Cardiovascular Deaths More Common in Low-Income Countries

(HealthDay News) — Although the burden of risk factors is lower, more deaths from major cardiovascular disease occur in low-income countries, according to research published in the New England Journal of Medicine.

Salim Yusuf, MB, BS, DPhil, of the Hamilton General Hospital in Canada, and colleagues assessed cardiovascular (CV) risk, using the INTERHEART Risk Score, for 156,424 individuals from urban and rural communities in 17 countries (three high-income, 10 middle-income and four low-income). 

The researchers examined patterns for CV risk factors and rates of major CV events, including deaths, according to income.

Mean INTERHEART Risk Score was lowest in low-income countries, intermediate in middle-income countries and highest in high-income countries (P<.001), the researchers found. 

Rates of major CV events, including CV deaths, myocardial infarction (MI), stroke and heart failure, were lower in high-income countries (3.99 events per 1,000 person-years; P<.001) than in middle-income countries (5.38 events per 1,000 person-years) and low-income countries (6.43 events per 1,000 person-years). 

The use of current treatments such as preventive medications and revascularization procedures was significantly higher in high-income countries than in low-income or middle-income countries (P<.001).

“The high burden of risk factors in high-income countries may have been mitigated by better control of risk factors and more frequent use of proven pharmacologic therapies and revascularization,” the researchers wrote.

Several pharmaceutical companies contributed funding to the study.


  1. Yusuf S et al. N Engl J Med. 2014;371:818-827.