Heterogeneous courses of cardiovascular disease incidence in Europe 2000-2019 – what are the causes?

Abstract Background Data from the Global Burden of Disease (GBD) project distributed by the Institute for health metrics and evaluation (IHME) include incidence and prevalence data for almost all countries in the world. In course of own research, the data on cardiovascular disease (CVD) incidence in Western European countries were analysed and revealed great variation in the course of CVD incidence, that is difficult to interpret. We want to present the different courses of CVD incidence for selected countries and discuss possible reasons for this diversity with the audience. Methods GBD data on CVD incidence and mortality for 25 European countries from 2000-2019 for men and women were to graphically display courses of CVD incidence for visual analysis. Results The course of CVD incidence in Western Europe is country-specific - and, within a country, even sex-specific. Yet, in many countries besides the Baltic states and Czechia, CVD incidence reaches a minimum in 2010, increasing afterwards again. Different patterns of incident courses were visible: a) wave-shaped courses which increase e.g. in Austria, Belgium, France and in males in Finland only, but decrease for both sexes Germany, Norway, Portugal and Poland, and in males in Denmark b) u-shaped courses in Spain, Great Britain, France, Italy, and for Finnish and Dutch females c) linearly increasing for both sexes in Czechia, the Baltic states and in Swiss males d) linearly decreasing for women Norway, Belgium, Denmark and Austria. Conclusions The patterns of CVD incidence in Europe are multitude and country-specific even between sexes, reaching a minimum in 2010 in most countries. The validity of analyses combining these different patterns for regional analyses of CVD incidence such as in GBD reports do not take account for this diversity. Unless these differences can be explained by country-specific prevention or risk factor profile, the validity of data on CVD incidence seems to be limited. Key messages • CVD incidence in Europe between 2000 and 2019 is country-specific changing and very heterogeneous. • Analyses summarizing data for (Western/Eastern) Europe will miss this heterogeneity and might come to invalid conclusions regarding the development of CVD incidence.