Globally, cardiovascular disease claims 18 millions lives per year. While high-income countries are at a higher risk for cardiovascular disease, this is often mitigated with medication and revascularization. Low and middle-income countries, on the other hand, have a higher rate of cardiovascular disease and death despite lower risk factors. In fact, the New England Journal of Medicine estimates that up to 80 percent of deaths caused by cardiovascular disease occur in low and middle-income countries. While this knowledge has been present for some time, many have puzzled as to why this pattern persists.
This trend appeared in the 1970s, as a mixture of risk reduction and improved disease management decreased the death rates associated with cardiovascular disease considerably in high-income countries. Meanwhile, low and middle-income countries have not been so fortunate. In addition to the correlation between the income of regions with cardiovascular disease-related risks and death, research shows these factors also differ when comparing urban and rural areas. As you might expect, those in rural areas have a lower risk of developing the disease, yet have higher rates of related death.
The most probable cause of these trends is the level of healthcare accessibility granted to the patient. Those who reside in a heavily populated region, especially one in a high-income country, have greater access to medication and healthcare facilities. This is partly due to the closer proximity of urban patients to hospitals and pharmacies. Another factor, however, relates to the economic status of patients, as many living in rural areas in low and middle-income countries tend to earn less than their city-dwelling counterparts. This strongly illustrates how important proper disease management is in effectively preventing cardiovascular disease, as well any deaths that result from its complications. It also indicates that access to treatment has thus far been superior to the inherent risk factors of patients.
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