ABSTRACT
Chronic diseases, including CVDs such as coronary heart disease, stroke, and hypertension, as well as cancer, lung disease, and diabetes mellitus, account for most deaths in nearly all regions of the world except sub-Saharan Africa. The peak mortality from CVD occurred in the 1960s in the United States, in the 1970s in Western Europe, and in the 1980s and 1990s in Eastern Europe. While infectious diseases, lack of nutrition, and poor childbearing practices are claiming fewer lives in developing countries, deaths attributable to chronic diseases are rising (Levenson et al. 2002; Yusuf et al. 2001). This current epidemiologic transition in developing countries, a collision of emerging epidemics of non-communicable diseases and injury, with existing epidemics of infectious diseases, malnutrition, and complications of childbirth, creates complexity in countries where health infrastructure is often inadequate to deal with already existing health challenges and needs, and where health systems are often not agile enough to respond with the development of preventive and cost-effective interventions. This chapter provides an overview of the problem of chronic disease, and the urgent need for action globally, with a specific focus on CVD, a term we will use to encompass coronary artery disease, hypertension, stroke, and diabetes.
