What are cardiovascular diseases?

Cardiovascular diseases are a group of disorders of the heart and blood vessels, including ischaemic heart disease (heart attack), cerebrovascular disease (stroke), peripheral arterial disease, rheumatic heart disease, congenital heart disease, deep vein thrombosis and pulmonary embolism. Together they are the leading cause of death globally — 17.9 million deaths in 2019, or 32% of all deaths.

What causes heart attacks?

Most heart attacks are caused by atherosclerosis — the build-up of fatty plaques inside coronary artery walls. When a plaque ruptures, a clot forms rapidly, blocking the artery and cutting off oxygen to heart muscle. Key risk factors are hypertension, high LDL cholesterol, smoking, diabetes, overweight, physical inactivity, unhealthy diet, older age, family history and psychosocial stress.

What is hypertension and why does it matter?

Hypertension is persistently elevated blood pressure (>=140/90 mmHg). More than 1.28 billion adults worldwide have it, but less than half know it — earning the name "silent killer." It is the single most important modifiable risk factor for heart attack and stroke. Treatment with antihypertensives and lifestyle modification dramatically reduces cardiovascular risk.

How can cardiovascular disease be prevented?

WHO estimates that 80% of premature heart attacks and strokes are preventable. The main strategies are: not using tobacco; eating a diet rich in fruit, vegetables, wholegrains and fish and low in salt, saturated fat and sugar; being physically active (150+ min/week); maintaining a healthy weight; and identifying and treating high blood pressure, high cholesterol and diabetes. These interventions work best when delivered as integrated primary care.

What are the warning signs of a heart attack?

Classic warning signs include: chest pain, pressure or tightness (often described as a heavy weight on the chest); pain spreading to the left arm, jaw, neck or back; shortness of breath; nausea; cold sweats; and lightheadedness. In women, heart attacks more commonly present with atypical symptoms (fatigue, nausea, back pain) — contributing to delayed diagnosis. Time is critical: "time is muscle," and thrombolysis or primary PCI within 90 minutes of symptom onset saves lives.

What is the difference between a heart attack and cardiac arrest?

A heart attack (myocardial infarction) is caused by a blocked coronary artery — the heart keeps beating but part of the muscle is dying from lack of oxygen. Cardiac arrest is a sudden loss of heart function when the heart stops beating, typically due to a fatal arrhythmia. Heart attacks can trigger cardiac arrest. Cardiac arrest requires immediate CPR and defibrillation; heart attacks require urgent reperfusion (opening the blocked artery).

What is stroke and how is it treated?

Stroke is sudden interruption of blood supply to the brain. Ischaemic stroke (blockage, ~87%) can be treated with clot-dissolving drugs (tPA) within 4.5 hours of onset, or mechanical thrombectomy in specialised centres. Haemorrhagic stroke (bleeding) requires different management. The mantra is "time is brain" — every minute of delay in ischaemic stroke results in ~1.9 million neurons lost. Stroke units with specialist care halve case fatality and disability.

What medicines prevent recurrent heart attacks?

Four cheap generic medicines dramatically reduce the risk of second cardiovascular events: aspirin (antiplatelet); statins (lower LDL cholesterol); ACE inhibitors (lower blood pressure and protect the heart); and beta-blockers (protect the heart after myocardial infarction). Together they can reduce recurrent events by up to 75%. Access to these medicines in LMICs is highly inequitable — a key target of the WHO HEARTS package.

What is the WHO HEARTS technical package?

WHO HEARTS is a technical package to guide countries in implementing evidence-based CVD prevention and management in primary care. It covers six areas: Healthy lifestyle counselling; Evidence-based treatment protocols; Access to essential medicines and technology; Risk-based cardiovascular management; Team-based care; Systems for monitoring. HEARTS is now being implemented in over 30 countries and has treated over 100 million people.

Why do more CVD deaths occur in poor countries?

Over 75% of CVD deaths occur in LMICs, where populations face multiple disadvantages: higher tobacco use and unhealthy diets; less primary care coverage; limited availability of basic medicines (aspirin, statins, antihypertensives); poor access to cardiac emergency care; and later diagnosis. The global inequity in CVD outcomes is one of the clearest examples of the relationship between poverty and preventable death.

What is the cardiovascular risk from air pollution?

Air pollution is a major but underappreciated cardiovascular risk factor. Fine particulate matter (PM2.5) from fossil fuel combustion, biomass burning and other sources causes endothelial inflammation, atherosclerosis progression and arrhythmias. WHO estimates that air pollution (indoor and outdoor combined) contributes to approximately 7 million deaths per year — the majority cardiovascular. Reducing air pollution is simultaneously a climate and cardiovascular health imperative.

How does GMJ News cover cardiovascular disease?

GMJ News tracks major cardiology trial results, WHO HEARTS implementation progress, hypertension and stroke guidelines updates, and the intersection of CVD with air pollution and climate. Georgia has a high CVD burden — cardiovascular diseases are the leading cause of death in Georgia — making this a direct priority for the Georgian Medical Journal and PHIG's public health work.

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Cardiovascular Disease

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Cardiovascular diseases remain the leading cause of death worldwide — an estimated 17.9 million deaths each year, about a third of all global mortality (WHO). Most premature heart attacks and strokes are preventable by addressing tobacco use, unhealthy diet, physical inactivity and harmful alcohol use, and by treating hypertension, diabetes and raised lipids — the priorities of the WHO Global Hearts initiative and HEARTS technical package now implemented in primary care worldwide.

Key messages

Leading killer

Cardiovascular diseases are the number one cause of death globally — 17.9 million lives lost in 2019, representing 32% of all global deaths (WHO). Heart attack and stroke account for 85% of these deaths.

Largely preventable

An estimated 80% of premature heart attacks and strokes are preventable through healthy diet, regular physical activity, no tobacco use, and management of blood pressure, cholesterol and diabetes.

Risk factor burden

Hypertension (high blood pressure) is the single most important modifiable risk factor for cardiovascular disease. More than 1.28 billion adults worldwide have hypertension — but less than half know it.

Equity gap

Over three quarters of CVD deaths occur in low- and middle-income countries, where primary care coverage, drug availability and cardiac emergency capacity are often severely limited.

Secondary prevention

Aspirin, statins, ACE inhibitors and beta-blockers — four cheap generic medicines — dramatically reduce the risk of second heart attacks and strokes, yet access is highly inequitable.

WHO response

The WHO HEARTS technical package guides countries to implement evidence-based cardiovascular disease management in primary care — covering Healthy lifestyle, Evidence-based protocols, Access to medicines, Risk assessment, Team-based care, Systems for monitoring.

Key statistics

17.9M

CVD deaths/year (2019)

WHO 2021

32%

of all global deaths

WHO 2021

523M

people living with CVD

GBD 2021

1.28B

adults with hypertension

WHO 2021

80%

of premature CVD preventable

WHO

75%+

CVD deaths in LMICs

WHO 2021

Cardiovascular disease deaths worldwide (millions) 2000-2019 — GBD / WHO

Source: Global Burden of Disease study / WHO. CVD includes ischaemic heart disease and stroke.

Glossary of key terms

Ischaemic heart disease
WHO/ICD-11Narrowing of the coronary arteries supplying the heart, typically by atherosclerosis. The leading cause of death globally. Clinical presentations range from angina to myocardial infarction (heart attack).

Stroke
WHO/ICD-11Sudden interruption of blood supply to the brain, either by blockage (ischaemic stroke, ~87% of cases) or by bleeding (haemorrhagic stroke). A leading cause of disability globally.

Hypertension
WHOPersistently elevated blood pressure (systolic >=140 mmHg or diastolic >=90 mmHg). The most important modifiable risk factor for CVD. Often called the "silent killer" because it has no symptoms until complications occur.

Atherosclerosis
WHO/ESCThe build-up of plaques — consisting of cholesterol, fatty substances and inflammatory cells — inside arterial walls. The underlying pathology of most heart attacks and ischaemic strokes.

WHO HEARTS
WHOA technical package to guide implementation of evidence-based CVD management in primary care — covering Healthy lifestyle, Evidence-based protocols, Access to medicines, Risk assessment, Team-based care, Systems for monitoring.

SCORE
ESCSystematic Coronary Risk Evaluation — the European Society of Cardiology's risk calculator estimating 10-year risk of fatal cardiovascular events, used to guide clinical decisions on preventive therapy.