Resurgence of cardiovascular disease mortality: a global and national infodemiological analysis of leading modifiable risk factors

INTRODUCTION: Cardiovascular disease (CVD) remains the leading cause of mortality worldwide. This study analyzes temporal trends in CVD mortality and assesses the impact of leading modifiable risk factors globally and in Italy. METHODS: An infodemiological analysis was conducted using the Global Burden of Disease (GBD) Collaborative Network data. Age-standardized CVD mortality rates were evaluated from 1990 to 2021, focusing on key risk factors: hypertension, elevated low-density lipoprotein cholesterol (LDL-C), high Body Mass Index (BMI), smoking, fasting hyperglycemia and physical inactivity. Global trends were compared with national data from Italy and between males and females. RESULTS: A global resurgence in CVD mortality was observed after 2010, primarily driven by an increase in hypertension-attributable CVD deaths, which remains the leading risk factor, and LDL-C-attributable CVD mortality. Conversely, hypertension- and LDL-C-attributable CVD deaths showed a declining trend in Italy from 1990 to 2021, despite a trend toward modest rise in hypertension-attributable mortality over the past five years. High BMI-related CVD mortality displayed an increasing trend globally and in Italy. A declining trend in smoking-related CVD deaths was noted in Italy, contrasting with more moderate trends of reductions globally. The worldwide burden of physical inactivity- and fasting hyperglycemia-attributable mortality displayed an increasing trend, while a concomitant declining trend was observed in Italy. DISCUSSION: The potential resurgence in global and national CVD mortality underscores the need for targeted prevention strategies. Enhanced primary prevention, addressing key modifiable risk factors, is essential to reduce the global and national burden of CVD.