The burden of cardiovascular disease in Europe: Almost 2 million deaths and €282 billion annually

Cardiovascular diseases (CVDs) are the leading cause of death and disability across the European Union, accounting for about 1.7 million deaths annually and affecting 62 million people, according to the Organisation for Economic Co-operation and Development (OECD).

Cardiovascular disease refers to conditions that affect the heart and blood vessels, such as heart attack, stroke, and heart failure.

Over the past 50 years, life expectancy has risen significantly in European countries, largely due to advances in preventing and treating CVD and its risk factors, but these conditions are still the leading cause of death.

In most European Union countries, the mortality rate from circulatory diseases is about 26-60 per cent higher in males than in females.

CVD can be caused by multiple factors, commonly classified as non-modifiable and modifiable.

Non-modifiable risk factors – such as sex, age, family history, and ethnicity or race – are those inherent individual characteristics that may increase the risk of developing a cardiovascular condition. Modifiable risk factors include clinical, metabolic, lifestyle, behavioural, and environmental factors.

Globally, 83 per cent of all deaths due to CVD in 2021 were attributable to modifiable risk factors, while in the EU this figure fell to 76 per cent.

Metabolic risk factors are the predominant group, accounting for around 70 per cent of CVD deaths globally and 68 per cent in the EU. This includes hypertension, high blood sugar, and cholesterol.

Behavioural risks, such as smoking, unhealthy diet, and harmful use of alcohol, are the second largest group, accounting for around 42 per cent of CVD deaths globally and 37 per cent in the EU.

Beyond deaths, CVD also affects people’s life quality.

The data showed that, across all measured dimensions – well-being, social functioning, physical health, and mental health – people with CVD report significantly worse outcomes than those without.

People who have experienced or are experiencing cardiovascular disease are often physically limited as they suffer from fatigue and shortness of breath, which restricts their mobility.

They also suffer higher levels of anxiety and fear of recurrent cardiac events, as well as challenges in adapting to lifestyle changes and long-term medication regimens.

Differences across Europe

The OECD report shows that while CVD is a burden across Europe, not every country suffers to the same degree.

Between 2012 and 2022, mortality from circulatory diseases fell in every EU member state, with an average decline of 20 per cent among men and 22 per cent among women.

Countries like France, Denmark, and Spain reported rates below 220 deaths per 100,000 population in 2022, while Bulgaria, Romania, and Latvia exceeded 800 deaths per 100,000 population.

The report shows that Central and Eastern European countries have a higher prevalence of modifiable risk factors such as smoking, obesity, harmful alcohol consumption, and physical inactivity.

Obesity rates range from 7 per cent in Italy to above 20 per cent in countries including Lithuania, Finland, Estonia, Hungary, Latvia, and Malta.

In 2023, daily smoking rates ranged from 23 per cent or more in countries like Bulgaria, Greece, Hungary, and France to below 12 per cent in Denmark, Finland, and Sweden.

Fruit consumption was lowest in Bulgaria, Latvia, Lithuania, and Romania.

The high price of cardiovascular disease

CVD doesn’t only take a heavy toll on people’s health, the report shows, it has long been a major contributor to healthcare expenditures and economic losses in the European Union – the OECD described it as “not only a health crisis but also a major societal and economic challenge”.

The most recent analysis estimated the total economic burden of CVD in the EU at €282 billion annually, amounting to approximately 2 per cent of the region’s gross domestic product – an increase from €169 billion in 2003.

This rise is driven not only by direct healthcare expenses but also by rising productivity losses and informal care needs, underscoring the urgency of effective prevention and long-term management strategies, according to the OECD.

How is the EU addressing this?

The European Commission is set to present tomorrow the first-ever EU-wide plan to tackle CVD.

The so-called “Safe Hearts Plan” aims to provide a comprehensive policy framework to support member states and stakeholders in improving cardiovascular health – which the OECD recommends in the report.

“There is a highlighted need for stronger and co-ordinated action across the EU to address the rising prevalence of cardiovascular diseases due to factors like an ageing population”, reads the publication.