Dariusz , Van Belle Eric , Weidinger Franz ,   ESC National Cardiac Societies, Kichou Brahim , Bououdina Yasmina , Hayrapetyan Hamlet , Sisakian Hamayak , Ordyan Marine , Metzer Bernhard , Delle-Karth Georg , Mirzoyev Ulvi , Uzeyir Rahimov , Gabulova Rahima , Gerber Bernhard , Kušljugić Zumreta , Smajić Elnur , Traykov Vassil , Dimitrova Elena , Gencheva Dolina , Yaneva Teodora , Milicic Davor , Heracleous Hera , Nikos Eteokleous , Ostadal Petr , Linhart Aleš , Schmidt Michael Rahbek , Elmet Märt , Kampus Priit , Laine Mika , Kiviniemi Tuomas , Niemelä Matti , Iung Bernard , Leclercq Christophe , Thiele Holger , Bestehorn Kurt , Baldus Stephan , Kochiadakis George , Toutouzas Konstantinos , Kanakakis Ioannis , Becker Dávid , Hrafnkelsdóttir Þórdís Jóna , Skuladottir Helga Margret , McKeown Pascal , Dalton Barbra , Segev Amit , Indolfi Ciro , Filardi Pasquale Perrone , Oliva Fabrizio , Salim Berkinbayev , Mahabbat Bekbossynova , Marat Pashimov , Mirrakhimov Erkin , Abilova Saamay , Kalysov Kurban , Erglis Andrejs , Dzerve Vilnis , Čelutkienė Jelena , Lapinskas Tomas , Banu Cristiana , Xuereb Robert George , Felice Tiziana , Dingli Philip , de Boer Rudolf A , Meeder Joan G , Bosevski Marijan , Kostov Jorgo , Mjølstad Ole Christian , Angel Kristin , Gil Robert , Mitkowski Przemyslaw , Maruszewski Bohdan , Pereira Helder , Ferreira Jorge , Oliveira Eduardo , Popescu Bogdan , Chioncel Ovidiu , Badila Elisabeta , Chukhrukidze Archil , Bajraktari Gani , Ibrahimi Pranvera , Bytyci Ibadete , Popovici Mihai , Foscoli Marina , Zavatta Marco , Stojsic-Milosavljevic Anastazija , Cankovic Milenko , Gonçalvesová Eva , Hlivák Peter , Luknár Milan , Fras Zlatko , Muñiz Javier , Perez-Villacastin Julian , Padial Luis Rodriguez , Oldgren Jonas , Norhammar Anna , Kobza Richard , Carballo David , Schäfer Luisa , Aytekin Vedat , Degertekin Muzaffer , Kovalenko Volodymyr , Nesukay Elena , Greenwood John , Archbold Andrew , Kurbanov Ravshanbek , Srojidinova Nigora , Fozilov Khurshid , Arandelovic Andelija , Boateng Dennis , Momotyuk Ganna 
Published: August 2024

Abstract
This report from the European Society of Cardiology (ESC) Atlas Project updates and expands upon the 2021 report in presenting cardiovascular disease (CVD) statistics for the ESC member countries. This paper examines inequalities in cardiovascular healthcare and outcomes in ESC member countries utilizing mortality and risk factor data from the World Health Organization and the Global Burden of Disease study with additional economic data from the World Bank. Cardiovascular healthcare data were collected by questionnaire circulated to the national cardiac societies of ESC member countries. Statistics pertaining to 2022, or latest available year, are presented. New material in this report includes contemporary estimates of the economic burden of CVD and mortality statistics for a range of CVD phenotypes. CVD accounts for 11% of the EU’s total healthcare expenditure. It remains the most common cause of death in ESC member countries with over 3 million deaths per year. Proportionately more deaths from CVD occur in middle-income compared with high-income countries in both females (53% vs. 34%) and males (46% vs. 30%). Between 1990 and 2021, median age-standardized mortality rates (ASMRs) for CVD decreased by median &gt;50% in high-income ESC member countries but in middle-income countries the median decrease was &lt;12%. These inequalities between middle- and high-income ESC member countries likely reflect heterogeneous exposures to a range of environmental, socioeconomic, and clinical risk factors. The 2023 survey suggests that treatment factors may also contribute with middle-income countries reporting lower rates per million of percutaneous coronary intervention (1355 vs. 2330), transcatheter aortic valve implantation (4.0 vs. 153.4) and pacemaker implantation (147.0 vs. 831.9) compared with high-income countries. The ESC Atlas 2023 report shows continuing inequalities in the epidemiology and management of CVD between middle-income and high-income ESC member countries. These inequalities are exemplified by the changes in CVD ASMRs during the last 30 years. In the high-income ESC member countries, ASMRs have been in steep decline during this period but in the middle-income countries declines have been very small. There is now an important need for targeted action to reduce the burden of CVD, particularly in those countries where the burden is greatest.