5.2.1. Introduction

Diseases of the circulatory system (ICD 9: 390-459) consist of ischemic heart diseases including myocardial infarction (ICD 9: 410-414), and other diseases (ICD 9: 390-409 and 415-459), including cerebral stroke (ICD 9: 430-438).

The most frequent forms of CVD are those of atherosclerotic origin such as ischemic heart disease (IHD) and stroke. Ischemic heart disease and stroke, are the main killers in both genders and all ages, accounting for 42% of all cases of death in the EU. In the EU, one in six men and one in seven women currently die from ischemic heart disease (IHD) and one in ten men and one in eight women die from stroke.

Cardiovascular disease (CVD) accounts for almost half of all deaths causing over 4,30 million deaths each year in Europe and more than 2.0 million deaths each year within the European Union (EU) (Allender et al, 2008). CVD is also a major cause of disability and reduced quality of life.

Although EU is experiencing declining rates of mortality from CVD, there is an increasing number of men and women living with CVD. This paradox relates to an increased longevity and an improved survival of patients with CVD.

The burden of CVD is killing more people than all cancers combined with a higher percentage of women (54% of all-cause mortality) than men (43% of all-cause mortality) (2733 Employment, Social Policy, Health and Consumer Affairs Council Meeting – Luxembourg – 1 and 2 June 2006; Allender et al, 2008) and a higher mortality in the lower socio-economic class.

IHD is the leading cause of mortality in EU, accounting for over 741,000 deaths every year (one in six men and over one in seven women). It is also one of the greatest contributors to health expenditures. Stroke is the second leading cause of death in the EU accounting for 508,000 deaths each year: around one in ten men and one in eight women die from this disease; many more suffer from non-fatal events (Allender et al, 2008; Petersen et al, 2005).

Even though clinical onset is mainly acute, CVD often evolves gradually, causing substantial loss of quality of life, disability, and life long dependence on health services and medications. The costs for our society are huge and are not only directly related to health care and social services, but are also linked to illness benefits and retirement, impact on families and caregivers and the loss of years of productive life.

In most European countries CVD mortality has declined since the mid 70s, but in Eastern Europe mortality has remained stable or has slightly increased (Kesteloot et al, 2006). Despite the decline in mortality, the annual number of CVD is expected to increase within the next few decades, mainly due to a growth in the elderly population, which will lead to an increase in the health burden of CVD and consequent increase in economic costs. Therefore, across Europe there is a pressing need to cope with costs increase and make CVD prevention and treatment a priority to reduce the growing health burden and lessen its socio-economic impact.