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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY VOL. 70, NO. 1, 2017 ª 2017 THE AUTHORS. PUBLISHED BY ELSEVIER ON BEHALF OF THE AMERICAN ISSN 0735-1097 COLLEGE OF CARDIOLOGY FOUNDATION. THIS IS AN OPEN ACCESS ARTICLE UNDER http://dx.doi.org/10.1016/j.jacc.2017.04.052 THE CC BY LICENSE (http://creativecommons.org/licenses/by/4.0/). ORIGINAL INVESTIGATIONS Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015 a a b c Gregory A. Roth, MD, MPH, Catherine Johnson, PHD, Amanuel Abajobir, MPH, Foad Abd-Allah, MD, d d e f a Semaw Ferede Abera, MSC, Gebre Abyu, MS, Muktar Ahmed, MPH, MBA, Baran Aksut, MD, Tahiya Alam, MPH, g h i j k Khurshid Alam, PHD, François Alla, PHD, Nelson Alvis-Guzman, PHD, Stephen Amrock, MD, Hossein Ansari, PHD, l m d n o Johan Ärnlöv, PHD, Hamid Asayesh, PHD, Tesfay Mehari Atey, MSC, Leticia Avila-Burgos, PHD, Ashish Awasthi, MSC, p q r s t Amitava Banerjee, DPHIL, Aleksandra Barac, PHD, Till Bärnighausen, MD, Lars Barregard, MD, Neeraj Bedi, MD, d u d v Ezra Belay Ketema, MSC, Derrick Bennett, PHD, Gebremedhin Berhe, MPH, Zulfiqar Bhutta, PHD, MBBS, w x y z Shimelash Bitew, MPH, Jonathan Carapetis, MBBS, PHD, Juan Jesus Carrero, PHD, Deborah Carvalho Malta, MD, PHD, aa bb cc Carlos Andres Castañeda-Orjuela, MSC, Jacqueline Castillo-Rivas, MPH, Ferrán Catalá-López, PHD, dd ee ff gg Jee-Young Choi, PHD, Hanne Christensen, DMSCI, Massimo Cirillo, MD, Leslie Cooper, JR,MD, hh ii jj a,kk Michael Criqui, MD, MPH, David Cundiff, MD, Albertino Damasceno, PHD, Lalit Dandona, MD, a,kk ll mm Rakhi Dandona, PHD, Kairat Davletov, MD, PHD, MPH, Samath Dharmaratne, MD, nn oo a Prabhakaran Dorairaj, MD, DM, MSC, Manisha Dubey, MPHIL, Rebecca Ehrenkranz, MPH, pp qq rr ss Maysaa El Sayed Zaki, MD, PHD, Emerito Jose A. Faraon, MD, Alireza Esteghamati, MD, Talha Farid, MD, r tt r uu e Maryam Farvid, PHD, Valery Feigin, PHD, Eric L. Ding, SCD, Gerry Fowkes, PHD, Tsegaye Gebrehiwot, MPH, r a vv ww Richard Gillum, MD, Audra Gold, MSC, Philimon Gona, PHD, Rajeev Gupta, MD, PHD, xx rr d d Tesfa Dejenie Habtewold, MSC, Nima Hafezi-Nejad, MD, Tesfaye Hailu, MBA, Gessessew Bugssa Hailu, MSC, x yy e y Graeme Hankey, MD, Hamid Yimam Hassen, MPH, Kalkidan Hassen Abate, MS, Rasmus Havmoeller, PHD, a,u zz aaa bbb Simon I. Hay, DSC, Masako Horino, MPH, Peter J. Hotez, PHD, Kathryn Jacobsen, PHD, ccc ddd nn eee Spencer James, MD, MPH, Mehdi Javanbakht, PHD, Panniyammakal Jeemon, PHD, Denny John, MBA, MPH, fff ggg hhh rr iii Jost Jonas, MD, Yogeshwar Kalkonde, MD, Chante Karimkhani, MD, Amir Kasaeian, PHD, Yousef Khader, SHD, Abdur Khan, MD,jjj Young-Ho Khang, MD,kkk Sahil Khera, MD,lll Abdullah T. Khoja, MBBS, MPH, MBA,mmm nnn ooo ppp qqq Jagdish Khubchandani, MBBS, PHD, Daniel Kim, DRPH, Dhaval Kolte, MD, Soewarta Kosen, MD, a kk rrr kk l Kristopher J. Krohn, BA, G. Anil Kumar, PHD, Gene F. Kwan, MD, Dharmesh Kumar Lal, MD, Anders Larsson, PHD, sss g ttt pp Shai Linn, MD MPH, DRPH, Alan Lopez, MS, PHD, Paulo A. Lotufo, DRPH, Hassan Magdy Abd El Razek, MBBCH, rr uuu vvv d Reza Malekzadeh, MD, Mohsen Mazidi, PHD, Toni Meier, PHD, Kidanu Gebremariam Meles, MPH, www g d xxx yyy George Mensah, MD, Atte Meretoja, PHD, Haftay Mezgebe, MSC, Ted Miller, PHD, Erkin Mirrakhimov, MD, zzz aaaa bbbb cccc Shafiu Mohammed, PHD, Andrew E. Moran, MD, MPH, Kamarul Imran Musa, MD, Jagat Narula, MD, PHD, dddd eeee a ffff Bruce Neal, MBCHB, PHD, Frida Ngalesoni, MSC, Grant Nguyen, MPH, Carla Makhlouf Obermeyer, PHD, gggg g hhhh iiii Mayowa Owolabi, MBBS, MSC,DMED, George Patton, MD, João Pedro, MS, Dima Qato, PHARMD, PHD, jjjj u kkkk llll z Mostafa Qorbani, PHD, Kazem Rahimi, DM, Rajesh Kumar Rai, MPH, Salman Rawaf, PHD, Antônio Ribeiro, MD, mmmm r ttt q Saeid Safiri, PHD, Joshua A. Salomon, PHD, Itamar Santos, PHD, Milena Santric Milicevic, MD, MSC,PHD, nnnn oooo rr Benn Sartorius, PHD, Aletta Schutte, PHD, Sadaf Sepanlou, MD, PHD, MPH, pppp qqqq f rrrr Masood Ali Shaikh, MD, MPH, MA, MS, Min-Jeong Shin, PHD, Mehdi Shishehbor, DO, MPH, Hirbo Shore, MPH, ssss tttt uuuu Diego Augusto Santos Silva, PHD, Eugene Sobngwi, MD, MPHIL,PHD, Saverio Stranges, MD, PHD, vvvv cc yy d Listen to this manuscript’s Soumya Swaminathan, MD, Rafael Tabarés-Seisdedos, PHD, Niguse Tadele Atnafu, MS, Fisaha Tesfay, MSC, audio summary by wwww xxxx yyyy zzzz J.S. Thakur, MD, Amanda Thrift, PHD, Roman Topor-Madry, PHD, Thomas Truelsen, MD, PHD, DMSC, JACC Editor-in-Chief aaaaa bbbbb ccccc Stefanos Tyrovolas, PHD, Kingsley Nnanna Ukwaja, MD, Olalekan Uthman, PHD, Dr. Valentin Fuster. ddddd eeeee fffff e Tommi Vasankari, PHD, Vasiliy Vlassov, MD, Stein Emil Vollset, DRPH, Tolassa Wakayo, MSC, a ggggg hhhhh hhhhh David Watkins, MD, MPH, Robert Weintraub, MBBS, Andrea Werdecker, PHD, Ronny Westerman, PHD, iiiii jjjjj e kkkkk Charles Shey Wiysonge, PHD, Charles Wolfe, MD, Abdulhalik Workicho, MPH, Gelin Xu, PHD, lllll mmmmm nnnnn ooooo Yuichiro Yano, MD, Paul Yip, PHD, Naohiro Yonemoto, MPH, Mustafa Younis, DHPH, ppppp a a a Chuanhua Yu, PHD, Theo Vos, PHD, Mohsen Naghavi, PHD, Christopher Murray, DPHIL 2 Roth et al. JACC VOL. 70, NO. 1, 2017 Global Burden of Cardiovascular Diseases 2015 JULY 4, 2017:1– 25 From the aUniversity of Washington, Seattle, Washington; bUniversity of Queensland, Brisbane, Queensland, Australia; cCairo University, Cairo, Egypt; dMekelle University, Addis Ababa, Ethiopia; eJimma University, Jimma, Ethiopia; fCleveland Clinic, Cleveland, Ohio; gUniversity of Melbourne, Melbourne, Victoria, Australia; hUniversity of Lorraine, Nancy, France; iUniversidad de Cartagena, Cartagena, Colombia; jOregon Health & Science University, Portland, Oregon; kZahedan University of Medical Sciences, Zahedan, Iran; lUppsala University, Uppsala, Sweden; mQom University of Medical Sciences, Qom, Iran; nNational Institute of Public Health, Cuernavaca, Mexico; oSanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; pUniversity College London, London, United Kingdom; qUniversity of Belgrade, Belgrade, Serbia; rHarvard University, Boston, Massachusetts; sUni- versity of Gothenburg, Gothenburg, Sweden; tCollege of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia; uUniversity of Oxford, Oxford, United Kingdom; vAga Khan University, Karachi, Pakistan; wWolaita Sodo University, Wolaita Sodo, Ethiopia; xThe University of Western Australia, Perth, Western Australia, Australia; yKarolinska Institutet, Stockholm, Sweden; zUniversidade Federal de Minas Gerais, Belo Horizonte, Brazil; aaInstituto Nacional de Salud, Bogotá, Colombia; bbCaja Costar- ricense de Seguro Social, San José, Costa Rica; ccUniversity of València/INCLIVA Health Research Institute and CIBERSAM, València, Spain; ddSeoul National University Hospital, Seoul, South Korea; eeBispebjerg University Hospital, Copenhagen, Denmark; ffUni- versity of Salerno, Salerno, Italy; ggMayo Clinic, Rochester, Minnesota; hhUniversity of California, San Diego, California; iiLong Beach, California; jjEduardo Mondlane University, Maputo, Mozambique; kkPublic Health Foundation of India, New Delhi, India; llRepublican Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan; mmUniversity of Peradeniya, Peradeniya, Sri Lanka; nnCentre for Chronic Disease Control, Gurgaon, India; ooInternational Institute for Population Sciences, Mumbai, India; ppMansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt; qqUniversity of Philippines Manila, Manila, Philippines; rrTehran University of Medical Sciences, Tehran, Iran; ssUniversity of Louisville, Louisville, Kentucky; ttAuckland University of Technology, Auckland, New Zealand; uuUniversity of Edinburgh, Edinburgh United Kingdom; vvUniversity of Massachusetts Boston, Boston, Massachusetts; wwEternal Heart Care Center and Research Institute, Jaipur, India; xxUniversity of Groningen, Groningen, the Netherlands; yyMizan-Tepi University, Mizan Teferi, Ethiopia; zzNevada Division of Public and Behavioral Health, Carson City, Nevada; aaaBaylor College of Medicine, Houston, Texas; bbbGeorge Mason University, Fairfax, Virginia; cccDenver Health/University of Colorado, Denver, Colorado; dddUniversity of Aberdeen, Aberdeen, United Kingdom; eeeInternational Center for Research on Women, New Delhi, India; fffRuprecht-Karls Universitaet Heidelberg, Heidelberg, Germany; gggSociety for Education, Action and Research in Community Health, Gadchiroli, India; hhhCase Western University Hospitals, Cleveland, Ohio; iiiJordan University of Science and Technology, Irbid, Jordan; jjjUniversity of Louisville, Louisville, Kentucky; kkkSeoul National University, Seoul, South Korea; lllNew York Medical College, Valhalla, New York; mmmAl-Imam Muhammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia; nnnBall State University, Muncie, Indiana; oooNortheastern University, Boston, Massachusetts; pppBrown University, Providence, Rhode Island; qqqHealth Policy and Humanities, National Institute of Health Research and Development, Jakarta, Indonesia; rrrBoston University School of Medicine, Boston, Massachusetts; sssUniversity of Haifa, Haifa, Israel; tttUniversity of São Paulo, São Paulo, Brazil; uuuChinese Academy of Sciences, Beijing, China; vvvMartin Luther University Halle-Wittenberg, Halle, Germany; wwwNational Institutes of Health, Bethesda, Maryland; xxxPacific Institute for Research & Evaluation, Beltsville, Mary- land; yyyKyrgyz State Medical Academy, Bishkek, Kyrgyzstan; zzzAhmadu Bello University, Zaria, Nigeria; aaaaColumbia University, New York, New York; bbbbUniversity of Science Malaysia, Penang, Malaysia; ccccThe Mount Sinai