number of individuals who survive to the age at which risk factors they accrued throughout childhood and early adulthood manifest as chronic diseases. This has resulted in an epidemic that is “old” in its similarity to the rise in CVD that occurred in the developed world in previous decades, yet brings with it new characteristics that are a result of contemporary global circumstances.


Over the past several decades, a considerable amount has been learned about the determinants of CVD as well as how to reduce CVD incidence and mortality. Building on this knowledge and the emerging evidence of the growing burden of CVD in developing countries, there has been a steady escalation of international reports, declarations, and resolutions calling attention to the growing threat of the global CVD epidemic. These are summarized in Figure 1.1 and Box 1.1 later in this chapter, where they are discussed in more detail to set the historical context for this report.

These declarations, reports, and resolutions have resulted in a growing recognition that CVD, and chronic noncommunicable diseases more broadly, are a worldwide problem whose burden is increasingly felt by low and middle income countries. In the past several years, this recognition has begun to translate into guidance for action. However, despite examples from the developed world that demonstrate promise and hope for the reduction of disease burden on a national level, the burden of CVD has continued to grow and concrete steps toward scaling up CVD treatment and prevention efforts in developing countries have been slow to materialize. Recognizing a need to help catalyze progress from guidance and strategies to actions, the National Heart, Lung, and Blood Institute (NHLBI) sponsored this study by the Institute of Medicine (IOM), and an ad hoc committee was convened to study the evolving global epidemic of CVD and offer conclusions and recommendations pertinent to its control.

Study Charge

The full Statement of Task for the Committee on Preventing the Global Epidemic of Cardiovascular Disease: Meeting the Challenges in Developing Countries can be found in Appendix A. In summary, the committee was charged with synthesizing and expanding relevant evidence and knowledge based on research findings, with an emphasis on developing concepts of global partnership and collaborations, and on recommending actions targeted at global governmental organizations, nongovernmental organizations (NGOs), policy and decision makers, funding agencies, academic and research institutions, and the general public.

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