Heart disease is still the leading cause of death around the world, responsible for nearly 18 million deaths each year. Although it affects people everywhere, some countries have especially high rates due to a mix of lifestyle, genetics, healthcare access, and environmental factors.

In this article, we’ll look at five countries with the highest heart disease rates. We’ll explore why cardiovascular health problems are so common in these areas and how each country is working to address this public health challenge and help people stay healthier.

Understanding Heart Disease

Before diving into specific countries, it’s important to understand what heart disease is. Heart disease, or cardiovascular disease (CVD), refers to a group of conditions that affect the heart and its blood vessels. These include coronary artery disease, heart failure, arrhythmias (irregular heartbeats), and heart valve disease.

Heart disease develops differently depending on the type. For example, with coronary artery disease, arteries that bring blood to the heart become narrow or blocked because of a buildup of fat called plaque. Other types of heart disease may be caused by stress, hypertension (high blood pressure), certain medications, and lifestyle choices such as smoking or drug use. Heart disease has been around for a long time, but it has become more common in recent years.

How Heart Disease Rates Are Calculated

Heart disease rates take into account all the different types. These rates are based on a few key measurements that help researchers and healthcare professionals see how common cardiovascular disease is in different groups of people.

Prevalence rates show how many people in a population are living with heart disease at a certain time. Incidence rates track how many new cases are diagnosed during a specific period. Mortality rates, also known as death rates, count how many people die from heart disease, usually reported as the number of deaths per 100,000 people. Looking at how these numbers change over time helps people see if heart disease is going up, going down, or staying the same in a country. These numbers also show how much heart disease costs the economy.

There is another measurement that takes into account the overall global burden of disease. It’s called disability-adjusted life years (DALYs). DALYs include both the number of people who die from a disease (called years of life lost, or YLL) and the people who live with the disease (called years lived with disability, or YLD). This helps public health officials get a full picture of how the disease has affected different groups of people.

This article discusses the five countries with the highest DALYs of heart disease.

1. Nauru

Nauru, a small island in the Pacific Ocean, ranked as the highest in the world for DALYs of heart disease in 2021. It also had the second-highest number of deaths from heart disease per 100,000 people.

Contributing Factors

There are a few different factors that likely contribute to Nauru having the highest DALYs of heart disease.

A normal diet in Nauru consists of foods that are high in sugar and fat. This type of diet can increase the risk of cardiovascular disease. In fact, this diet has led to high rates of obesity in this country. The Global Nutrition Report, which tracks global health and nutrition data, reports that about 65 percent of women and 61 percent of men in Nauru have obesity, which contributes to heart disease. Nauru is also known for some of the highest rates of diabetes across the globe. Complications from diabetes, such as amputations, are also common.

Nauru is a small island nation with a limited healthcare system. It can be hard to treat noncommunicable diseases (NCDs) — long-term illnesses like diabetes, high blood pressure, and cancer that don’t spread from person to person. As a result, it’s harder to prevent, manage, and treat heart disease in the country.

Improvement Efforts

With help from the World Health Organization, the Nauruan government is working to improve access to affordable care and medicine. Their programs focus on risk factors linked to noncommunicable diseases like heart disease and aim to raise awareness. To encourage healthier eating, the country has added taxes on foods with added sugar.

2. Vanuatu

Another island in the Pacific Ocean, Vanuatu, has a high rate of heart disease. Vanuatu had the second-highest heart disease DALY rate in 2021.

Contributing Factors

Traditional diets in Vanuatu include a lot of salt, which can raise the risk of CVD. A 2019 survey found that people in Vanuatu eat more salt each day than the World Health Organization recommends.

Vanuatu also faces frequent natural disasters, which can damage roads, buildings, and healthcare services. In rural areas — places that are outside of cities and towns — it’s even harder for people to get the care they need. Doctors and healthcare systems in Vanuatu are often overwhelmed.

Many people in Vanuatu live sedentary lifestyles — they aren’t physically active every day. The World Health Organization found that nearly 90 percent of teenagers don’t get enough daily physical activity.

Improvement Efforts

Vanuatu’s Ministry of Health started the Vanuatu Health Program to give financial support and make healthcare easier to access. The government has also taken steps to encourage interventions to promote healthier lifestyles, such as a tax on carbonated drinks with added sugars and limiting advertisements on unhealthy foods.

3. Afghanistan

Afghanistan ranks third in the world for heart disease DALYs.

Contributing Factors

Many rural areas across Afghanistan don't have enough access to healthcare and critical services. Recent funding shortages also threaten to shut down more healthcare services, although access is already limited. Additionally, ongoing conflict and economic instability may lead to stress, a potential risk factor for cardiovascular disease.

Research from the Tobacco Atlas — a global report on tobacco use and its health effects — shows that tobacco use is high in Afghanistan, especially among men. It’s also a major contributing factor to heart disease, cancer, diabetes, and respiratory diseases.

Traditional Afghan cuisine is often high in animal fats and cooked with a lot of oil, which may raise cholesterol levels — another risk factor for heart disease.

Improvement Efforts

Community programs, such as the Afghanistan NCD Alliance, aim to raise awareness about heart health and the dangers of cardiovascular disease. Conferences and events provide education on risk factors and promote healthy lifestyles to participants, as well as schools.

4. Uzbekistan

The DALYs of heart disease in Uzbekistan, which is located in Central Asia, are also ranked among the highest. In 2021, the country had the world’s highest CVD death rate, with 798 deaths per 100,000 people each year.

Contributing Factors

Obesity rates have nearly tripled for both men and women in Uzbekistan since 1990, per research in the International Journal of Environmental Research and Public Health. The traditional Uzbek diet is high in salt and trans fats. According to the World Health Organization, people in Uzbekistan eat nearly three times more salt each day than the recommended amount. Smoking rates are high, particularly among men. Research from the journal IJC Heart & Vasculature shows that about 25 percent of men in Uzbekistan smoke.

Air pollution is also a big concern for heart disease in areas of Uzbekistan, as people exposed to poor air quality are more likely to experience damage to their hearts, lungs, immune systems, and blood vessels.

Improvement Efforts

Uzbekistan has taken steps to lower heart disease rates, such as creating a plan to give nurses a bigger role in healthcare. By doing this, facilities were able to reduce the burden of physicians and treat more people. Uzbekistan has also increased the use of cardiovascular risk assessments in communities, allowing healthcare professionals to follow up with those who have a higher risk.

5. Marshall Islands

The Marshall Islands, another country in the Pacific Ocean, comes in fifth in terms of global heart disease DALYs.

Contributing Factors

As an island nation, the Marshall Islands struggles with not having enough medical supplies and equipment, which limits healthcare access and delivery. Traditional diets in the Marshall Islands often include processed foods and canned goods, which may lead to poor health outcomes. Incidences of diabetes have increased due to unhealthy lifestyles and limited access to diabetes education and care.

In the mid-1900s, the Marshall Islands were used for nuclear testing sites, which led to environmental damage and left behind health problems that still affect the community today.

Improvement Efforts

In the Marshall Islands, the Ministry of Health and the Ministry of Education have collaborated with the Diabetes Wellness Center to create prevention programs. These programs aim to add healthy diets and physical activity into the daily lives of children and their families. Education on reducing the risk of diabetes and cardiovascular diseases has also been included in school programs.

Why Do Global Heart Disease Rates Matter?

Heart disease remains a serious worldwide health problem, and some countries are more affected than others. Genetics, access to healthcare, and economic conditions all play a role — but there’s still hope. With strong public health programs, better medical care, and more awareness about prevention, even people in countries with high rates of heart disease can live healthier lives.

As research grows and healthcare systems improve, continued progress will take ongoing effort from governments, healthcare providers, and individuals. By identifying which populations are most at risk, we can make sure resources go where they’re needed most — and improve health outcomes for millions around the world.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 62,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Did you know which countries have the highest heart disease rates? Did any of these surprise you? Share your experience in the comments below, or start a conversation by posting on your Activities page.