UC Berkeley

Key PointsDeath rates from ischaemic heart disease (IHD), stroke, and other cardiovascular diseases (CVDs) are decreasing in high-income and many Latin American countries, and this trend shows no signs of slowingDeclines in some behavioural risk factors, including smoking, and physiological risk factors, such as blood pressure and serum cholesterol, are likely to have helped to reduce CVDsBy contrast, the nearly universal increase in adiposity seems not to have modified the long-term declining trend in CVD mortality, although it might have had some slowing effectImproved medical care, including effective treatment of physiological risk factors, diagnosis, treatment of acute CVDs, and post-hospital care, has also contributed to declining CVD events and mortalityMeasured risk factor and treatment variables, while important, explain neither why the decline began when it did nor many of the similarities and differences between countries or between men and womenSubstantial fluctuations in CVDs, and in alcohol intake, in former communist countries of Europe have followed times of massive political and social changes since the early 1990s