Abstract
It is well known that cardiovascular diseases (CVD) are the major health problem and the leading cause of death worldwide, both for women and for men. In Europe CVD cause not only nearly half of all deaths (48%), but are also the main cause of the disease burden (23% illness and death) [ [1] Allender S. Scarborough P. Peto V. Rayner M. Leal J. Luengo-Fernendaz R. et al. European cardiovascular disease statistics – 2008 edition. European Heart Network, Brussels2008 Google Scholar ]. Therefore they contribute substantially to the escalating costs of healthcare [ 2 Lopez A. Mathers C.D. Ezzati M. Jamison DT. Murray CJ. Global and regional burden of disease and risk factors: systematic analysis of population health data. Lancet. 2006; 367: 1747-1757 Abstract Full Text Full Text PDF PubMed Scopus (4077) Google Scholar , 3 Leal J. Luengo-Fernández R. Gray A. Petersen S. Rayner M. Economic burden of cardiovascular diseases in the enlarged European Union. Eur Heart J. 2006; 27: 1610-1619 Crossref PubMed Scopus (510) Google Scholar ]. In most of the high-income countries the incidence of CVD has been decreasing over the last decades but the incidence in low- and middle-income countries has been rising continuously [ [4] Reiner Z. Tedeschi-Reiner E. Atherosclerosis – a paradox of Eastern European countries. Atherosclerosis. 2006; 7/3: 461 Abstract Full Text PDF Google Scholar ]. The burden of CVD in these countries is set to rise further due to unfavourable trends in the CVD risk factors but also due to epidemiological transition from communicable diseases, causing a decrease in infant and childhood mortality and an increase in life expectancy, to non-communicable such as CVD, the majority of which is preventable. To reduce this burden and to reduce the mentioned inequalities is a major challenge. However, even in many high-income countries with declining CVD death rates, decreasing rates in younger age groups are associated with an older age at presentation and an increased number of subjects with chronic CVD conditions, such as heart failure.
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