Coordinating Efforts to Reduce the Global Incidence of Cardiovascular Disease

This NEJM editorial assesses global data on five key modifiable cardiometabolic risk factors elevated systolic blood pressure, non-HDL cholesterol, current smoking, diabetes, and body-mass index and their contributions to cardiovascular disease (CVD) and all-cause mortality across eight global regions. Drawing from over 1.5 million participants across 112 cohort studies in 34 countries, the authors highlight disparities in risk-factor prevalence, control, and policy response. Elevated systolic blood pressure was the leading contributor (22% in men, 29% in women), followed by non-HDL cholesterol, smoking, diabetes, and BMI. The editorial advocates task-shifting care to nonphysician health workers, expanding polypill use, strengthening WHO tobacco control measures, and integrating prevention into public health strategies. The authors argue that reducing global CVD incidence is feasible with coordinated action among policymakers, clinicians, and communities—potentially delivering substantial benefit at low cost.

This NEJM editorial assesses global data on five key modifiable cardiometabolic risk factors elevated systolic blood pressure, non-HDL cholesterol, current smoking, diabetes, and body-mass index and their contributions to cardiovascular disease (CVD) and all-cause mortality across eight global regions. Drawing from over 1.5 million participants across 112 cohort studies in 34 countries, the authors highlight disparities in risk-factor prevalence, control, and policy response. Elevated systolic blood pressure was the leading contributor (22% in men, 29% in women), followed by non-HDL cholesterol, smoking, diabetes, and BMI. The editorial advocates task-shifting care to nonphysician health workers, expanding polypill use, strengthening WHO tobacco control measures, and integrating prevention into public health strategies. The authors argue that reducing global CVD incidence is feasible with coordinated action among policymakers, clinicians, and communities—potentially delivering substantial benefit at low cost.