A new report published by the World Health Organization calculates that almost two-thirds of all worldwide deaths are now the result of non-communicable diseases. These mainly comprise cardiovascular diseases, cancers, diabetes and chronic lung diseases, and their epidemic, says WHO Director-General Dr Margaret Chan, is being driven by powerful forces now touching every region of the world: demographic ageing, rapid unplanned urbanisation, and the globalisation of unhealthy lifestyles. “While many chronic conditions develop slowly,” adds Dr Chan, “changes in lifestyles and behaviours are
occurring with a stunning speed and sweep.”
The report also points out that, contrary to popular opinion, nearly 80% of deaths from non-communicable disease occur in low- and middle-income countries. And the culprit risk factors – tobacco use, unhealthy diet, insufficient physical activity and the harmful use of alcohol – are now the “pervasive aspects of economic transition, rapid urbanization and 21st-century life”.
Commenting on the report for the ESC, Professor Pantaleo Giannuzzi, President of the European Association for Cardiovascular Prevention & Rehabilitation, one of the five ESC associations, said: “This is a very important document. For the first time we now have the hard figures representing the present and future impact of non-communicable diseases worldwide, not only in the acute phase but in the chronic phase too.
“Within the context of cardiovascular diseases this is a reminder of how important the prevention and management of chronic disease – and its impact – really is. We have made great progress in managing CVD in the acute phase, but the WHO research emphasises the extent to which avoidable risk factors and unhealthy lifestyle contribute to global mortality. So here is an authoritative statement that only through simple improvements in lifestyle – with attention to diet, exercise, smoking and weight – will this epidemic of chronic disease be reversed. This can only be achieved through the concerted efforts of populations, professionals and politicians.
“In our own field we still face the challenge of developing a successful model for the prevention of readmissions and new episodes. We have been successful with acute episodes, but more must now be done for structured follow-up and the continuity of care. Again, simple interventions will be appropriate and should be central to our post-discharge programmes.”
Among “best-buys” recommended by the WHO report at the population level are restrictions on smoking (sales and community bans), raised taxes on tobacco and alcohol, reduced salt in foods, the replacement of trans-fats with polyunsaturated fat, and public awareness about diet and physical activity.
Best-buys at the individual intervention level include counselling and multidrug therapy, including glycaemic control for diabetes, and aspirin therapy for AMI
The report estimates that the worldwide number of deaths attributable to non-communicable disease will increase by 15% between 2010 and 2020, with the greatest increases in Africa and South-East Asia. Most of these deaths will be associated with the four risk factors noted above. Tobacco use, for example, if unchecked will account for 10% of all deaths by 2010.
The report emphasises the power of primary prevention initiatives, and particularly their effect on CVD. More than half the dramatic decline in CHD mortality in the UK between 1981 and 2000 was attributed to risk factor reduction. The WHO’s own MONICA data indicate that population-wide primary prevention and individual healthcare interventions go hand-in-hand to reduce the burden of CVD. Yet many of these initiatives and interventions are unavailable in many poor resource countries.
The World Heart Federation, of the which the ESC is a member, has described the forecasted trend in rising CVD incidence as “unacceptable” and has urged a global response which puts CVD prevention at the centre of national development initiatives.
The Chronic Disease Alliance, an association of ten science-based European organisations of which the ESC is a founding member, has also declared its objective in reversing the rise in chronic non-communicable diseases by urging political action against tobacco use, poor nutrition, lack of physical activity and alcohol.
Notes to editor
ESC Press Office
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Chronic non-communicable diseases kill 86% of all people in the WHO European Region. Cardiovascular diseases, cancer, respiratory diseases, diabetes, kidney and liver diseases account for more than 40% the disease burden in Europe. Heart disease, stroke and diabetes alone are projected to lead to loss of national income in the billions, e.g. almost $33 billion in the United Kingdom (from 2005 to 2015).
The Chronic Disease alliance consists of the organisations mentioned below:
About the European Association for the Study of the Liver
EASL is the leading European scientific society involved in promoting research and education in hepatology. EASL attracts the foremost hepatology experts as members and has an impressive track record in promoting research in liver disease, supporting wider education and promoting changes in European liver policy.
About the European CanCer Organisation
Following the philosophy that every cancer patient deserves the best, ECCO focuses on creating awareness of patients’ needs and wishes, stimulating progressive thinking in Cancer policy, training and education, and encouraging European cancer research and its application through the organisation of international multidisciplinary conferences including the premier European cancer meetings: the ECCO – ESMO Multidisciplinary Cancer Congresses.
About the European Heart Network
The European Heart Network (EHN) is a Brussels-based alliance of heart foundations and like-minded nongovernmental organisations throughout Europe. EHN has member organisations in 26 countries. EHN plays a leading role in the prevention and reduction of cardiovascular diseases, in particular heart disease and stroke, through advocacy, networking, education and patient support, so that they are no longer a major cause of premature death and disability throughout Europe.
About the European Kidney Health Alliance
The European Kidney Health Alliance (EKHA) is an Alliance of not-for-profit organisations who represent the key stakeholders in kidney health issues in Europe. EKHA takes a multidisciplinary approach involving patients and their families, doctors and nurses, researchers and other healthcare professionals who work cooperatively for a European health environment in which there is a sustained decrease in kidney disease and its consequences.
About the European Respiratory Society
The ERS, European Respiratory Society, is a professional, medical organisation with more than 10,000 members in over 100 countries representing medical and scientific experts in the field of respiratory medicine and lung science. Its mission is to promote lung health through research, knowledge sharing, and medical education.
About the European Society of Cardiology
The ESC unites over 62,000 cardiology professionals from across Europe and the Mediterranean, with the mission of reducing the burden of cardiovascular disease in Europe through education, congresses, surveys on cardiovascular diseases and the publishing of scientific materials, including journals and Clinical Practice Guidelines.
About the European Society of Hypertension
The main purpose of the European Society of Hypertension (ESH) is to provide a stable and organised European platform for scientific exchange in hypertension. The objectives of ESH are to promote, endorse and organise activities involved with the continuing medical education in the field of hypertension and associated cardiovascular diseases.
About the European Society for Medical Oncology
The European Society for Medical Oncology (ESMO) is the leading European professional organisation committed to advancing the specialty of medical oncology and promoting a multidisciplinary approach to cancer treatment and care. ESMO’s mission is to advance cancer care and cure through fostering and disseminating good science that leads to better medicine and determines best practice.
About the Federation of European Nurses in Diabetes
FEND has established a unique voice for nurses working in the field of diabetes care, research and education in Europe. Its mission statement is to promote the delivery of evidence based care for people with diabetes throughout Europe.
About the International Diabetes Federation – Europe
IDF-Europe is the European Regional section of the International Diabetes Federation. Its constituents are the member associations of the national diabetes organisations (representing both health care professionals and patients & carers) from 45 European countries. Within the EU there are over 30 million people with diabetes, it is increasing at an alarming rate and this number is predicted to exceed 50 million by 2030. IDF-Europe aims to encourage the prevention, the earlier diagnosis, better management and education of diabetes.
1. World Health Organization. Global status report on noncommunicable disease 2010.