Q&A: Cardiovascular disease is rapidly increasing in the ASEAN region

37 million people in the Association of Southeast Asian Nations (ASEAN) region suffer from cardiovascular disease. It’s now the leading cause of mortality and morbidity and one of the fastest growing non-communicable diseases in this region, according to new research using data from the Global Burden of Disease 2021 study.​

Lead author Dr. Marie Ng, Affiliate Associate Professor at IHME and Associate Professor at National University of Singapore’s Yong Loo Lin School of Medicine, discusses the findings.

Video transcript

This transcript has been lightly edited for clarity

Why is it important to study the burden of disease at the ASEAN regional level?

The Association of Southeast Asian Nations, also known as ASEAN, is home to 680 million people, a population size 1.5 times larger than that of the European Union. The region is the fifth largest economy in the world and has undergone significant demographic and economic transformation over the past few decades. Along with socioeconomic changes, the epidemiological landscape has also shifted remarkably.

Understanding the disease patterns and burdens in this region can help inform policy changes and address existing and emerging public health challenges.

Why was studying the burden of cardiovascular disease in the ASEAN region important?

Similar to global trends, the epidemiological profiles in most ASEAN countries have shifted over the years from infectious diseases to non-communicable diseases. Cardiovascular disease is the leading cause of death and disability in ASEAN. In 2021, there were an estimated 36.8 million prevalent cases of cardiovascular diseases, and 1.7 million people died from it. Understanding the magnitude of the prevalence and disease burden of cardiovascular disease is crucial for identifying care gaps and resource planning.

The map shows the distribution of age-standardized prevalence rate on the left panel, mortality rate in the center, and disability-adjusted life years on the right panel across the 10 ASEAN countries. Red color indicates higher rate, and blue indicates lower rate. As shown in the graphs, there are considerable geographical disparities in the region in terms of prevalence, mortality, and DALYs.

Regarding prevalence, Malaysia has the highest prevalence of cardiovascular disease in ASEAN, while Laos observed the highest mortality and DALY rates in the region.

What were the key findings of your research?

One of the key findings in our research is that cardiovascular mortality is very high in the ASEAN region. In many countries, mortality rates exceed the global average.

The time trends here illustrate the changes in cardiovascular diseases’ prevalence, mortality, and DALYs over time, among ASEAN countries, compared with the global average. The colored line represents country-level value, while the dotted line reflects the global average.

There’s huge disparity in cardiovascular disease mortality across the region, with more people dying from the disease in Laos and Indonesia compared to Singapore, for example. The age-standardized mortality rates in Laos and Indonesia were about 400 per 100,000, which is more than five times higher than the mortality rate in Singapore, which is estimated as 76 per 100,000. This signals a gap in access to lifesaving intervention and care.

What needs to be done to reduce cardiovascular disease in the ASEAN region?

The high cardiovascular disease mortality rate indicates a need to improve surgical capacity and enhance access to lifesaving interventions. However, beyond that, the more cost-effective approach is to focus on risk reduction through primary and secondary prevention. For example, smoking continues to be a major public health issue in several ASEAN countries. Stepping up tobacco control and reducing tobacco consumption can substantially lower population health burden of cardiovascular diseases.

In addition, there is a continuous rise in obesity in this region, where prevalence in some countries has quadrupled over the years. Addressing overweight and obesity will be vital to CVD prevention. While many policy changes require local and national government’s effort, ASEAN as a regional cooperative network can play a crucial role in fostering a favorable macro policy environment to support national public health strategies.