Cardiovascular disease (CVD) remains the world's leading cause of death — claiming an estimated 19 million lives each year — but what has changed over the past three decades, and what lies ahead?
In a new podcast episode hosted by the Preventive Cardiovascular Nurses Association (PCNA), Dr Salim Virani, Vice Provost of Research at the Aga Khan University and a global leader in cardiovascular medicine, explores three decades of progress in heart health, current disparities, and what must happen over the next 20 to 30 years to stem the growing tide of heart disease.
Reflecting on global data, Dr Virani highlights that while many high-income countries have seen a decline in deaths from heart disease and stroke, low- and middle-income regions are facing a worrying rise. “High-income countries have seen tremendous reductions in heart disease mortality," he notes. “But in many parts of the world, including South Asia and sub-Saharan Africa, people are developing risk factors earlier and dying younger — largely due to weak health care systems, limited access to medications, and low rates of preventive screening."
The discussion also focuses on how climate change, air pollution, and changing lifestyles are reshaping global patterns of heart disease. “Environmental factors such as air quality and temperature extremes can have a profound effect on cardiovascular health," he explains. “These are not just ecological issues — they're heart health issues."
Emphasising the importance of starting prevention early, Dr Virani points to emerging evidence linking maternal health to lifelong heart outcomes. “We need to start early — ideally even before birth," he says. “Addressing high blood pressure and diabetes during pregnancy can have lasting cardiovascular benefits for the child."
He adds that lasting progress depends on tackling the root causes of poor heart health — poverty, education, and inequity. “The best outcomes come when we address these social determinants of health," Dr Virani stresses. “Heart disease is not just a medical problem — it's a societal one that requires collective action."
Listen to the full conversation here: PCNA Podcast with Dr Salim Virani
