eur cvd stats
TRANSCRIPT
Europeancardiovascular
disease statistics
1
Europeancardiovasculardiseasestatistics
2000 edition
Compiled by:
Mike Rayner and Sophie Petersen
British Heart Foundation Health Promotion Research Group
Department of Public Health
University of Oxford
Institute of Health Sciences
Old Road
Headington
Oxford OX3 7LF
www.dphpc.ox.ac.uk/bhfhprg
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disease statistics
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disease statistics
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ContentsPage
Foreword
Summary
Introduction
1. MortalityTable 1.1 Total numbers of deaths by cause and sex, latest available yearFigure 1.1a Deaths by cause, men, latest available year, EuropeFigure 1.1b Deaths by cause, women, latest available year, EuropeFigure 1.1c Deaths by cause, men, latest available year, EUFigure 1.1d Deaths by cause, women, latest available year, EUTable 1.2 Deaths under 75 by cause and sex, latest available yearFigure 1.2a Deaths under 75 by cause, men, latest available year, EuropeFigure 1.2b Deaths under 75 by cause, women, latest available year, EuropeFigure 1.2c Deaths under 75 by cause, men, latest available year, EUFigure 1.2d Deaths under 75 by cause, women, latest available year, EUTable 1.3 Deaths under 65 by cause and sex, latest available yearFigure 1.3a Deaths under 65 by cause, men, latest available year, EuropeFigure 1.3b Deaths under 65 by cause, women, latest available year, EuropeFigure 1.3c Deaths under 65 by cause, men, latest available year, EUFigure 1.3d Deaths under 65 by cause, women, latest available year, EUTable 1.4 Age-standardised death rates from CHD, for adults aged 35-74, by
sex, 1968-1997Figure 1.4a Death rates from CHD, men aged 35-74, latest available yearFigure 1.4b Death rates from CHD, women aged 35-74, latest available yearFigure 1.4c Death rates from CHD, men aged 35-74, 1968-1997, selected
countriesFigure 1.4d Death rates from CHD, women aged 35-74, 1968-1997, selected
countriesTable 1.5 Age-standardised death rates from stroke, for adults aged 35-74, by
sex, 1968-1997Figure 1.5a Death rates from stroke, men aged 35-74, latest available yearFigure 1.5b Death rates from stroke, women aged 35-74, latest available yearFigure 1.5c Death rates from stroke, men aged 35-74, 1968-1997, selected
countriesFigure 1.5d Death rates from stroke, women aged 35-74, 1968-1997, selected
countriesTable 1.6 Years of life lost in early death by cause, 1990, EU and Europe
2. MorbidityTable 2.1 Coronary event rates, coronary case fatality, annual change in
coronary event rates and annual change in coronary case fatality,adults aged 35-64, by sex, latest available year, MONICA Projectpopulations
Table 2.2 Years lived with disability and disability-adjusted life years lost, bycause, 1990, EU and Europe
Figure 2.2 Disability-adjusted life years lost by cause, 1990, EU
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8
1014161617171820202121222424252526
282829
29
30
323233
33
34
3537
38
39
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3. TreatmentTable 3.1 Rates of hospital discharges for CVD, CHD and stroke, latest
available yearFigure 3.1 Rates of hospital discharges for CHD, crude and adjusted for
standardised mortality rates from CHD in adults aged 35-74, latestavailable year
Table 3.2 Age and sex-standardised rates of various procedures for treatingCVD, around 1995
Figure 3.2 Rates of coronary artery bypass surgery, crude and adjusted forstandardised mortality rates from CHD, in adults aged 35-74, around1995
Table 3.3 Reported medication, hospital patients with established CHD, around1995, EUROASPIRE Survey populations
4. SmokingTable 4.1 Total numbers of deaths and numbers of deaths due to smoking,
adults aged 35 and over, by sex and cause, 1995Table 4.2 Prevalence of smoking, adults aged 15 and over, by sex, latest available
yearFigure 4.2a Prevalence of smoking, men aged 15 and over, latest available yearFigure 4.2b Prevalence of smoking, women aged 15 and over, latest available
yearTable 4.3 Prevalence of smoking, adults aged 35-64, by sex, latest available
year, MONICA Project populationsTable 4.4 Prevalence of smoking, 15 year olds, by sex, 1989/90 and 1993/94Table 4.5 Prevalence of smoking, adults aged 15 and over, by sex, 1980-1997Table 4.6 Prevalence of smoking, adults aged 15 and over, by sex, 1974-1994Figure 4.6 Prevalence of smoking, adults aged 15 and over, by sex, 1974-1994
5. DietTable 5.1 Fruit and vegetable consumption, adults, by sex, latest available yearTable 5.2 Percentage of total energy from fruit and vegetables, 1972-1997Figure 5.2a Percentage of total energy from fruit and vegetables, 1997Figure 5.2b Percentage of total energy from fruit and vegetables, 1972-1997,
selected countriesTable 5.3 Percentage of total energy from fat, adults, by sex, latest available
yearTable 5.4 Percentage of total energy from fat, 1972-1997Figure 5.4a Percentage of total energy from fat, 1997Figure 5.4b Percentage of total energy from fat, 1972-1997, selected countriesTable 5.5 Percentage of total energy from cereals, 1972-1997Figure 5.5 Percentage of total energy from cereals, 1972-1997, selected countries
6. Physical activityTable 6.1 Participation in various physical activities in a typical week, adults
aged 15 and over, 1997, EU countriesTable 6.2 Number of hours spent participating in various physical activities in
a typical week, adults aged 15 and over, 1997, EU countriesFigure 6.2 Percentage of adults aged 15 and over who do no physical activity in
a typical week, 1997
7. AlcoholTable 7.1 Alcohol consumption, 1970-1997Figure 7.1 Alcohol consumption, 1997
4041
41
42
42
43
4446
47
4848
49
49505152
5355565757
58
5960606162
6364
65
65
666768
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8. Blood pressureTable 8.1 Systolic blood pressure levels, adults aged 35-64, by sex, latest
available year, MONICA Project populationsFigure 8.1 Percentage of adults aged 35-64 with systolic blood pressure levels
>160 mmHg, latest available year
9. Blood cholesterolTable 9.1 Blood cholesterol levels, adults aged 35-64, by sex, latest available
year, MONICA Project populationsFigure 9.1 Percentage of adults aged 35-64 with blood cholesterol levels > 7.8
mmol/l, latest available year
10. Overweight and obesityTable 10.1 Prevalence of overweight and obesity, adults aged 15 and over, 1997,
EU countriesTable 10.2 Prevalence of overweight and obesity, adults aged 35-64, by sex,
latest available year, MONICA Project populationsTable 10.3 Prevalence of obesity, adults, by sex, 1978-1997Figure 10.3 Prevalence of obesity, adults, by sex 1978-1997
11. DiabetesTable 11.1 Prevalence of diabetes, 1980-1997
Appendix
Acknowledgements
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ForewordCardiovascular disease (CVD) is the main cause of death in Europe. It is responsible for hundreds
of thousands of early deaths and for much suffering. CVD is not only a major threat to individuals'
lives and their quality of life, it is also a major economic burden to all European countries.
This publication - European cardiovascular disease statistics - sponsored by the British Heart
Foundation – is the first we know of which brings together all the currently available sources of
information about how much death and illness is caused by CVD across Europe, and also about
levels of underlying risk factors for the disease.
Accurate and comprehensive data on CVD and its risk factors are essential to the development of
a coherent European strategy for the prevention and treatment of CVD. European cardiovascular
disease statistics shows that there is a considerable amount of relevant data collected. This data
indicate how and where efforts to prevent and treat CVD should be targeted.
However the data vary considerably in quality and in particular there is an urgent need to improve
their comparability. The problem of data comparability was raised in 1993, at the Third
International Conference on Preventive Cardiology, and again in 1994 at a conference organised
by the European Heart Network and sponsored by the Netherlands Heart Foundation and the
European Commission - the Eurodata Conference1. This conference examined various ways of
increasing the comparability of health data.
The European Heart Network considers that there is an urgent need for the European Union
(EU) to create structures which facilitate the collection of accurate, comprehensive and comparable
data in relation to CVD.
In the meantime we hope this publication will be a valuable tool for policy makers, health
professionals, researchers and all those working to improve the length and quality of life of
Europeans.
Susanne Løgstrup
Director
European Heart Network
1. European Heart Network (1994) European Heart Network's Eurodata Conference. Measuring the burden ofcardiovascular disease in Europe: Steps towards establishing comparable data. Netherlands Heart Foundation: DenHaag.
Europeancardiovascular
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Summary■ Cardiovascular disease (CVD) causes 4 million deaths each year in Europe and over 1.5
million deaths each year in the European Union (EU).
■ CVD causes nearly half of all deaths in Europe (48%) and in the EU (41%).
■ CVD is the main cause of death in women in all countries of Europe and is the main cause
of death in men in all countries except France.
■ CVD is the main cause of years of life lost in early death in Europe and the EU.
■ Nearly 30% of years of life lost in Europe are due to CVD (over 30% in the EU).
■ CVD mortality, incidence and case fatality are falling in most Northern, Southern and Western
European Countries but rising in Central and Eastern European countries.
■ Each year smoking kills about 1.2 million people in Europe (430,000 from CVD) and
about 500,000 people in the EU (130,000 from CVD).
■ Smoking has been declining in many European countries but the rate of decline is now
slowing. Women are now smoking nearly as much as men in many European countries and
girls often smoke more than boys.
■ Diets are generally improving in Northern and Western European countries but deteriorating
in Southern, Central and Eastern European countries.
■ Dietary patterns across Europe - once very different - are now converging.
■ Levels of obesity are increasing across Europe.
■ The prevalence of diabetes is increasing across Europe.
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IntroductionThe aim of the publicationEuropean cardiovascular disease statistics is designed for policy makers, health professionals,
medical researchers and anyone else with an interest in cardiovascular disease (CVD). It provides
the most recent European statistics related to the incidence, prevalence, causes and effects of the
disease.
The aim of European cardiovascular disease statistics is to show:
(i) the extent to which CVD is the major health problem in Europe;
(ii) where, in Europe, this problem is greatest;
(iii) the variability in efforts to treat and prevent CVD across Europe as shown by differences in
levels of treatment and in levels of risk factors for the disease;
(iv) trends in CVD and its treatment, prevention and risk factors over time.
European cardiovascular disease statistics is divided into 11 sections. The first two sections on
mortality and morbidity deal with the burden of CVD in Europe. Next there is a section on
treatment. Then there are four sections on the main aspects of lifestyle which affect the risk of the
disease: smoking, diet, physical activity and alcohol consumption. Finally there are four sections
on the main physiological risk factors for the disease: raised blood pressure, raised blood
cholesterol, overweight/obesity and diabetes. Each section contains a set of tables and graphs
and a brief description of the data presented.
In European cardiovascular disease statistics we aim only to describe and not to explain. So
although there may be relationships between the various geographical and temporal patterns
observed we have made no attempt to draw any conclusions about the strength of these
relationships or about causality.
Sources and scope of the dataIn compiling European cardiovascular disease statistics we have only consulted international
sources: that is the World Health Organization (WHO), the WHO MONICA (monitoring trends
and determinants in cardiovascular disease) Project, the Food and Agriculture Organization of
the United Nations (FAO), the European Union (EU), the European Society of Cardiology, etc.
We have not sought data from national sources though we may do so in future editions. The data
presented are extremely variable in quality. The original sources need to be consulted for
information about data quality.
The statistics in European cardiovascular disease statistics are only a selection of the data available.
The original sources should be consulted for further data.
We also investigated several sources of data from which we have not extracted statistics: either
because the data provided were similar, but less comprehensive or less recent, than the data we
have included, or were not directly relevant to the focus of the publication.
Europeancardiovascular
disease statistics
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There are many different definitions of 'Europe'. We have chosen to use the member states of the
World Health Organization's European Region as our definition of 'Europe'. (An Appendix lists
the member states of the World Health Organization's European Region and of the EU and has
a map.) The number of European countries covered in the tables and graphs varies considerably.
We have, where possible, given an overall figure for Europe and also for the EU.
One omission from the statistics deserves special mention. We do not have a section on the
economic costs of CVD. We know that for some individual countries estimates have been made
of the cost of CVD to the economy1, but we could find no adequate analysis for Europe (or the
EU) as a whole. This is a deficiency we propose to rectify in future editions.
Previous publicationsThere have been several previous attempts to characterise the burden of CVD in Europe and to
examine geographical and temporal patterns in the disease and its prevention and treatment.
Notable in this regard is a report of a Task Force of the European Society of Cardiology on
Cardiovascular Mortality and Morbidity Statistics in Europe2 and a report, recently published
by the European Society of Cardiology entitled Cardiovascular diseases in Europe from which
we draw data on rates of procedures in Europe3. European cardiovascular disease statistics,
complements these publications. It is less detailed but more up-to-date than the European Society
of Cardiology Task Force report, and, in contrast to both previous publications includes data on
the prevalence of risk factors for CVD.
European cardiovascular disease statistics is also designed to complement the work of the European
Commission on monitoring health in the EU. The 1993 European Commission Communication
on the framework for action in the field of public health proposed4 that health status reports
should be prepared for the EU on a regular basis. The first Report from the Commission on the
state of health in the European Community5 was a general report. This report - like European
cardiovascular disease statistics - shows that CVD is the main health problem in the EU.
A second report, updating the first Report from the Commission on the state of health in the
European Community (but this time covering not only the member states of the EU but also
Hungary, Iceland, Norway and Switzerland), is currently in preparation6. Since 1993 the European
Commission, besides its first general report, has produced other reports covering specific health
topics. In particular it has published a report on the state of women's health in the European
Community which contains data about CVD in women7.
1. British Heart Foundation (1998) Coronary heart disease statistics. Economics supplement. BHF: London (forexample).
2. Task Force of the European Society of Cardiology on Cardiovascular Mortality and Morbidity Statistics in Europe(1997) The burden of cardiovascular diseases mortality in Europe. European Heart Journal 18; 1231-48.
3. European Society of Cardiology (1999) Cardiovascular diseases in Europe. ESC: Nice.
4. Commission of the European Communities (1993) Commission communication on the framework for action in thefield of public health . Office for the Official Publications of the European Communities: Brussels (COM (93) 559final).
5. Commission of the European Communities (1996) Report from the commission to the Council, the EuropeanParliament, the Economic and Social Committee and the Committee of the Regions on the state of health in theEuropean Community. Office for the Official Publications of the European Communities: Luxembourg (COM(95)357 final).
6. The editors of this new report are Paulo Ferrinho and Jose Periera Miguel, Ministerio da Saude, Portugal.
7. Commission of the European Communities (1997) Report from the commission to the Council, the EuropeanParliament, the Economic and Social Committee and the Committee of the Regions on the state of women's healthin the European Community. Office for the Official Publications of the European Communities: Luxembourg(COM(97) 224 final).
Europeancardiovascular
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1. MortalityTotal mortalityDiseases of the heart and circulatory system (cardiovascular disease or CVD) are the main cause
of death in Europe: accounting for over 4 million deaths each year1. Nearly half (49%) of all
deaths are from CVD (55% of deaths in women and 43% deaths in men). The main forms of
CVD are coronary heart disease (CHD) and stroke. About half of all deaths from CVD are from
CHD and nearly a third are from stroke (Table 1.1, Figures 1.1a and 1.1b).
CVD is also the main cause of death in the European Union (EU): accounting for over 1.5 million
deaths each year. Nearly half (42%)2 of all deaths in the EU (46% deaths in women and 38%
deaths in men) are from CVD - slightly less than for Europe as a whole. Between a third and a
half of deaths from CVD are from CHD and over a quarter are from stroke (Table 1.1, Figures
1.1c and 1.1d).
CHD by itself is the most common cause of death in Europe: accounting for nearly 2 million
deaths in Europe each year. Over one in five women (22%) and men (21%) die from the disease
(Table 1.1).
CHD by itself is also the most common cause of death in the EU: accounting for over 600,000
deaths in the EU each year. One in six men (17%) and one in seven women (15%) die from the
disease (Table 1.1).
CVD is the main cause of death for women in all 49 countries of Europe for which we have
mortality data and it is the main cause of death for men in all these countries except France. CVD
causes more than 50% of deaths in women in 27 countries. These countries are mostly in Central
and Eastern Europe but they also include some Southern and Western European countries such
as Greece and Germany. CVD causes more than 50% of deaths in men in five countries: Georgia,
Bulgaria, Romania, the Czech Republic and Macedonia (Table 1.1).
CVD is the main cause of death for women in all 15 countries of the EU and it is the main cause
of death for men in all these countries except France. For men living in EU countries CVD causes
between 49% (Sweden) and 29% of deaths (France) and for women between 59% (Austria) and
36% of deaths (France) (Table 1.1).
Deaths before the age of 75CVD is the main cause of deaths before the age of 75 in Europe: accounting for nearly 2 million
deaths each year. 43% of deaths before the age of 75 in women and 38% of deaths before the age
of 75 in men are from CVD. One in four of all men (26%) and one in six of all women (17%) die
from CVD before the age of 75 (Tables 1.1 and 1.2, Figures 1.2a and 1.2b).
CVD is the second main cause of deaths before the age of 75 in the EU: accounting for over
460,000 deaths. CVD causes 31% of deaths but cancer causes 36% of deaths. 31% of deaths
before the age 75 in men and 29% of deaths before the age of 75 in women are from CVD. One
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in six of all men (17%) and one in 12 of all women (8%) die from CVD before the ages of 75
(Tables 1.1 and 1.2, Figures 1.2c and 1.2d).
CHD by itself is the most common cause of deaths before the age of 75 in Europe: accounting for
nearly 1 million deaths. 20% of deaths before the age of 75 in men and 19% of deaths before the
age of 75 in women are from CHD (Table 1.2).
CHD by itself is the most common cause of deaths before the age of 75 in the EU: accounting for
nearly 230,000 deaths. In the EU CHD causes 17% of deaths before the age of 75 in men - more
than the most common form of cancer in men - lung cancer - which causes 10% of deaths. CHD
causes 12% of deaths before the age of 75 in women - more that the most common form of
cancer in women - breast cancer - which causes 8% of deaths (Table 1.2).
CVD is the main cause of deaths before the age of 75 for men in 38 of the 49 countries of Europe
and for women in 27 countries. The countries where CVD is the main cause of deaths before the
age of 75 are generally Central and Eastern European countries but they also include many
Northern, Southern and Western countries. CVD causes between 53% (Bulgaria) and 19%
(Tajikistan) of deaths before the age of 75 in men, and between 58% (Bulgaria) and 20% (Iceland)
of deaths before the age of 75 in women (Table 1.2).
CVD is the main cause of deaths before the age of 75 for men in eight countries out of 15 in the
EU (Austria, Finland, Germany, Greece, Ireland, Portugal Sweden and the UK). For women it is
the main cause in two countries: Greece and Portugal (Table 1.2).
Deaths before the age of 65CVD is the main cause of deaths before the age of 65 in Europe: accounting for over 800,000
deaths each year. 30% of deaths before the age of 65 in men and 29% of deaths before the age of
65 in men are from CVD. One in eight of all men (13%) and one in 17 of all women (6%) die
from CVD before the age of 65 (Tables 1.1 and 1.3, Figures 1.3a and 1.3b).
CVD is the second main cause of deaths before the age of 65 in the EU: accounting for over
170,000 deaths. CVD causes 22% of deaths but cancer causes 35% of deaths. 25% of deaths
before the age 65 in men and 18% of deaths before the age of 65 in women are from CVD. 7%
of all men and 2% of all women die from CVD before the age of 65 (Tables 1.1 and 1.3, Figures
1.3c and 1.3d).
CHD by itself is the most common cause of deaths before the age of 65 in Europe: accounting for
nearly 90,000 deaths. 16% of deaths before the age of 65 in men and 12% of deaths before the
age of 65 in women are from CHD (Table 1.3).
CHD by itself is the most common cause of deaths before the age of 65 in the EU: accounting for
over 170,000 deaths. In the EU, CHD causes 14% of deaths before the age of 65 in men - more
than the most common form of cancer in men - lung cancer - which causes 9% of deaths. CHD
causes 7% of deaths before the age of 65 in women - which is less than the most common form
of cancer in women - breast cancer - which causes 12% of deaths (Table 1.3).
CVD is the main cause of deaths before the age of 65 for men in 30 of the 49 countries of Europe
and for women in 20 countries. The countries where CVD is the main cause of deaths before the
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age of 65 are generally Central and Eastern European countries but they also include some
Northern, Southern and Western countries. CVD causes between 44% (Bulgaria) and 13%
(Tajikistan) of deaths before the age of 65 in men, and between 42% (Bulgaria) and 12% (France)
of deaths before the age of 65 in women (Table 1.3).
CVD is the main cause of deaths before the age of 65 for men in six countries in the EU (Austria,
Finland, Greece, Ireland, Sweden and the UK). For women it is not the main cause of deaths
before the age of 65 for any country in the EU (Table 1.3).
Death ratesDeath rates from CHD are generally higher in Northern, Central and Eastern Europe than in
Southern and Western Europe. For example the death rate for men aged 35-74 living in Russia is
eight times higher than in France and for women it is 12 times higher. Western European countries
generally have higher rates than Southern European Countries. For example the death rate for
men aged 35-74 living in Ireland is twice as high as in Italy and for women it is three times higher
(Table 1.4 Figures 1.4a and 1.4b).
Death rates from stroke are higher in Central and Eastern Europe than in Northern, Southern
and Western Europe. For example the death rate in men aged 35-74 living in Russia is nine times
higher than in France and for women of the same age it is 10 times higher (Table 1.5, Figures
1.5a and 1.5b).
Death rates from CHD are falling rapidly in most Northern and Western European countries but
they are rising rapidly in most Central and Eastern European countries. For example death rates
for men aged 35-74 living in Finland and the Netherlands fell by 38% and 38% respectively
between 1984 and 1994, but rose by 41% for men of the same age living in Romania. For
women aged 35-74 living in Finland and the Netherlands death rates fell by 36% and 31%
respectively, but rose by 24% for women living in Romania. Death rates in some Southern
European countries are falling but in others (such as Greece and Albania) they are stable or
possibly rising (Table 1.4, Figure 1.4c and 1.4d).
Death rates from stroke are falling rapidly in most Northern, Southern and Western European
countries but they are rising in most Central and Eastern European countries. For example death
rates for men aged 35-74 living in Italy and Ireland fell by 41% and 38% respectively between
1983 and 1993 but rose by 25% for men of the same age living in Romania. For women aged 35-
74 living in Italy and Ireland death rates fell by 44% and 37% respectively but rose by 12% for
women living in Romania (Table 1.5, Figure 1.5c and 1.5d).
Years of life lost due to an early deathCVD is not only the main cause of death in Europe and the EU but is also the main cause of years
lost due to an early death.
The Global Burden of Disease Study has shown that on average 31% of years of life lost are due
to CVD in 'Established Market Economies' (mostly Northern, Southern and Western countries
in Europe and all the member states of the EU). This is more than any other cause. On average
16% of years of life lost are due to CHD in Established Market Economies, so by itself CHD is
the most important cause of years of life lost in these countries3. (See also Table 1.6.)
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In 'Formerly Socialist Economies of Europe' (Central and Eastern European countries) 35% of
years of life lost are due to CVD - again more than from any other cause - and 18% are lost due
to CHD3.
In the EU alone nearly 7 million years of life lost are due to CVD of which nearly 4 million are
lost due to CHD and 1.5 million to stroke. In Europe as a whole over 23 million years of life lost
are due to CVD of which over 11 million are lost due to CHD and nearly 6 million to stroke
(Table 1.6).
1 When we state, in this section, that CVD is the main cause of death we are comparing "Diseases of the circulatorysystem" (Chapter VII 9th Revision/Chapter IX 10th Revision) of the International Classification of Diseases, withother chapters (e.g. Chapter II "Neoplasms"). When we state that CHD is the most common cause of death we arecomparing CHD (Chapter VII, ICD code 410-414, 9th Revision/Chapter IX, I20-I25, 10th Revision) with alldiseases within all chapters (e.g. with lung cancer, Chapter II, 162, 9th Revision/Chapter II, C33-C34, 10th Revision).
2 This figure and similar figures in the text are calculated from the tables rather than the graphs. Figures in the textmay not seem to correspond exactly to figures in graphs because of rounding.
3 Murray JL, Lopez AD (1996) The global burden of disease. WHO: Geneva.
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Tabl
e 1.
1To
tal n
umbe
r of
dea
ths
by c
ause
and
sex
, lat
est a
vaila
ble
year
All
caus
esC
oron
ary
Stro
keO
ther
CV
DSt
omac
hC
olo-
rect
alLu
ngBr
east
Oth
erR
espi
rato
ryIn
juri
es a
ndA
ll ot
her
hear
t dis
ease
canc
erca
ncer
canc
erca
ncer
canc
erdi
seas
epo
ison
ing
caus
esM
EN
Alb
ania
(93)
9629
796
948
1543
142
3431
40
781
1478
1002
2591
Arm
enia
(92)
1387
444
5714
6338
830
813
667
40
929
1057
2029
2433
Aus
tria
(97)
3702
183
4236
4359
8372
613
2023
350
5441
1815
3001
4415
Aze
rbai
jan
(96)
2601
985
4223
7312
4565
816
659
20
1382
3076
2141
5844
Bela
rus
(93)
6482
518
777
6957
3107
2056
902
3446
048
5943
5510
653
9713
Belg
ium
(92)
5276
662
9339
3675
0072
714
7056
690
7936
5524
4041
9670
Bulg
aria
(96)
6378
512
413
1085
415
311
1141
1256
2655
044
4533
8841
0782
15C
roat
ia (9
6)25
897
4477
3735
768
606
702
1973
1329
6111
0122
7672
85C
zech
Rep
ublic
(97)
5669
213
414
6228
9415
954
2416
4493
2375
9622
8450
5748
12D
enm
ark
(96)
3038
859
0022
9428
5130
910
1820
9410
4360
2697
1999
6856
Esto
nia
(96)
9634
2877
1208
489
227
176
554
081
342
217
8110
87Fi
nlan
d (9
6)24
266
6735
1959
1621
358
464
1482
430
6421
8028
9035
09Fr
ance
(95)
2751
0625
935
1816
034
866
3534
8365
2032
50
5615
420
992
2713
759
638
Geo
rgia
(90)
2297
782
9444
3050
542
421
583
00
1466
1260
2333
3220
Ger
man
y (9
7)39
8317
8457
533
530
5332
673
5613
667
2845
70
6056
526
953
2341
566
473
Gre
ece
(96)
5325
381
6275
9191
6977
180
445
330
7593
3120
3324
8186
Hun
gary
(97)
7327
815
681
8465
9251
1344
2554
5816
3892
3434
5666
0910
830
Icel
and
(95)
983
269
106
7718
2249
014
697
9910
0Ir
elan
d (9
5)17
075
4635
1213
1586
259
550
1035
022
7025
1899
420
15Is
rael
(96)
1767
832
2117
0514
5526
960
879
30
2646
1164
1304
4513
Ital
y (9
3)28
5059
4094
031
009
3915
976
7780
1926
029
048
339
1977
117
653
4646
3K
azak
hsta
n (9
6)92
317
2078
792
7766
2918
8669
635
810
5746
8923
1793
816
854
Kyr
gyzs
tan
(96)
1867
335
1924
3869
638
682
331
075
928
6929
7546
18La
tvia
(96)
1750
949
3724
9311
1739
027
193
51
1410
626
2936
2393
Lith
uani
a (9
6)22
848
7149
1887
1344
547
416
1259
020
5311
0745
0625
80Lu
xem
bour
g (9
7)18
2527
114
826
425
5716
30
257
147
153
340
Mac
edon
ia, F
mr
Yug
Rep
(97)
9076
1209
1598
1923
246
132
471
080
947
248
717
29M
alta
(97)
1532
403
135
144
3244
103
020
817
073
220
Mol
dova
, Rep
of (
96)
2561
373
8231
3976
542
630
687
013
1644
1995
3500
5573
Mon
aco
(87)
252
2326
694
625
040
98
42N
ethe
rlan
ds (9
6)69
008
1159
448
0188
1011
7520
4267
7025
1074
271
8331
2112
745
Nor
way
(95)
2302
455
8220
7023
6435
879
911
020
3441
2360
1414
3534
Pola
nd (9
6)20
3483
2495
413
116
5496
940
3837
6115
478
022
411
8638
2019
835
920
Port
ugal
(96)
5644
451
8110
318
4983
1602
1450
2206
069
1149
2942
9214
572
Rom
ania
(96)
1548
6230
983
2678
028
877
2594
1782
6451
011
671
1171
313
438
2057
3R
ussi
an F
eder
atio
n (9
6)10
8362
125
2146
1482
4074
852
2714
813
743
5212
80
7103
167
435
2395
4713
7351
Slov
akia
(95)
2812
874
6923
3940
7254
375
219
3911
3354
1889
2620
3140
Slov
enia
(96)
9498
1197
986
1196
218
315
745
012
8379
012
2615
42Sp
ain
(95)
1844
8821
541
1664
721
638
3915
5508
1493
10
3117
620
614
1188
336
635
Swed
en (9
5)47
428
1352
142
3056
2658
512
4618
160
7359
3730
2772
6543
Switz
erla
nd (9
4)31
228
5380
2159
4496
465
974
2128
1056
5324
2429
7545
64Ta
jikis
tan
(92)
1979
026
0414
6112
0035
566
227
070
337
5127
1667
07Tu
rkm
enis
tan
(94)
1709
337
9711
7615
8619
168
188
078
233
7317
0042
32U
krai
ne (9
6)38
8707
1196
8147
291
2177
782
1654
2616
747
026
259
2936
563
112
5083
3U
K -
Engl
and
and
Wal
es (9
7)26
4865
6692
721
649
2089
440
4678
2619
087
040
295
4153
010
348
3226
3U
K -
Nor
ther
n Ir
elan
d (9
7)72
4420
6463
546
710
319
149
90
1083
1121
404
677
UK
- Sc
otla
nd (9
7)28
305
7355
2609
2055
392
904
2448
038
6635
2814
6436
84U
zbek
ista
n (9
3)75
150
1873
172
1140
5710
4128
198
10
3458
1350
978
3018
051
Yug
osla
via,
Fm
r (9
0)11
2832
1196
313
969
2684
223
7318
7168
980
1089
356
4399
8422
396
Tota
l EU
1832
858
3199
7116
4372
2207
9833
560
5490
113
9879
3929
7411
1683
5211
8891
3146
84To
tal E
urop
e45
5336
594
3085
5006
3550
3327
9316
495
879
2746
5514
850
8277
3585
5155
7465
7181
79
Europeancardiovascular
disease statistics
15
Tabl
e 1.
1 co
ntin
ued
All
caus
esC
oron
ary
Stro
keO
ther
CV
DSt
omac
hC
olo-
rect
alLu
ngBr
east
Oth
erR
espi
rato
ryIn
juri
es a
ndA
ll ot
her
hear
t dis
ease
canc
erca
ncer
canc
erca
ncer
canc
erdi
seas
epo
ison
ing
caus
esW
OM
EN
Alb
ania
(93)
7010
361
963
1312
8627
7066
437
1198
318
2172
Arm
enia
(92)
1195
145
0120
3744
519
714
113
330
882
863
352
522
03A
ustr
ia (9
7)42
411
8742
6402
9879
697
1266
929
1651
4922
1740
1427
4756
Aze
rbai
jan
(96)
2222
380
1630
2915
6031
113
812
727
410
6126
6671
543
26Be
laru
s (9
3)63
719
2085
810
766
3178
1429
1003
475
1112
3691
2748
2861
1559
8Be
lgiu
m (9
2)51
434
4807
5968
9995
608
1636
927
2343
6173
3334
2392
1325
1Bu
lgar
ia (9
6)53
271
9974
1112
715
496
727
1044
545
1190
3258
2133
1248
6529
Cro
atia
(96)
2473
946
5150
8744
1940
855
341
770
622
2782
810
1944
24C
zech
Rep
ublic
(97)
5605
212
712
8993
1257
277
419
3610
6819
4366
3320
2927
9745
95D
enm
ark
(96)
3065
551
2231
7032
0319
110
4312
9313
6535
3329
9213
7273
71Es
toni
a (9
6)93
8535
7019
6541
218
420
112
025
776
516
354
212
06Fi
nlan
d (9
6)24
895
6234
3337
2157
308
500
397
774
2710
2034
1237
5207
Fran
ce (9
5)25
6512
2112
025
393
4617
823
5278
0336
0410
789
3371
519
138
1770
168
719
Geo
rgia
(90)
2296
896
2463
7548
728
922
617
858
113
1710
8870
420
99G
erm
any
(97)
4620
7294
047
6009
790
225
6859
1610
087
8318
374
5556
123
469
1338
675
171
Gre
ece
(96)
4748
749
2710
515
1123
454
278
177
515
8049
7526
2811
5883
72H
unga
ry (9
7)66
156
1521
710
419
1227
610
3022
2919
4723
2369
4323
9437
0076
78Ic
elan
d (9
5)94
017
211
387
1126
4164
9815
852
118
Irel
and
(95)
1518
432
9116
7918
6315
142
453
965
416
7123
8442
421
04Is
rael
(96)
1698
027
0320
3617
1722
361
932
288
823
3711
5266
343
20It
aly
(93)
2673
0632
897
4331
754
370
5557
7352
4876
1144
734
994
1230
710
748
4944
1K
azak
hsta
n (9
6)73
711
2145
113
607
7262
1277
827
789
1231
5288
5505
5230
1124
4K
yrgy
zsta
n (9
6)15
889
3513
3021
607
200
9982
179
749
2217
863
4359
Latv
ia (9
6)16
811
5134
4324
1054
262
376
179
402
1267
292
951
2570
Lith
uani
a (9
6)20
048
8369
3120
1618
366
406
188
571
1772
586
1342
1710
Luxe
mbo
urg
(97)
1941
229
256
397
2676
5178
241
122
7239
3M
aced
onia
, Fm
r Y
ug R
ep (9
7)75
2067
916
2822
0512
611
282
222
594
316
161
1395
Mal
ta (9
7)13
5633
015
815
815
3413
7016
396
3428
5M
oldo
va, R
ep o
f (96
)24
446
9106
3808
757
220
294
175
491
1308
1057
1191
6039
Mon
aco
(87)
251
651
732
119
825
125
49N
ethe
rlan
ds (9
6)68
553
8967
7430
9705
751
2134
1801
3552
8228
5871
2196
1791
8N
orw
ay (9
5)22
158
4065
2917
2869
260
827
507
789
2569
2570
860
3925
Pola
nd (9
6)18
2013
1396
317
089
7023
522
9438
3234
1147
3819
895
5648
7024
3388
4Po
rtug
al (9
6)50
815
4174
1334
466
8710
9711
6641
515
4744
3936
4115
0312
802
Rom
ania
(96)
1312
9627
682
3079
532
564
1320
1594
1337
2682
9061
7776
4353
1213
2R
ussi
an F
eder
atio
n (9
6)99
8628
2743
9126
5704
9838
120
376
1797
190
5119
597
6308
231
992
6767
713
0406
Slov
akia
(95)
2455
869
9630
2950
1531
758
128
868
424
7817
5310
2823
89Sl
oven
ia (9
6)91
2211
7913
9319
5216
728
216
335
510
8956
858
613
88Sp
ain
(95)
1617
3916
147
2332
632
411
2642
4617
1579
6026
1909
912
710
4442
3874
0Sw
eden
(95)
4621
310
474
5718
6820
388
1268
1079
1561
6067
3591
1549
7698
Switz
erla
nd (9
4)30
759
4890
3321
6433
327
887
619
1595
4034
2064
1870
4719
Tajik
ista
n (9
2)16
928
2547
1829
1464
219
6873
126
620
3439
731
5812
Turk
men
ista
n (9
4)14
974
3632
1610
1837
137
5447
123
709
2705
731
3389
Ukr
aine
(96)
3880
1015
3204
7527
029
601
5148
5622
3034
7558
2114
314
626
1724
055
564
UK
- En
glan
d an
d W
ales
(97)
2904
1655
509
3610
127
400
2567
7393
1088
911
980
3354
051
012
5972
4805
3U
K -
Nor
ther
n Ir
elan
d (9
7)77
2717
0010
1162
868
221
273
265
964
1543
189
865
UK
- Sc
otla
nd (9
7)31
189
6658
4350
2884
318
795
1658
1154
3519
4363
909
4581
Uzb
ekis
tan
(93)
7014
421
630
9518
4751
682
251
366
609
3053
1145
930
2314
802
Yug
osla
via,
Fm
r (9
0)99
316
7249
1676
833
890
1431
1748
1304
2642
8776
3966
3921
1762
1
Tota
l EU
1856
549
2850
4525
1414
3160
3625
122
5457
539
868
7514
022
4351
1528
7966
677
3654
42To
tal E
urop
e43
5988
194
7420
7732
8467
2723
6593
798
594
6702
812
9524
4016
2126
8716
2006
4273
4392
ICD
cod
es (9
th R
evis
ion,
10t
h R
evis
ion)
: CH
D (4
10-4
14, I
20-I
25);
stro
ke (4
30-4
38, I
60-I
69);
othe
r C
VD
(390
-459
, I00
-I99
min
us C
HD
and
str
oke)
; sto
mac
h ca
ncer
(151
, C16
); co
lo-r
ecta
l can
cer
(153
-154
, C18
-C21
); lu
ng c
ance
r (1
62, C
33-
C34
); br
east
can
cer
(174
, C50
); ot
her
canc
er (1
40-2
39, C
00-C
97 m
inus
sto
mac
h, c
olo-
rect
al, l
ung
and
brea
st c
ance
r); r
espi
rato
ry d
isea
se (4
60-5
19, J
00-J
99) a
nd in
juri
es a
nd p
oiso
ning
(800
-999
, V01
-Y98
).
NB
:No
natio
nal m
orta
lity
data
is a
vaila
ble
for
And
orra
, Bos
nia
and
Her
zego
vina
, San
Mar
ino
and
Turk
ey.
Sour
ce:
Wor
ld H
ealth
Org
aniz
atio
n (1
999)
htt
p://w
ww
.who
.ch/
Europeancardiovascular
disease statistics
16
Figure 1.1a Deaths by cause, men, latest availableyear, Europe
Injuries and poisoning12%
Respiratory disease8%
Other cancer11%
Lung cancer6%
Colo-rectal cancer 2%
Stomach cancer 2%
Other CVD11%
Stroke11%
CHD21%
Other causes16%
Figure 1.1b Deaths by cause, women, latest availableyear, Europe
Other cancer9%
Respiratory disease6%
Injuries and poisoning5%
Other causes17%
CHD21%Stroke
18%
Other CVD15%
Stomach cancer 2%Colo-rectal cancer 2%
Lung cancer 2%Breast cancer 3%
Europeancardiovascular
disease statistics
17
Figure 1.1c Deaths by cause, men, latest availableyear, EU
Figure 1.1d Deaths by cause, women, latest availableyear, EU
Respiratory disease9%
Injuries and poisoning6%
Other causes17%
CHD18%
Stroke9%
Other CVD12%
Stomach cancer 2%
Colo-rectal cancer 3%
Lung cancer8%
Other cancer16%
Other causes20%
Injuries and poisoning4%
Respiratory disease8%Other cancer
12%
Breast cancer 4%
Lung cancer 2%
Colo-rectal cancer 3%Stomach cancer 1%
Other CVD17%
Stroke14%
CHD15%
Europeancardiovascular
disease statistics
18
Tabl
e 1.
2D
eath
s un
der
75 b
y ca
use
and
sex,
late
st a
vaila
ble
year
All
caus
esC
oron
ary
Stro
keO
ther
CV
DSt
omac
hC
olo-
rect
alLu
ngBr
east
Oth
erR
espi
rato
ryIn
juri
es a
ndA
ll ot
her
hear
t dis
ease
canc
erca
ncer
canc
erca
ncer
canc
erdi
seas
epo
ison
ing
caus
esM
EN
Alb
ania
(93)
6925
564
540
806
120
2727
40
653
1133
976
1832
Arm
enia
(92)
1038
927
3784
827
327
311
662
70
830
771
1967
1947
Aus
tria
(97)
1992
141
5612
6622
7739
776
917
220
3253
716
2518
2847
Aze
rbai
jan
(96)
2322
570
9319
9110
4562
415
557
80
1323
2834
2120
5462
Bela
rus
(93)
4901
813
017
4945
2453
1788
709
3156
042
7030
6910
370
5241
Belg
ium
(92)
2811
335
4913
9030
1539
078
939
020
4557
2340
3336
4845
Bulg
aria
(96)
4099
174
3463
4281
0889
191
123
840
3554
2151
3681
5535
Cro
atia
(96)
1780
227
3021
6736
543
751
917
1911
2267
586
2019
4982
Cze
ch R
epub
lic (9
7)36
545
8115
2815
4763
645
1652
3733
1854
9912
9143
4136
73D
enm
ark
(96)
1516
124
9781
711
0817
953
413
794
2412
926
1451
3854
Esto
nia
(96)
7201
1816
738
418
171
118
486
065
434
516
7178
4Fi
nlan
d (9
6)14
203
3724
924
900
219
296
1003
317
9577
125
5920
09Fr
ance
(95)
1472
5312
617
6253
1242
819
6445
2515
178
034
794
6730
2062
432
140
Geo
rgia
(90)
1632
548
5725
6437
635
517
772
00
1253
958
2232
2833
Ger
man
y (9
7)22
5874
4293
512
358
2301
343
8883
3721
480
037
982
1133
419
571
4447
6G
reec
e (9
6)26
240
4781
2407
2810
473
426
3250
044
2911
0029
5736
07H
unga
ry (9
7)50
200
9681
4905
4777
927
1705
4876
3067
5119
6354
8091
05Ic
elan
d (9
5)47
810
829
3313
1139
083
1991
52Ir
elan
d (9
5)87
8325
0445
961
815
833
567
10
1275
813
884
1066
Isra
el (9
6)87
1613
5061
164
314
025
554
20
1386
391
1018
2380
Ital
y (9
3)14
8855
2162
994
8813
277
4384
4707
1928
70
2969
964
6713
484
2643
3K
azak
hsta
n (9
6)79
504
1566
568
8554
2216
8059
833
230
5131
7586
1751
015
704
Kyr
gyzs
tan
(96)
1574
226
2218
5662
935
772
306
069
724
7129
0938
23La
tvia
(96)
1322
133
2114
6986
633
318
582
51
1158
476
2836
1751
Lith
uani
a (9
6)16
725
3902
1063
900
443
283
1100
016
4171
643
6523
12Lu
xem
bour
g (9
7)10
2814
755
112
1332
123
016
054
130
202
Mac
edon
ia, F
mr
Yug
Rep
(97)
5933
939
901
818
197
105
421
063
726
643
812
11M
alta
(97)
752
192
4861
1926
660
121
5556
108
Mol
dova
, Rep
of (
96)
1958
745
3523
1761
138
825
881
412
1497
1646
3384
4125
Mon
aco
(87)
9515
713
03
160
192
713
Net
herl
ands
(96)
3511
561
8818
2538
3769
711
9242
8415
6158
2118
2444
6357
Nor
way
(95)
1014
325
5956
874
716
039
674
70
1612
572
1020
1762
Pola
nd (9
6)14
3056
2018
385
0527
326
3077
2773
1341
80
1762
153
0018
766
2608
7Po
rtug
al (9
6)31
022
2923
3722
1852
1043
853
1717
042
6819
9436
8889
62R
oman
ia (9
6)10
9691
1998
516
204
1451
221
5314
1760
010
9732
8391
1279
718
499
Rus
sian
Fed
erat
ion
(96)
9667
5921
5916
1182
8762
681
2562
512
454
5039
40
6704
760
961
2326
9512
0699
Slov
akia
(95)
1925
846
1913
4321
7138
253
616
677
2602
1025
2360
2546
Slov
enia
(96)
6350
758
525
549
135
216
633
093
534
810
7911
72Sp
ain
(95)
9944
811
717
5791
8201
2450
3126
1082
00
1932
874
3110
330
2025
4Sw
eden
(95)
1921
751
9011
7215
2727
662
411
360
3529
766
2090
2907
Switz
erla
nd (9
4)15
163
2309
531
1494
249
506
1509
528
6676
422
8126
49Ta
jikis
tan
(92)
1662
415
9387
772
430
254
209
060
632
6726
8263
10Tu
rkm
enis
tan
(94)
1486
726
4089
412
8616
561
178
072
332
1116
6340
46U
krai
ne (9
6)30
4121
8251
132
833
1533
973
5945
0715
402
023
586
2256
360
450
3957
1U
K -
Engl
and
and
Wal
es (9
7)12
5592
3286
272
3685
5521
2144
0411
349
022
310
1219
285
3916
024
UK
- N
orth
ern
Irel
and
(97)
3781
1107
233
197
6210
232
20
640
344
362
412
UK
- Sc
otla
nd (9
7)15
477
4135
964
939
223
545
1578
022
9412
9612
4322
60U
zbek
ista
n (9
3)64
301
1227
452
7035
0096
926
393
90
3240
1279
477
4117
311
Yug
osla
via,
Fm
r (9
0)72
353
9109
7340
1022
218
0413
3959
520
8379
3036
8837
1633
5
Tota
l EU
9650
8316
2661
5636
084
666
1943
731
596
9920
122
1788
8357
392
9621
017
8655
Tota
l Eur
ope
3127
143
6278
1029
2578
2585
9771
618
6400
322
2255
106
3572
5620
8353
5160
5250
8515
Europeancardiovascular
disease statistics
19
Tabl
e 1.
2 co
ntin
ued
All
caus
esC
oron
ary
Stro
keO
ther
CV
DSt
omac
hC
olo-
rect
alLu
ngBr
east
Oth
erR
espi
rato
ryIn
juri
es a
ndA
ll ot
her
hear
t dis
ease
canc
erca
ncer
canc
erca
ncer
canc
erdi
seas
epo
ison
ing
caus
esW
OM
EN
Alb
ania
(93)
4033
180
398
478
6321
5058
341
890
299
1255
Arm
enia
(92)
6487
1581
937
241
168
116
114
279
707
409
467
1468
Aus
tria
(97)
1164
317
8197
314
5226
949
155
595
923
6933
578
216
77A
zerb
aija
n (9
6)13
999
3843
1677
902
221
112
102
246
923
2044
672
3257
Bela
rus
(93)
2842
679
3854
0516
5310
2367
634
696
730
1411
9625
1036
98Be
lgiu
m (9
2)15
746
1343
1110
1744
217
654
608
1525
3146
765
1330
3304
Bulg
aria
(96)
2419
237
4848
4154
5945
973
641
194
125
4799
299
630
62C
roat
ia (9
6)10
710
1407
1984
1321
246
329
309
543
1516
294
646
2115
Cze
ch R
epub
lic (9
7)21
642
4142
2241
3222
383
1046
778
1318
4081
692
1280
2459
Den
mar
k (9
6)10
288
1060
574
604
8043
694
487
419
1397
160
822
24Es
toni
a (9
6)40
9310
2568
927
112
911
592
208
592
8942
046
3Fi
nlan
d (9
6)71
4812
8067
442
115
921
922
452
913
4230
173
112
68Fr
ance
(95)
6951
237
7338
1460
5874
828
3822
5568
4716
004
2692
7817
1666
6G
eorg
ia (9
0)10
973
3221
2484
283
215
161
144
501
1081
678
613
1592
Ger
man
y (9
7)13
2068
1861
794
5414
401
2659
6228
5533
1141
426
591
5238
6736
2519
7G
reec
e (9
6)14
365
1611
1874
1939
285
351
499
1128
2843
587
890
2358
Hun
gary
(97)
2894
452
0235
5634
8853
511
7714
2416
1744
0195
217
7548
17Ic
elan
d (9
5)30
132
1216
79
2646
4921
4241
Irel
and
(95)
5329
975
364
396
6920
533
045
194
553
327
578
6Is
rael
(96)
6589
735
540
482
126
271
193
596
1269
287
391
1699
Ital
y (9
3)82
577
7646
7325
8844
2170
3364
3013
7785
1852
924
2041
6417
317
Kaz
akhs
tan
(96)
4435
290
7266
5240
4399
365
164
310
6142
1937
2448
8284
12K
yrgy
zsta
n (9
6)99
9716
5617
2448
016
183
6715
964
216
3080
125
94La
tvia
(96)
7527
1683
1524
475
170
223
134
340
927
163
754
1134
Lith
uani
a (9
6)89
7420
6411
0064
424
527
512
448
213
3126
111
6912
79Lu
xem
bour
g (9
7)63
150
4685
1024
4244
143
3144
112
Mac
edon
ia, F
mr
Yug
Rep
(97)
4137
447
819
792
9383
7219
449
016
911
985
9M
alta
(97)
515
107
4036
620
1043
110
2315
105
Mol
dova
, Rep
of (
96)
1450
242
7623
8053
119
223
515
244
611
5772
710
8133
25M
onac
o (8
7)54
05
131
22
39
33
13N
ethe
rlan
ds (9
6)21
239
2509
1365
1889
294
960
1293
2216
4164
1077
1044
4428
Nor
way
(95)
5851
891
450
388
104
346
347
457
1193
393
348
934
Pola
nd (9
6)78
402
7840
7353
1824
914
2523
5126
6436
6414
171
2200
4315
1417
0Po
rtug
al (9
6)16
677
1310
2682
1345
532
598
260
1119
2568
839
1004
4420
Rom
ania
(96)
6479
211
180
1329
597
7796
011
7011
0222
2773
1440
0738
1099
50R
ussi
an F
eder
atio
n (9
6)49
8174
1115
7510
5591
4011
914
731
1276
867
5416
471
4905
518
036
5926
963
805
Slov
akia
(95)
1109
125
9011
1016
1218
434
119
552
717
3062
761
215
63Sl
oven
ia (9
6)36
1535
339
841
790
160
115
257
686
113
347
679
Spai
n (9
5)46
710
3956
3739
4856
1111
2117
922
4119
9950
2189
2928
1082
3Sw
eden
(95)
1157
617
7579
681
615
950
370
690
827
6459
876
217
89Sw
itzer
land
(94)
8455
798
406
827
128
363
425
916
1826
337
834
1595
Tajik
ista
n (9
2)12
583
1129
855
858
161
5259
113
517
2902
692
5245
Turk
men
ista
n (9
4)10
970
1757
846
1264
114
4642
110
599
2473
701
3018
Ukr
aine
(96)
1823
2060
899
3371
610
402
4105
4235
2339
6552
1753
869
6114
930
2064
3U
K -
Engl
and
and
Wal
es (9
7)83
975
1356
762
0358
5599
330
1362
3571
1416
698
8991
3047
1225
9U
K -
Nor
ther
n Ir
elan
d (9
7)25
1248
319
316
323
102
167
169
506
263
111
332
UK
- Sc
otla
nd (9
7)10
604
2006
855
715
135
323
994
731
1773
1031
443
1598
Uzb
ekis
tan
(93)
4628
382
2543
1533
2653
620
429
153
726
1210
109
2915
1321
3Y
ugos
lavi
a, F
mr
(90)
4569
840
0767
8788
2794
711
0499
420
9463
0817
9927
2910
102
Tota
l EU
5426
0063
742
4204
151
583
9913
2242
624
580
4793
211
2248
2886
132
716
1065
58To
tal E
urop
e17
6128
132
7345
2561
7117
2479
3883
451
907
4510
091
905
2452
0394
062
1431
5329
5122
ICD
cod
es (9
th R
evis
ion,
10t
h R
evis
ion)
: CH
D (4
10-4
14, I
20-I
25);
stro
ke (4
30-4
38, I
60-I
69);
othe
r C
VD
(390
-459
, I00
-I99
min
us C
HD
and
str
oke)
; sto
mac
h ca
ncer
(151
, C16
); co
lo-r
ecta
l can
cer
(153
-154
, C18
-C21
); lu
ng c
ance
r (1
62, C
33-
C34
); br
east
can
cer
(174
, C50
); ot
her
canc
er (1
40-2
39, C
00-C
97 m
inus
sto
mac
h, c
olo-
rect
al, l
ung
and
brea
st c
ance
r); r
espi
rato
ry d
isea
se (4
60-5
19, J
00-J
99) a
nd in
juri
es a
nd p
oiso
ning
(800
-999
, V01
-Y98
).
NB
:No
natio
nal m
orta
lity
data
is a
vaila
ble
for
And
orra
, Bos
nia
and
Her
zego
vina
, San
Mar
ino
and
Turk
ey.
Sour
ce:
Wor
ld H
ealth
Org
aniz
atio
n (1
999)
htt
p://w
ww
.who
.ch/
Europeancardiovascular
disease statistics
20
Figure 1.2a Deaths under 75 by cause, men, latestavailable year, Europe
Figure 1.2b Deaths under 75 by cause, women, latestavailable year, Europe
Other causes16%
Injuries and poisoning17%
Respiratory disease7%
Other cancer11%
Lung cancer 7%
Colo-rectal cancer 2%
Stomach cancer 2%
Other CVD8%
Stroke9%
CHD20%
Other causes17%
Injuries and poisoning8%
Respiratory disease5%Other cancer
14%
Breast cancer 5%
Lung cancer 3%
Colo-rectal cancer 3%
Stomach cancer 2%
Other CVD10%
Stroke15%
CHD18%
Europeancardiovascular
disease statistics
21
Figure 1.2c Deaths under 75 by cause, men, latestavailable year, EU
Figure 1.2d Deaths under 75 by cause, women, latestavailable year, EU
Other causes19%
Injuries and poisoning10%
Respiratory disease6%Other cancer
19%
Lung cancer 10%
Colo-rectal cancer 3%
Stomach cancer 2%
Other CVD9%
Stroke6%
CHD17%
Other causes20%
Injuries and poisoning6%
Respiratory disease5%
Other cancer21%
Breast cancer 9%
Lung cancer 5%
Colo-rectal cancer 4%
Stomach cancer 2%
Other CVD10%
Stroke8%
CHD12%
Europeancardiovascular
disease statistics
22
Tabl
e 1.
3D
eath
s un
der
65 b
y ca
use
and
sex,
late
st a
vaila
ble
year
All
caus
esC
oron
ary
Stro
keO
ther
CV
DSt
omac
hC
olo-
rect
alLu
ngBr
east
Oth
erR
espi
rato
ryIn
juri
es a
ndA
ll ot
her
hear
t dis
ease
canc
erca
ncer
canc
erca
ncer
canc
erdi
seas
epo
ison
ing
caus
esM
EN
Alb
ania
(93)
5083
325
250
412
8019
178
043
496
193
714
87A
rmen
ia (9
2)76
9917
0745
818
417
776
432
061
956
218
7116
13A
ustr
ia (9
7)10
504
1787
463
920
163
341
803
016
6027
621
8419
07A
zerb
aija
n (9
6)16
046
3848
1046
642
355
105
392
093
022
6020
1844
50Be
laru
s (9
3)34
760
7766
2882
1822
1139
407
2125
029
2118
3797
6141
00Be
lgiu
m (9
2)14
516
1606
516
1180
164
355
1807
023
1975
928
7629
34Bu
lgar
ia (9
6)21
785
3503
2474
3593
424
425
1493
020
3311
2231
5535
63C
roat
ia (9
6)10
202
1334
917
167
218
250
987
713
1425
516
9330
60C
zech
Rep
ublic
(97)
1964
135
8510
1720
6629
975
119
866
2933
629
3751
2618
Den
mar
k (9
6)77
4395
932
142
392
226
586
311
6627
912
4924
39Es
toni
a (9
6)47
6190
134
030
092
6325
30
407
231
1557
617
Finl
and
(96)
7806
1575
398
469
113
137
402
386
426
122
2013
64Fr
ance
(95)
8201
552
7124
4550
3882
617
7578
700
1779
024
7817
121
2140
1G
eorg
ia (9
0)12
062
3161
1488
298
247
128
511
092
980
621
0623
88G
erm
any
(97)
1235
3618
768
4778
1086
120
9939
6910
823
020
633
4090
1716
530
350
Gre
ece
(96)
1320
524
4685
810
1022
516
715
250
2052
441
2572
1909
Hun
gary
(97)
3000
549
1221
8522
7742
874
529
1516
4044
994
4571
6918
Icel
and
(95)
242
448
105
315
033
484
36Ir
elan
d (9
5)41
7110
0115
424
877
149
278
059
922
779
963
9Is
rael
(96)
4768
521
203
335
5911
626
10
728
157
839
1549
Ital
y (9
3)75
517
9532
3330
5323
1941
2091
8943
014
510
1987
1130
316
557
Kaz
akhs
tan
(96)
6076
097
6438
6239
5910
5634
621
790
3431
5553
1662
013
990
Kyr
gyzs
tan
(96)
1183
015
5410
5152
622
542
192
046
918
9027
3631
45La
tvia
(96)
8999
1897
708
637
194
9048
11
719
326
2600
1346
Lith
uani
a (9
6)11
440
2059
495
601
258
129
626
097
139
440
1418
93Lu
xem
bour
g (9
7)53
366
1845
317
530
7714
115
125
Mac
edon
ia, F
mr
Yug
Rep
(97)
3322
514
334
312
9854
276
037
512
238
485
3M
alta
(97)
351
7712
256
1422
060
2053
62M
oldo
va, R
ep o
f (96
)12
978
1875
1139
447
241
135
527
910
3111
3030
9333
51M
onac
o (8
7)43
62
60
19
010
04
5N
ethe
rlan
ds (9
6)17
141
2685
661
1552
328
551
1784
729
8952
421
6238
98N
orw
ay (9
5)46
0194
416
125
156
150
282
068
514
486
010
68Po
land
(96)
8660
311
864
4161
1143
415
8212
9473
650
1007
123
0517
021
1950
6Po
rtug
al (9
6)16
922
1350
1201
709
513
388
877
022
0077
031
4957
65R
oman
ia (9
6)67
377
1067
871
2764
4511
7170
439
800
5998
5570
1132
014
384
Rus
sian
Fed
erat
ion
(96)
6390
4211
5746
4835
138
550
1398
256
1427
925
039
601
3547
221
5880
9792
1Sl
ovak
ia (9
5)11
083
2146
548
957
178
245
928
515
9654
220
6918
69Sl
oven
ia (9
6)37
2834
822
224
366
104
334
053
912
092
283
0Sp
ain
(95)
5326
651
7821
4536
8411
5513
8053
070
9889
2505
8896
1312
7Sw
eden
(95)
8657
1806
340
567
106
234
459
014
5222
617
6417
03Sw
itzer
land
(94)
8233
935
177
643
115
214
725
313
5223
419
8518
50Ta
jikis
tan
(92)
1448
096
350
548
620
143
155
047
030
0826
2360
26Tu
rkm
enis
tan
(94)
1230
016
2553
688
110
838
136
052
730
6316
2337
63U
krai
ne (9
6)20
1030
4075
516
123
1044
044
3722
6494
080
1567
012
921
5550
833
504
UK
- En
glan
d an
d W
ales
(97)
5756
813
223
2427
3231
760
1811
4280
010
108
3861
7662
1020
5U
K -
Nor
ther
n Ir
elan
d (9
7)18
4446
484
7030
4913
60
296
120
312
283
UK
- Sc
otla
nd (9
7)75
6818
1835
335
589
225
580
010
6843
211
1215
36U
zbek
ista
n (9
3)49
682
6121
2703
2462
576
178
630
023
1411
619
7497
1558
2Y
ugos
lavi
a, F
mr
(90)
4979
762
3238
7452
8311
1180
941
770
5797
1824
7881
1280
9
Tota
l EU
5025
1269
535
2049
235
685
8684
1386
546
513
1389
672
1925
082
661
1161
42To
tal E
urop
e19
2724
531
7245
1258
5113
2379
3786
829
421
1184
1860
1986
8311
5325
4696
9738
2298
Europeancardiovascular
disease statistics
23
Tabl
e 1.
3 co
ntin
ued
All
caus
esC
oron
ary
Stro
keO
ther
CV
DSt
omac
hC
olo-
rect
alLu
ngBr
east
Oth
erR
espi
rato
ryIn
juri
es a
ndA
ll ot
her
hear
t dis
ease
canc
erca
ncer
canc
erca
ncer
canc
erdi
seas
epo
ison
ing
caus
esW
OM
EN
Alb
ania
(93)
3010
7919
323
742
1028
5125
978
628
210
43A
rmen
ia (9
2)39
3859
043
314
210
473
7622
549
631
440
010
85A
ustr
ia (9
7)49
3243
628
040
511
117
127
757
010
8311
458
789
8A
zerb
aija
n (9
6)91
1016
8580
355
113
880
6820
268
017
4561
825
40Be
laru
s (9
3)14
104
2583
2062
931
494
328
172
690
1784
533
2174
2353
Belg
ium
(92)
7585
386
363
578
9028
631
997
415
5530
410
2217
08Bu
lgar
ia (9
6)98
5410
4613
3917
7319
834
421
562
214
2252
176
116
13C
roat
ia (9
6)45
3639
355
939
392
134
152
353
799
9844
711
16C
zech
Rep
ublic
(97)
8782
1008
548
907
168
400
411
735
2035
296
925
1349
Den
mar
k (9
6)48
7929
519
219
143
182
479
554
947
331
445
1220
Esto
nia
(96)
1878
265
211
151
7450
2613
130
540
357
268
Finl
and
(96)
3103
253
193
157
5288
9834
959
110
057
964
3Fr
ance
(95)
3464
294
111
7819
3528
211
2211
7442
1576
6596
758
3793
26G
eorg
ia (9
0)61
7212
9810
3519
213
294
9336
374
054
652
511
54G
erm
any
(97)
5909
847
9227
2245
5711
7425
4028
7471
4912
724
1815
5130
1362
1G
reec
e (9
6)60
6150
944
051
012
516
124
569
813
9420
466
311
12H
unga
ry (9
7)13
723
1637
1187
1182
232
490
826
1021
2349
460
1204
3135
Icel
and
(95)
161
67
61
614
2823
437
29Ir
elan
d (9
5)23
5325
612
913
130
9012
229
546
016
423
044
6Is
rael
(96)
3062
178
127
156
6813
176
372
611
112
284
947
Ital
y (9
3)37
124
2048
2199
2785
969
1560
1364
4884
8995
858
2928
8534
Kaz
akhs
tan
(96)
2660
934
0328
0323
5551
331
332
077
825
0625
9043
4166
87K
yrgy
zsta
n (9
6)64
3261
583
037
693
4240
105
443
1258
727
1903
Latv
ia (9
6)36
9456
250
427
165
8742
209
499
8561
575
5Li
thua
nia
(96)
4663
650
370
302
113
120
5831
874
713
095
989
6Lu
xem
bour
g (9
7)30
412
1327
610
2325
7514
3960
Mac
edon
ia, F
mr
Yug
Rep
(97)
2045
200
265
260
5347
5014
930
273
9355
3M
alta
(97)
221
2710
92
116
2955
913
50M
oldo
va, R
ep o
f (96
)76
8512
6798
232
711
212
982
326
767
459
905
2329
Mon
aco
(87)
190
06
00
11
32
24
Net
herl
ands
(96)
1016
076
148
159
912
642
369
414
3721
5632
883
323
22N
orw
ay (9
5)24
2120
710
583
4215
016
427
858
695
256
455
Pola
nd (9
6)36
027
2902
2568
4908
619
1046
1450
2409
7697
924
3313
8191
Port
ugal
(96)
7619
370
724
416
242
262
143
732
1304
307
774
2345
Rom
ania
(96)
3164
538
9745
1430
8945
559
160
114
9645
4424
9331
0768
58R
ussi
an F
eder
atio
n (9
6)24
4338
3561
232
670
1897
466
2957
0330
6511
138
2733
493
4450
128
4374
1Sl
ovak
ia (9
5)48
5669
931
253
985
154
105
324
945
286
458
949
Slov
enia
(96)
1646
106
9811
744
7961
157
351
3324
735
3Sp
ain
(95)
2158
510
2610
4616
0246
993
047
327
2648
8075
822
5554
20Sw
eden
(95)
5036
420
230
236
6420
536
755
612
4320
661
289
7Sw
itzer
land
(94)
4227
190
120
299
5715
724
558
685
911
966
493
1Ta
jikis
tan
(92)
1023
749
442
651
710
331
3987
376
2605
644
4915
Turk
men
ista
n (9
4)82
2872
238
875
566
2526
8341
623
3965
627
52U
krai
ne (9
6)83
042
1641
011
301
4822
2036
1922
1088
4492
1041
130
1212
458
1509
0U
K -
Engl
and
and
Wal
es (9
7)35
682
3598
1950
1853
365
1213
2307
4401
8124
2630
2409
6832
UK
- N
orth
ern
Irel
and
(97)
1103
128
5363
650
6211
426
377
9619
1U
K -
Scot
land
(97)
4619
579
274
237
6113
139
246
988
232
834
092
6U
zbek
ista
n (9
3)34
304
3232
2083
2293
321
142
164
433
1884
9301
2776
1167
5Y
ugos
lavi
a, F
mr
(90)
2574
420
4027
7534
0753
161
762
815
4339
8510
2521
7470
19
Tota
l EU
2458
8516
810
1246
716
282
4215
9424
1141
330
148
5434
195
0524
779
5650
1To
tal E
urop
e86
2298
1008
1384
095
6661
217
897
2293
021
805
5988
213
0554
5114
211
7329
1892
39
ICD
cod
es (9
th R
evis
ion,
10t
h R
evis
ion)
: CH
D (4
10-4
14, I
20-I
25);
stro
ke (4
30-4
38, I
60-I
69);
othe
r C
VD
(390
-459
, I00
-I99
min
us C
HD
and
str
oke)
; sto
mac
h ca
ncer
(151
, C16
); co
lo-r
ecta
l can
cer
(153
-154
, C18
-C21
); lu
ng c
ance
r (1
62, C
33-
C34
); br
east
can
cer
(174
, C50
); ot
her
canc
er (1
40-2
39, C
00-C
97 m
inus
sto
mac
h, c
olo-
rect
al, l
ung
and
brea
st c
ance
r); r
espi
rato
ry d
isea
se (4
60-5
19, J
00-J
99) a
nd in
juri
es a
nd p
oiso
ning
(800
-999
, V01
-Y98
).
NB
:No
natio
nal m
orta
lity
data
is a
vaila
ble
for
And
orra
, Bos
nia
and
Her
zego
vina
, San
Mar
ino
and
Turk
ey.
Sour
ce:
Wor
ld H
ealth
Org
aniz
atio
n (1
999)
htt
p://w
ww
.who
.ch/
Europeancardiovascular
disease statistics
24
Figure 1.3a Deaths under 65 by cause, men, latestavailable year, Europe
Figure 1.3b Deaths under 65 by cause, women, latestavailable year, Europe
Other causes20%
Injuries and poisoning24%
Respiratory disease6%
Other cancer10%
Lung cancer 6%
Colo-rectal cancer 2%
Stomach cancer 2%
Other CVD7%
Stroke7%
CHD16%
Other causes21%
Injuries and poisoning14%
Respiratory disease6%
Other cancer14%
Breast cancer 7%
Lung cancer 2%
Colo-rectal cancer 3%
Stomach cancer 2%
Other CVD8%
Stroke10%
CHD12%
Europeancardiovascular
disease statistics
25
Figure 1.3c Deaths under 65 by cause, men, latestavailable year, EU
Figure 1.3d Deaths under 65 by cause, women, latestavailable year, EU
Other causes23%
Injuries and poisoning10%
Respiratory disease4%
Other cancer22%
Breast cancer12%
Lung cancer 5%
Colo-rectal cancer 4%Stomach cancer 2%
Other CVD7%
Stroke5%
CHD7%
Other causes23%
Injuries and poisoning16%
Respiratory disease4%
Other cancer18%
Lung cancer 9%
Colo-rectal cancer 3%
Stomach cancer 2%
Other CVD7% Stroke
4%CHD14%
Europeancardiovascular
disease statistics
26
Tabl
e 1.
4A
ge-s
tand
ardi
zed
deat
h ra
tes
from
CH
D, f
or a
dults
age
d 35
-74,
by
sex,
196
8-19
97D
eath
s pe
r 10
0,00
019
6819
6919
7019
7119
7219
7319
7419
7519
7619
7719
7819
7919
8019
8119
8219
8319
8419
8519
8619
8719
8819
8919
9019
9119
9219
9319
9419
9519
9619
97
MEN
Alb
ania
128
126
146
140
124
Arm
enia
375
408
405
429
380
460
473
495
496
524
Aus
tria
327
334
336
335
332
341
345
359
347
349
346
311
324
329
333
315
308
290
283
262
262
253
255
249
241
241
236
226
223
Aze
rbai
jan
575
577
568
567
606
651
588
643
737
692
757
654
711
694
Bela
rus
526
534
587
517
545
503
513
530
560
664
Belg
ium
345
348
351
360
364
340
335
334
332
310
313
282
273
265
270
257
247
239
221
201
184
166
159
150
147
Bulg
aria
195
219
235
248
261
271
291
287
300
317
311
303
308
265
295
307
315
316
321
309
309
304
315
316
312
359
352
Cro
atia
216
222
218
202
205
203
235
253
277
269
257
299
Cze
ch R
epub
lic54
351
650
550
453
349
648
746
044
242
539
1C
zech
oslo
vaki
a40
844
945
945
644
245
646
045
845
846
946
445
547
146
346
950
251
351
751
448
548
248
752
649
8D
enm
ark
421
430
434
454
454
445
444
465
436
443
448
438
441
404
403
392
388
370
373
342
324
315
297
289
271
239
239
204
Esto
nia
655
616
696
653
632
603
599
648
615
659
707
744
670
600
Finl
and
718
697
727
680
695
700
680
700
693
664
639
616
603
599
574
562
576
531
507
477
471
434
417
407
377
346
340
Fran
ce15
214
914
915
616
015
816
416
716
015
315
415
014
814
514
514
414
314
214
012
711
811
010
610
510
199
9492
Geo
rgia
514
494
507
482
514
571
552
527
Ger
man
y25
325
725
124
823
723
121
820
6G
erm
any,
Dem
Rep
229
231
234
236
227
244
274
279
272
280
280
277
273
271
273
268
289
Ger
man
y, F
ed R
ep31
732
832
534
134
634
734
835
736
234
735
433
534
134
133
633
432
832
329
828
727
025
524
5G
reec
e12
813
913
514
015
516
116
116
918
818
819
217
918
117
718
518
418
118
918
019
119
019
318
718
118
117
416
817
517
6H
unga
ry33
534
935
936
035
936
136
237
239
242
038
041
845
846
346
246
446
145
944
443
843
243
545
245
848
045
245
944
142
6Ic
elan
d44
746
142
346
938
845
638
239
941
845
347
438
845
442
135
629
630
033
428
926
426
621
6Ir
elan
d45
551
049
547
852
253
754
854
152
652
754
253
252
152
651
552
750
351
650
548
346
244
042
141
238
139
736
836
7Is
rael
425
434
401
395
360
347
349
356
315
310
281
305
283
255
228
211
210
219
206
199
196
150
Ital
y23
024
022
522
822
423
723
524
324
924
624
923
622
121
521
121
720
319
619
118
317
216
615
916
115
315
0K
azak
stan
504
499
508
456
472
462
475
487
498
516
594
638
699
720
Kyr
gyzs
tan
430
437
416
384
395
391
402
394
385
389
451
517
491
500
Latv
ia69
558
862
059
358
765
363
771
984
990
479
264
7Li
thua
nia
511
508
572
522
541
521
540
585
592
629
673
663
610
549
Luxe
mbo
urg
228
175
199
195
184
167
189
150
Mac
edon
ia, F
mr
Yug
Rep
215
247
231
253
233
257
Mal
ta35
938
229
429
432
633
633
440
146
845
250
452
652
245
445
542
636
634
036
633
336
530
830
928
930
930
624
622
625
125
1M
oldo
va, R
ep o
f60
060
759
950
950
045
543
045
249
746
950
660
065
562
6N
ethe
rlan
ds37
140
038
940
837
737
238
339
338
337
936
334
633
933
332
531
832
030
928
426
825
424
022
821
021
319
619
1N
orw
ay44
644
544
643
044
642
842
941
541
441
441
341
141
340
739
640
540
440
440
236
934
534
531
229
727
626
325
9Po
land
151
179
194
205
210
212
231
244
253
263
256
277
262
266
261
284
297
307
317
310
324
326
344
327
304
281
273
267
Port
ugal
170
185
187
177
177
188
180
177
181
173
157
146
156
159
156
146
146
151
140
144
149
142
147
128
125
125
Rom
ania
131
138
144
151
161
156
158
172
186
195
215
230
227
254
258
271
267
278
272
263
282
303
337
367
368
372
388
Rus
sian
Fed
erat
ion
588
533
545
534
539
556
555
591
739
816
737
Slov
akia
463
448
470
454
Slov
enia
247
230
206
187
172
183
199
220
232
219
183
178
Spai
n99
107
130
137
147
164
169
165
158
161
160
151
150
150
150
151
149
146
144
141
132
131
134
131
130
125
125
Swed
en38
339
742
941
843
542
342
143
642
443
644
344
044
041
739
838
438
937
235
333
429
529
228
126
325
324
023
521
6Sw
itzer
land
224
227
230
224
216
221
240
239
238
246
228
236
235
225
218
224
213
205
202
190
183
181
176
170
163
147
Tajik
ista
n40
537
433
933
335
535
736
936
333
534
1Tu
rkm
enis
tan
545
552
545
549
536
590
664
638
634
619
770
725
Ukr
aine
617
625
610
521
521
486
486
512
546
588
Uni
ted
Kin
gdom
517
526
523
528
554
548
551
543
540
535
546
537
521
507
497
502
490
488
470
453
434
407
393
379
364
357
325
314
297
276
USS
R57
558
860
658
152
152
951
652
053
8U
zbek
ista
n49
450
748
946
042
746
248
148
050
153
457
3Y
ugos
lavi
a, F
mr
118
145
137
139
151
163
170
188
184
182
182
182
196
176
187
206
210
218
223
215
205
201
200
Europeancardiovascular
disease statistics
27
Tabl
e 1.
4 co
ntin
ued
Dea
ths
per
100,
000
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
WO
MEN
Alb
ania
4048
5048
37A
rmen
ia19
820
219
921
021
620
920
220
821
924
8A
zerb
aija
n26
426
727
428
428
030
327
430
133
235
737
630
733
332
9A
ustr
ia12
011
712
012
011
712
112
512
112
311
911
399
9810
110
410
210
094
8984
8180
8481
8280
7981
74Be
laru
s24
024
927
124
424
022
320
821
122
025
6Be
lgiu
m11
112
412
112
211
711
411
211
010
799
100
8890
8486
8583
7872
6961
5648
5046
Bulg
aria
124
140
150
154
157
159
168
162
162
171
162
151
148
118
137
135
142
141
134
124
126
125
126
129
122
137
132
Cro
atia
6766
7070
6360
8297
105
100
9910
6C
zech
Rep
ublic
202
185
174
180
179
177
162
166
162
160
149
Cze
chos
lova
kia
164
182
184
188
177
184
183
178
181
176
172
171
173
170
176
190
191
190
191
177
169
176
181
184
Den
mar
k16
315
715
615
915
815
815
215
913
914
114
614
213
913
313
213
212
713
011
611
610
510
810
098
101
8387
76Es
toni
a24
423
625
324
824
521
923
023
620
421
222
925
222
420
5Fi
nlan
d20
419
220
519
318
818
417
918
817
117
717
616
116
616
215
515
515
515
115
314
113
012
611
410
910
598
93Fr
ance
4950
5052
5250
5051
4845
4442
4142
4240
4140
3834
3028
2726
2625
2422
Geo
rgia
241
241
242
235
256
264
252
247
Ger
man
y80
8482
8279
7875
72G
erm
any,
Dem
Rep
8079
8482
7983
9595
9194
9999
9994
9793
97G
erm
any,
Fed
Rep
9410
010
010
310
610
610
811
011
210
510
610
099
100
101
103
100
101
9390
8479
76G
reec
e42
5147
5155
5559
5960
6160
5352
5353
5554
5652
6559
6157
5355
5248
5350
Hun
gary
162
161
169
167
162
165
161
162
161
168
148
157
171
170
177
170
175
174
164
161
161
162
165
168
178
173
169
169
163
Icel
and
125
128
126
106
129
9513
612
414
611
713
612
298
102
116
8389
9678
8471
57Ir
elan
d19
621
219
919
321
321
522
520
820
220
520
019
419
218
518
618
318
618
017
617
216
016
614
213
213
413
712
012
5Is
rael
237
215
214
207
172
153
174
179
146
141
138
141
131
121
110
100
102
8989
9389
65It
aly
8794
8786
8589
8585
8484
8274
6865
6366
6158
5653
5149
4645
4342
Kaz
akst
an21
921
523
521
021
221
019
819
620
921
225
326
628
629
6K
yrgy
zsta
n21
220
422
419
820
220
819
319
319
018
821
125
024
324
9La
tvia
249
250
268
242
221
229
201
226
230
229
258
292
245
199
Lith
uani
a21
620
923
220
721
720
420
920
821
721
022
022
321
818
8Lu
xem
bour
g53
5242
5551
4936
42M
aced
onia
, Fm
r Yu
g R
ep92
8999
9497
104
Mal
ta15
815
710
711
113
913
210
716
716
917
624
823
825
924
020
120
414
811
117
618
114
615
715
315
015
694
126
115
105
115
Mol
dova
, Rep
of
409
403
415
364
339
324
287
284
306
285
324
366
412
407
Net
herl
ands
120
125
124
126
119
116
113
118
114
112
107
102
106
100
9597
9690
8579
7472
7370
7067
63N
orw
ay13
813
413
512
912
212
811
611
611
111
411
111
411
011
110
910
310
410
610
510
398
9794
8781
8077
Pola
nd42
5558
5962
6166
6971
7672
7470
7170
7780
8388
8390
9094
9489
8482
79Po
rtug
al76
8183
7575
7271
6972
6259
5960
5757
5654
5651
5252
4853
4745
44R
oman
ia73
7575
7785
8081
8994
9711
111
211
613
113
013
913
814
213
513
413
313
814
716
616
416
517
6R
ussi
an F
eder
atio
n23
422
924
922
222
321
120
420
420
020
925
728
125
5Sl
ovak
ia17
417
318
518
7Sl
oven
ia79
6454
6059
6271
6774
7263
59Sp
ain
3336
4242
4650
5350
5048
4844
4344
4442
4140
3939
3737
3736
3634
34Sw
eden
142
147
154
149
146
143
143
137
130
133
131
129
128
121
116
111
107
108
9999
8588
8685
7772
7068
Switz
erla
nd72
6766
6364
6266
6364
6967
6261
6057
5657
5150
5150
4843
4643
41Ta
jikis
tan
238
223
189
195
209
222
223
208
204
202
Turk
men
ista
n28
427
129
730
127
231
438
234
335
936
145
443
0U
krai
ne31
030
931
527
026
024
122
122
624
225
7U
nite
d K
ingd
om17
517
717
317
218
418
418
518
018
317
818
217
917
417
117
117
217
217
316
716
215
615
014
514
113
413
112
011
410
710
0U
SSR
252
261
272
267
238
236
225
215
216
Uzb
ekis
tan
271
273
284
272
250
270
282
270
289
315
350
Yug
osla
via,
Fm
r59
7263
6569
7077
8389
7981
8180
6871
7983
8482
8177
7473
ICD
cod
es: 4
10-4
14 (8
th a
nd 9
th R
evis
ion)
, I20
-I25
(10t
h R
evis
ion)
Age
sta
ndar
dize
d us
ing
the
Eur
opea
n st
anda
rd p
opul
atio
n.So
urce
:W
orld
Hea
lth O
rgan
izat
ion
(199
9) h
ttp:
//ww
w.w
ho.c
h/
Europeancardiovascular
disease statistics
28
Figure 1.4a Death rates from CHD, men aged 35-74, latest available year
Figure 1.4b Death rates from CHD, women aged 35-74, latest available year
574 - 737388 - 573252 - 367177 - 251
92 - 176
CHD deathsper 100,000
249 - 430150 - 248
78 - 14951 - 7722 - 50
CHD deathsper 100,000
Europeancardiovascular
disease statistics
29
Figure 1.4c Death rates from CHD, men aged 35-74, 1968-1997, selected countries
Figure 1.4d Death rates from CHD, women aged 35-74, 1968-1997, selected countries
UK
Finland
Italy
Austria
Romania
Poland
0
100
200
300
400
500
600
700
800
68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97
Year
Dea
ths/
10
0,0
00
(ag
e-st
and
ard
ised
)
UK
Finland
Austria
Italy
Poland
Romania
0
50
100
150
200
250
68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97
Year
Dea
ths/
10
0,0
00
(ag
e-st
and
ard
ised
)
Europeancardiovascular
disease statistics
30
Tabl
e 1.
5A
ge-s
tand
ardi
zed
deat
h ra
tes
from
str
oke,
for
adul
ts a
ged
35-7
4, b
y se
x, 1
968-
1997
Dea
ths
per
100,
000
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
MEN
Alb
ania
143
158
145
142
121
Arm
enia
134
130
148
134
139
156
147
157
158
164
Aus
tria
179
173
171
170
161
163
159
154
151
148
136
146
142
130
148
138
127
116
106
9886
8378
7772
7070
6867
Aze
rbai
jan
244
246
229
238
216
184
162
170
185
200
173
188
194
Bela
rus
206
206
225
202
205
199
203
210
224
253
Belg
ium
149
156
144
144
140
132
134
130
127
113
111
9193
8992
9288
7975
6963
6056
5656
Bulg
aria
221
242
234
244
247
241
255
264
269
294
290
294
314
285
297
302
310
305
289
281
276
274
277
281
298
320
314
Cro
atia
219
228
215
207
201
197
201
199
209
209
208
239
Cze
ch R
epub
lic24
122
621
120
020
818
717
616
516
015
413
7C
zech
olos
lova
kia
170
192
203
208
216
226
231
227
217
221
214
204
224
213
225
235
232
224
221
206
198
191
200
186
Den
mar
k93
8988
8584
8281
8480
7878
7576
7876
6770
6864
6364
6967
6866
6366
Esto
nia
245
232
278
262
229
252
229
277
238
283
278
268
263
241
Finl
and
202
178
181
170
165
157
143
148
145
142
131
119
118
118
110
114
114
119
108
100
9210
395
9388
8282
Fran
ce14
615
013
814
213
813
513
412
511
810
410
196
9491
8685
8177
7364
5854
4950
4747
4445
Geo
rgia
291
297
327
305
262
282
286
284
Ger
man
y70
7371
7069
6662
59G
erm
any,
Dem
Rep
5858
6157
5655
7977
7782
8080
7872
7676
75G
erm
any,
Fed
Rep
161
162
156
153
151
148
142
141
137
125
125
123
120
118
112
111
103
9887
8177
7169
Gre
ece
116
111
104
107
115
117
110
116
118
118
118
111
115
108
108
110
109
109
101
100
9694
8789
8581
8383
85H
unga
ry18
818
619
017
518
718
819
420
520
521
523
925
825
726
327
327
527
024
724
322
923
222
822
923
723
923
122
522
121
4Ic
elan
d10
110
083
112
8981
8853
6053
7965
8745
5664
6362
4352
7254
Irel
and
148
163
160
143
153
151
146
140
132
139
128
126
115
107
105
107
101
9590
8482
7974
7265
66Is
rael
130
127
128
119
106
109
8997
9684
7980
7569
6258
6574
6862
6368
Ital
y16
616
115
315
415
014
913
914
213
913
613
512
712
211
611
511
711
210
710
292
8579
7270
6864
Kaz
akst
an25
925
725
825
224
523
825
925
925
825
028
429
931
232
3K
yrgy
zsta
n30
929
930
728
527
826
129
228
229
931
136
039
241
436
2La
tvia
288
270
285
262
252
247
256
277
277
285
317
344
312
285
Lith
uani
a15
814
916
714
915
113
915
916
415
116
417
417
016
115
0Lu
xem
bour
g15
015
613
412
615
615
114
314
311
711
510
010
284
5876
55M
aced
onia
, Fm
r Y
ug R
ep17
020
421
120
521
821
9M
alta
242
205
140
152
165
156
161
150
163
238
220
127
156
125
162
156
9389
142
150
8289
8092
8373
6764
7261
Mol
dova
, Rep
of
241
244
288
246
233
230
225
251
274
251
278
298
309
320
Net
herl
ands
9397
9196
9489
9187
8180
7977
7370
6770
6262
5657
5856
5454
5356
51N
orw
ay12
912
611
312
011
110
196
9586
8482
7975
7478
7573
7174
6567
6664
6267
55Po
land
6466
7374
7978
8796
102
103
103
105
9192
9210
010
911
010
710
610
610
911
311
711
911
411
411
1Po
rtug
al27
030
232
331
430
831
729
528
627
128
626
524
424
924
122
621
919
919
717
818
618
617
517
415
915
815
4R
oman
ia19
918
718
918
819
818
518
618
719
019
618
819
119
520
120
621
021
322
221
019
820
120
721
528
629
630
131
1R
ussi
an F
eder
atio
n31
431
032
229
829
829
628
929
028
929
835
339
437
4Sl
ovak
ia13
413
713
813
2Sl
oven
ia17
515
217
815
912
915
215
114
213
613
912
112
2Sp
ain
133
143
146
141
156
160
160
151
136
135
130
117
117
105
103
101
9788
8179
7469
6965
6159
Swed
en86
8286
8585
8885
8477
8073
7474
7064
6464
6158
5855
5762
6057
5251
Switz
erla
nd92
9797
8893
9082
8379
7870
6868
6461
5654
5146
4439
4136
3936
33Ta
jikis
tan
200
193
183
162
169
169
176
164
167
188
Turk
men
ista
n32
835
336
034
332
732
918
119
725
221
527
824
7U
krai
ne23
123
426
123
123
923
323
224
326
027
1U
nite
d K
ingd
om15
015
014
514
314
414
113
713
212
612
111
912
011
110
610
210
010
197
9487
8279
7676
7167
6363
6259
USS
R27
628
029
529
226
826
826
526
126
5U
zbek
ista
n24
925
625
323
824
623
523
023
224
725
624
8Y
ugos
lavi
a, F
mr
135
144
139
136
138
143
151
153
146
145
138
132
137
151
164
179
176
168
168
170
170
166
168
Europeancardiovascular
disease statistics
31
Tabl
e 1.
5 co
ntin
ued
Dea
ths
per
100,
000
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
WO
MEN
Alb
ania
101
105
9794
79A
rmen
ia98
117
130
122
126
121
138
137
131
146
Aus
tria
120
119
113
113
106
101
100
100
9393
8586
9081
8881
7772
6656
4945
4944
4545
4344
40A
zerb
aija
n17
218
818
717
716
513
311
911
313
615
113
014
214
5Be
laru
s14
214
116
415
715
515
014
314
815
717
8Be
lgiu
m10
211
010
510
297
9795
9389
8079
6964
6466
6759
5654
4944
4040
3737
Bulg
aria
230
236
225
228
232
223
228
228
234
243
239
231
241
222
235
224
220
218
207
199
186
183
179
188
186
189
184
Cro
atia
156
142
146
132
132
128
128
130
137
140
132
150
Cze
ch R
epub
lic16
014
313
012
412
410
910
510
094
9082
Cze
chol
oslo
vaki
a12
913
814
815
015
216
116
315
915
215
115
114
015
013
814
715
315
314
914
713
112
211
711
910
7D
enm
ark
6972
6668
5761
5756
5252
5053
5051
5147
4948
4543
4449
4748
5142
41Es
toni
a17
517
618
417
116
316
415
815
516
017
618
217
316
014
1Fi
nlan
d16
014
314
512
311
311
010
710
393
9183
8182
7678
6974
7172
6563
6158
5655
5250
Fran
ce88
8884
8380
7876
7166
5955
5251
5048
4844
4138
3329
2726
2625
2423
23G
eorg
ia18
519
221
020
117
919
319
718
9G
erm
any
4446
4443
4442
3937
Ger
man
y, D
em R
ep45
4345
4241
4257
5757
5760
6057
5357
5055
Ger
man
y, F
ed R
ep11
311
410
610
610
097
9390
8779
7878
7474
7169
6460
5649
4744
41G
reec
e11
911
210
410
710
911
311
210
910
910
310
310
110
610
096
100
9392
8986
8381
7576
7464
6263
56H
unga
ry14
614
514
413
513
713
513
314
414
313
915
917
017
116
517
317
016
815
814
813
913
113
213
012
812
512
512
512
011
2Ic
elan
d83
8284
7947
4938
7347
7943
4134
3838
4240
3638
4637
23Ir
elan
d15
116
514
414
613
713
714
812
511
812
610
399
102
8788
8678
7877
6062
5655
5353
46Is
rael
131
116
123
110
106
9893
9081
7970
6762
5353
4950
5256
4843
47It
aly
118
116
107
106
104
102
9694
9490
8783
7975
7574
7169
6458
5449
4543
4140
Kaz
akst
an17
117
317
818
318
017
418
617
917
717
019
521
221
721
9K
yrgy
zsta
n20
621
022
422
720
521
020
319
322
123
125
628
628
926
5La
tvia
191
187
206
188
183
165
176
167
169
175
198
196
190
180
Lith
uani
a12
111
111
611
411
010
411
010
710
510
311
011
511
110
1Lu
xem
bour
g88
105
8377
9585
9486
7280
7266
5552
4637
Mac
edon
ia, F
mr
Yug
Rep
144
169
168
174
179
170
Mal
ta18
018
714
010
110
912
713
211
816
418
818
589
9410
210
110
772
4792
8187
9264
6774
5953
5254
42M
oldo
va, R
ep o
f19
118
825
222
020
419
819
419
422
019
620
823
124
923
3N
ethe
rlan
ds79
8069
7172
7068
6461
5954
5349
4945
4543
4138
3637
3737
3837
3537
Nor
way
9691
8987
8080
7870
6664
5854
6050
4948
5146
4648
4645
3842
4138
Pola
nd53
5459
6063
6467
7777
7977
7570
7165
7477
7675
7371
6870
7171
7169
72Po
rtug
al19
921
623
122
120
820
219
518
718
218
817
715
915
915
714
413
612
812
011
111
711
010
310
189
9089
Rom
ania
180
173
167
166
172
157
156
159
162
162
154
155
156
160
165
163
166
176
165
154
151
153
156
202
202
207
208
Rus
sian
Fed
erat
ion
200
199
216
208
208
205
193
191
189
197
225
241
231
Slov
akia
8078
8347
Slov
enia
100
9883
8479
7689
7170
7372
65Sp
ain
109
117
110
111
120
117
117
109
101
9691
8280
7270
6863
5954
4947
4243
3836
32Sw
eden
7167
7165
6965
6763
5754
5051
5249
4245
4443
3841
3736
3836
3632
34Sw
itzer
land
6969
6868
6159
5555
4946
4846
4343
3735
2931
2724
2524
2323
2021
Tajik
ista
n16
415
014
812
912
913
013
912
714
015
2Tu
rkm
enis
tan
245
242
259
272
234
248
151
153
169
175
222
205
Ukr
aine
153
160
180
171
171
171
162
165
174
179
Uni
ted
Kin
gdom
123
120
117
115
112
109
109
101
9896
9392
8682
8178
7775
7268
6461
5857
5552
5049
4745
USS
R18
418
820
120
219
419
318
918
017
9U
zbek
ista
n16
017
117
617
419
016
916
216
717
318
018
1Y
ugos
lavi
a, F
mr
118
124
117
113
118
122
128
129
126
117
111
101
107
115
123
128
134
129
124
129
125
122
123
ICD
cod
es: 4
30-4
38 (8
th a
nd 9
th R
evis
ion)
, I60
-I69
(10t
h R
evis
ion)
.A
ge s
tand
ardi
zed
usin
g th
e E
urop
ean
stan
dard
pop
ulat
ion.
Sour
ce:
Wor
ld H
ealth
Org
aniz
atio
n (1
999)
htt
p://w
ww
.who
.ch/
Europeancardiovascular
disease statistics
32
Figure 1.5a Death rates from stroke, men aged 35-74, latest available year
Figure 1.5b Death rates from stroke, women aged 35-74, latest available year
254 - 374169 - 253
69 - 16857 - 6833 - 56
Stroke deathsper 100,000
181 - 265124 - 180
48 - 12338 - 4721 - 37
Stroke deathsper 100,000
Europeancardiovascular
disease statistics
33
Figure 1.5c Death rates from stroke, men aged 35-74, 1968-1997, selected countries
Figure 1.5d Death rates from stroke, women aged 35-74, 1968-1997, selected countries
0
50
100
150
200
250
300
350
68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97
Year
Dea
ths/
10
0,0
00
(ag
e-st
and
ard
ised
)
Romania
Poland
Italy
Sweden
0
50
100
150
200
250
68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97Year
Dea
ths/
10
0,0
00
(ag
e-st
and
ard
ised
) Romania
Poland
Italy
Sweden
Europeancardiovascular
disease statistics
34
Table 1.6 Years of life lost in early death, by cause,1990, EU and Europe
EU EUROPEGlobal Burden of Years of life % of total Years of life % of totalDisease Study code lost (1000s) years of life lost lost (1000s) years of life lost
II.G Cardiovascular disease 7000 30.8 23578 27.4II.G.2 Coronary heart disease 3715 16.3 11391 13.3II.G.3 Stroke 1568 6.9 5796 6.7
II.C Diabetes 371 1.6 851 1.0
II.A Cancer 5946 26.1 13567 15.8II.A.7 Lung cancer 1269 5.6 2891 3.4II.A.4 Cancer of the colon and rectum 593 2.6 1217 1.4II.A.3 Stomach cancer 427 1.9 1426 1.7II.A.9 Breast cancer 562 2.5 1085 1.3
I.A.2&3 Sexually transmitted diseases incl. HIV 438 1.9 604 0.7I.A.4 Diarrhoeal diseases 11 0.0 3765 4.4I.B Respiratory infections 546 2.4 5594 6.5
II.E Neuro-psychiatric disorders 716 3.1 1926 2.2II.E.5 Alcohol use 102 0.4 219 0.3II.E.9 Drug addiction 49 0.2 64 0.1II.E.1 Depression 0 0.0 0 0.0
II.H.1&2 Chronic obstructive lung disease and asthma 601 2.6 1450 1.7II.I.2 Liver cirrhosis 567 2.5 1356 1.6II.L.2&3 Musculo-skeletal (non-rheumatic) disease 66 0.3 146 0.2
III Injuries 3619 15.9 15330 17.8III.A.1 Road traffic injuries 1356 6.0 3980 4.6III.A.2-6 Other unintentional injuries 995 4.4 5062 5.9III.B.1 Suicide 911 4.0 2759 3.2III.B.2 Violence 356 1.6 1353 1.6
Total 22746 100.0 85951 100.0
Table adapted from National Institute of Public Health, Stockholm, 1997; figures from Murray and Lopez, 1996 andWorld Health Organization, 1999.
Sources: Murray JL, Lopez AD (1996) The global burden of disease. WHO: Geneva;National Institute of Public Health, Stockholm (1997) Determinants of the burden of disease in the EuropeanUnion. NIPH: Stockholm;World Health Organization (1999) European Health for All statistical database. http://www.who.dk/
Europeancardiovascular
disease statistics
35
2. MorbidityIncidence ratesComparable data on morbidity from CVD are not collected on a country-wide basis across
Europe. The World Health Organization MONICA (monitoring trends and determinants in
cardiovascular disease) Project1 has examined the incidence of CHD in 37 different populations
in 21 countries (including 29 populations in 16 European countries) but these populations are
not necessarily representative of the countries in which they are located.
Nevertheless the Project has shown that the incidence of coronary events (a definite or likely
myocardial infarction - heart attack) is higher in MONICA Project populations in Northern,
Central and Eastern Europe than in Southern and Western Europe. For example the incidence
rate for men aged 35-64 living in Warsaw (Poland) is three times higher than it is in Catalonia
(Spain) and for women it is four times higher. The geographical pattern in incidence rates is
therefore similar to the geographical pattern in death rates (Table 2.1).
The results of the MONICA Project also show that incidence of coronary events is falling rapidly
in most of the MONICA Project populations in Northern and Western Europe but is not falling
as fast in the populations in Southern, Central and Eastern Europe and in some cases is rising.
For example incidence rates for men aged 35-64 living in North Karelia (Finland) fell by 6.5%
per year over the study period (1983-1996) but rose by 1.2% for men of the same age living in
Kaunas (Lithuania). For women aged 35-64 living in North Karelia the incidence rate fell by
5.1% per year but rose by 2.7% per year for women living in Kaunas. Again the geographical
pattern in trends in incidence rates is similar to the geographical pattern in trends in death rates
(Table 2.1).
Case fatalityThe MONICA Project has also investigated patterns and trends in case fatality. Case fatality is
defined by the MONICA Project as dying within 28 days of a coronary event. Case fatality rates
are affected by many factors including the accuracy of diagnosis, the severity of the disease and
the impact of treatment.
The MONICA Project shows that case fatality from CHD is higher in many populations in
Central and Eastern Europe than in most populations in Northern, Southern and Western Europe.
For example case fatality for both men and women (aged 35-64) living in Moscow (Russia) is
50% higher than in Belfast (United Kingdom) or in Catalonia (Spain) (Table 2.1).
The results of the MONICA Project also show that case fatality is falling in most of the MONICA
Project populations in Southern, Northern and Western Europe but is not falling as fast in the
populations in Central and Eastern Europe and in some cases is rising in these populations. For
example case fatality for men aged 35-64 living in Toulouse (France) fell by 3.8% per year over
the study period but rose by 3.0% for men of the same age living in Moscow (Russia). For
women aged 35-64 living in Toulouse the case fatality rate fell by 3.6% per year but rose by
1.5% per year for women living in Moscow (Table 2.1).
Europeancardiovascular
disease statistics
36
The MONICA Project was partly established to investigate how much of reported declines in
CHD mortality are attributable to improvements in case fatality and how much to declines in
incidence. The Project concludes that the 'contribution to changing CHD mortality varied, but in
populations in which mortality decreased, coronary-event rates contributed two thirds and case
fatality one third1.
Years of life lost in disability and disease adjustedlife years lostAlthough CVD is not a major cause of years of life lost in disability - compared with neuro-
psychiatric disorders and injuries - it is still a significant cause. The Global Burden of Disease
Study has shown that 6% of years of life lost in disability are due to CVD in 'Established Market
Economies' (Northern, Southern and Western countries in Europe and all the member states of
the EU) compared with 4% due to cancer2. (See also Table 2.2.) In 'Formerly Socialist Economies
of Europe' (Central and Eastern European countries) 7% of years of life lost in disability are due
to CVD compared with 2% due to cancer2. In the EU alone nearly 1.4 million years of life lost in
disability are due to CVD of which more than half - over 0.7 million - are lost due to stroke. In
Europe as a whole nearly 4 million years of life lost in disability are lost due to CVD of which
over 1.6 million are lost due to stroke (Table 2.2).
The Global Burden of Disease Study has developed a measure to quantify the burden of disease
in different populations which takes into account time lost due to premature mortality and time
lived with disability. This measure is called the Disability-Adjusted Life Year (DALY). The Burden
of Disease Study shows that CVD is a major cause of DALYs lost in Established Market Economies
accounting for 19% of all DALYs lost. This is more than any cause apart from neuro-psychiatric
disorders (Table 2.2 , Figure 2.2). In Formerly Socialist Economies of Europe 23% of DALYs are
lost are due to CVD - this is more than any other cause, including neuro-psychiatric disorders2.
In the EU alone over 8 million DALYs are lost due to CVD of which over 4 million are lost due
to CHD and over 2 million are lost due to stroke. In Europe as a whole over 27 million DALYs
are lost due to CVD of which nearly 13 million are lost due to CHD and over 7 million are lost
due to stroke (Table 2.2).
1 Tunstall-Pedoe H, Kuulasmaa K, Mahonen M, Tolonen H, Ruokokoski E, Amouyel P, for the WHO MONICAProject (1999) Contribution of trends in survival and coronary-event rates to changes in coronary heart diseasemortality: 10-year results from 37 MONICA Project populations. Lancet 353; 1547-57.
2 Murray JL, Lopez AD (1996) The global burden of disease. WHO: Geneva.
Europeancardiovascular
disease statistics
37
Tabl
e 2.
1C
oron
ary
even
t rat
es, c
oron
ary
case
fata
lity,
ann
ual c
hang
e in
cor
onar
y ev
ent r
ates
and
ann
ual
chan
ge i
n co
rona
ry c
ase
fata
lity,
adu
lts a
ged
35-6
4, b
y se
x, l
ates
t av
aila
ble
data
, M
ON
ICA
Proj
ect p
opul
atio
nsM
ENW
OM
EN
Cor
onar
y ev
ent
Cor
onar
y ca
seA
nnua
l cha
nge
Ann
ual c
hang
eC
oron
ary
even
tC
oron
ary
case
Ann
ual c
hang
eA
nnua
l cha
nge
rate
fata
lity
in c
oron
ary
in c
oron
ary
rate
fata
lity
in c
oron
ary
in c
oron
ary
even
t rat
eca
se fa
talit
yev
ent r
ate
case
fata
lity
Eve
nts
per
100,
000
% o
f fat
aliti
es%
%E
vent
s pe
r 10
0,00
0%
of f
atal
ities
%%
with
in 2
8 da
ysw
ithin
28
days
MO
NIC
A p
opul
atio
nM
ON
ICA
popu
latio
n co
de
Belg
ium
-Cha
rler
oiBE
L-C
HA
1983
/92
487
50.1
0.3
-1.8
118
59.3
1.1
-1.8
Belg
ium
-Ghe
ntBE
L-G
HE
1983
/92
346
47.4
-3.2
-1.6
7758
.0-3
.0-1
.8C
zech
Rep
ublic
CZ
E-C
ZE
1984
/93
515
52.8
-0.4
0.7
101
53.9
2.1
-1.2
Den
mar
k-G
lost
rup
DEN
-GLO
1982
/91
517
52.5
-4.2
1.5
140
58.0
-2.5
2.5
Finl
and-
Kuo
pio
Prov
ince
FIN
-KU
O19
83/9
271
845
.7-6
.01.
012
438
.7-4
.51.
0Fi
nlan
d-N
orth
Kar
elia
FIN
-NK
A19
83/9
283
548
.1-6
.5-0
.514
541
.3-5
.1-0
.2Fi
nlan
d-Tu
rku/
Loim
aaFI
N-T
UL
1983
/92
549
48.5
-4.2
-0.2
9448
.9-4
.5-1
.9Fr
ance
-Lill
eFR
A-L
IL19
85/9
429
858
.7-1
.1-0
.364
69.5
-1.6
0.8
Fran
ce-S
tras
bour
gFR
A-S
TR
1985
/93
292
49.0
-3.9
-1.7
6457
.1-6
.6-2
.3Fr
ance
-Tou
lous
eFR
A-T
OU
1985
/93
233
40.0
-2.1
-3.8
3659
.8-1
.7-3
.6G
erm
any-
Aug
sbur
gG
ER-A
UG
1985
/94
286
55.1
-3.2
1.3
6364
.60.
9-0
.4G
erm
any-
Brem
enG
ER-B
RE
1985
/92
361
49.6
-3.4
-0.9
8152
.00.
7-2
.9G
erm
any-
East
Ger
man
yG
ER-E
GE
1985
/93
370
50.0
-0.5
1.7
7862
.82.
5-2
.2Ic
elan
dIC
E-IC
E19
81/9
448
636
.9-4
.7-2
.199
34.1
-3.7
-1.0
Ital
y-A
rea
Bria
nza
ITA
-BR
I19
85/9
427
940
.7-2
.3-0
.842
52.5
-3.5
-4.8
Ital
y-Fr
iuli
ITA
-FR
I19
84/9
325
345
.1-0
.9-2
.047
49.9
-0.8
-2.0
Lith
uani
a-K
auna
sLT
U-K
AU
1983
/92
498
54.8
1.2
1.0
8053
.72.
7-1
.2Po
land
-Tar
nobr
zeg
Vovo
idsh
ipPO
L-TA
R19
84/9
346
182
.71.
11.
211
088
.4-0
.1-0
.7Po
land
-War
saw
POL-
WA
R19
84/9
458
659
.90.
8-0
.415
359
.21.
0-2
.1R
ussi
a-M
osco
w (c
ontr
ol)
RU
S-M
OC
1985
/93
477
60.7
-1.0
3.0
9260
.2-6
.71.
5R
ussi
a-N
ovos
ibir
sk (c
ontr
ol)
RU
S-N
OC
1984
/92
464
59.9
0.9
-0.1
111
66.5
2.3
0.3
Spai
n-C
atal
onia
SPA
-CAT
1985
/94
210
36.7
1.8
-1.7
3545
.52.
01.
5Sw
eden
-Got
henb
urg
SWE-
GO
T19
84/9
436
343
.6-4
.20.
384
45.4
-3.7
1.2
Swed
en-N
orth
ern
Swed
enSW
E-N
SW19
85/9
550
936
.1-5
.1-2
.911
934
.4-2
.40.
4Sw
itzer
land
-Tic
ino
SWI-
TIC
1985
/93
290
33.5
-2.6
-4.2
Switz
erla
nd-V
aud/
Frib
ourg
SWI-
VAF
1985
/93
231
38.4
-3.6
-3.0
Uni
ted
Kin
gdom
-Bel
fast
UN
K-B
EL19
83/9
369
541
.0-4
.6-1
.518
841
.5-2
.4-1
.7U
nite
d K
ingd
om-G
lasg
owU
NK
-GLA
1985
/94
777
48.2
-1.4
-1.3
265
46.4
0.2
-2.1
Yug
osla
via-
Nov
i Sad
YU
G-N
OS
1984
/95
422
51.9
0.4
-0.4
101
49.9
2.8
0.5
Age
-sta
ndar
dise
d ra
tes:
see
sou
rce
for
defin
ition
s, d
etai
ls o
f age
-sta
ndar
disa
tion
and
how
tren
ds w
ere
calc
ulat
ed.
Sour
ce:
Tuns
tall-
Pedo
e H
, Kuu
lasm
aa K
, Mah
onen
M, T
olon
en H
, Ruo
koko
ski E
, Am
ouye
l P, f
or th
e W
HO
MO
NIC
A P
r oje
ct (1
999)
. Con
trib
utio
n of
tren
ds in
surv
ival
and
cor
onar
y-ev
ent r
ates
to c
hang
es in
cor
onar
y he
art d
isea
se m
orta
lity:
10-y
ear
resu
lts fr
om 3
7 M
ON
ICA
Pro
ject
pop
ulat
ions
. Lan
cet 3
53; 1
547-
57.
Europeancardiovascular
disease statistics
38
Tabl
e 2.
2Ye
ars l
ived
with
dis
abili
ty a
nd d
isab
ility
-adj
uste
d lif
e ye
ars l
ost,
by c
ause
, 199
0, E
U a
nd E
urop
eEU
EUR
OPE
EUEU
RO
PE
Glo
bal B
urde
n of
Year
s liv
ed%
of t
otal
Year
s liv
ed%
of t
otal
Dis
abili
ty-a
djus
ted
% o
f tot
alD
isab
ility
-adj
uste
d%
of t
otal
Dis
ease
Stu
dy c
ode
with
dis
abili
tyye
ars
lived
with
dis
abili
tyye
ars
lived
life
year
s lo
stdi
sabi
lity-
adju
sted
life
year
s lo
stdi
sabi
lity-
adju
sted
(100
0s)
with
dis
abili
ty(1
000s
)w
ith d
isab
ility
(100
0s)
life
year
s lo
st(1
000s
)lif
e ye
ars
lost
II.G
Car
diov
ascu
lar
dise
ase
1397
6.2
3739
6.1
8397
18.6
2731
718
.6II
.G.2
Cor
onar
y he
art d
isea
se35
01.
612
082.
040
649.
012
600
8.6
II.G
.3St
roke
711
3.2
1620
2.7
2279
5.0
7416
5.0
II.C
Dia
bete
s70
83.
112
972.
110
792.
421
471.
5
II.A
Can
cer
851
3.8
1585
2.6
6797
15.0
1515
210
.3II
.A.7
Lung
can
cer
990.
420
80.
313
683.
030
992.
1II
.A.4
Can
cer
of th
e co
lon
and
rect
um15
10.
726
30.
474
51.
614
801.
0II
.A.3
Stom
ach
canc
er59
0.3
164
0.3
486
1.1
1590
1.1
II.A
.9Br
east
can
cer
880.
414
80.
265
11.
412
330.
8
I.A.2
&3
Sexu
ally
tran
smitt
ed d
isea
ses
incl
. HIV
327
1.5
919
1.5
765
1.7
1426
1.0
I.A.4
Dia
rrho
eal d
isea
ses
950.
432
50.
510
50.
240
892.
8I.B
Res
pira
tory
infe
ctio
ns71
0.3
384
0.6
616
1.4
5978
4.1
II.E
Neu
ro-p
sych
iatr
ic d
isor
ders
1061
647
.223
743
39.0
1133
225
.025
671
17.5
II.E
.5A
lcoh
ol u
se20
459.
138
136.
321
484.
740
322.
7II
.E.9
Dru
g ad
dict
ion
647
2.9
1420
2.3
697
1.5
1486
1.0
II.E
.1D
epre
ssio
n30
6113
.673
9812
.130
616.
873
985.
0
II.H
.1&
2C
hron
ic o
bstr
uctiv
e lu
ng d
isea
se a
nd a
sthm
a10
114.
523
663.
916
123.
638
152.
6II
.I.2
Live
r ci
rrho
sis
158
0.7
359
0.6
725
1.6
1715
1.2
II.L
.3M
uscu
lo-s
kele
tal (
non-
rheu
mat
ic) d
isea
se13
946.
237
826.
214
613.
239
302.
7
III
Inju
ries
1765
7.8
6749
11.1
5384
11.9
2208
015
.0II
I.A.1
Roa
d tr
affic
inju
ries
618
2.7
1449
2.4
1974
4.4
5427
3.7
III.A
.2-6
Oth
er u
nint
entio
nal i
njur
ies
973
4.3
4151
6.8
1968
4.4
9213
6.3
III.B
.1Su
icid
e76
0.3
206
0.3
987
2.2
2965
2.0
III.B
.2V
iole
nce
980.
426
50.
445
51.
016
181.
1
Tota
l22
492
100.
060
954
100.
045
238
100.
014
6905
100.
0
Tabl
e ad
apte
d fr
om N
atio
nal I
nstit
ute
of P
ublic
Hea
lth, S
tock
holm
, 199
7; fi
gure
s fr
om M
urra
y an
d L
opez
, 199
6 an
d W
orld
Hea
lth O
rgan
izat
ion,
199
9.
Sour
ces:
Mur
ray
JL, L
opez
AD
(199
6) T
he g
loba
l bur
den
of d
isea
se. W
HO
: Gen
eva;
Nat
iona
l Ins
titut
e of
Pub
lic H
ealth
, Sto
ckho
lm (1
997)
Det
erm
inan
ts o
f the
bur
den
of d
isea
se in
the
Eur
opea
n U
nion
. N
IPH
: Sto
ckho
lm;
Wor
ld H
ealth
Org
aniz
atio
n (1
999)
Eur
opea
n H
ealth
for
All
stat
istic
al d
atab
ase.
htt
p://w
ww
.who
.dk/
Europeancardiovascular
disease statistics
39
Figure 2.2 Disability-adjusted life years lost bycause, 1990, EU
All other causes29%
Injuries12%Neuropsychiatric disorders
25%
Cancer15%
Other CVD5% Stroke
5%
CHD9%
Europeancardiovascular
disease statistics
40
3. TreatmentHospital admissionsRates of admissions (or more technically discharges) for CVD vary considerably across Europe.
In general there are higher hospital admission rates in Northern, Central and Eastern European
countries than in Southern and Western countries. For example the admission rate is over three
times higher in Belarus than in Spain. The geographical pattern in rates of admissions for CHD
and stroke is similar to the geographical pattern in admissions for CVD (Table 3.1, Figure 3.1).
There are likely to be many reasons for these differences in admission rates but one possible
reason could be that incidence of CVD in Northern, Central and Eastern European countries is
generally higher than in Southern and Western countries (see Section 2). If admission rates for
CHD are adjusted for standardised mortality rates from CHD in adults aged 35-74 (as a surrogate
for incidence rates) we can see that some countries have higher rates of admissions than might be
expected and some lower. Countries which have lower rates than might be expected given their
incidence rates are generally countries of Central and Eastern Europe - Belarus, Lithuania, Latvia,
Ukraine and the Russian Federation have particularly low rates. Countries with higher rates than
expected are generally countries of Southern and Western Europe - France, Belgium and Israel
have particularly high rates (Figure 3.1).
SurgerySurgery rates vary widely across Europe. In general Central and Eastern European countries
have lower surgery rates than Northern, Southern and Western Countries. Within Northern,
Southern and Western European countries there is no consistent geographical pattern but some
countries have high rates of all procedures and some countries have low. For example France has
higher than average rates for pacemaker implantation, percutaneous coronary interventions,
coronary stents, coronary artery bypass surgery and valve surgery, and the UK has lower than
average rates for all these procedures (Table 3.2).
Again there are likely to be many reasons for these differences. If surgery rates are adjusted to
take account of incidence we find that some countries have lower rates of surgery than might be
expected and some higher. For example if rates of coronary artery bypass surgery are adjusted
(as above) for incidence of CHD we can see that France, Switzerland and Belgium have much
higher rates than might be expected whilst Finland, Ireland and the Czech Republic have much
lower rates (Figure 3.2).
DrugsData on the use of drugs in the treatment and prevention of CVD in different countries can be
obtained from pharmaceutical market research companies but the data we have obtained from
this source are difficult to interpret and we have not included any in this edition of European
cardiovascular disease statistics.
The European Society of Cardiology's EUROASPIRE Study has investigated one aspect of use -
i.e. in relation to the secondary prevention of CHD - in nine different countries. This study
shows that the use of drugs in CHD patients varies considerably, except in the case of anti-
platelet drugs where over 70% of patients took this form of drug (mostly aspirin) in all the
countries studied (Table 3.3).
Europeancardiovascular
disease statistics
41
Table 3.1 Rates of hospital discharges for CVD,CHD and stroke, latest available year
Dischages per 100,000
CVD CHD Stroke
Albania 1996 417 121 45Andorra 1998 538 120 111Armenia 1998 611 271 112Austria 1997 3679 921 699Azerbaijan 1998 515 163 44Belarus 1998 3671 1782 649Belgium 1996 2235 689 362Bosnia and Hezegovina 1990 883 162 104Bulgaria 1998 1615 551 323Croatia 1998 1562 378 385Czech Republic 1998 3102 1112 584Denmark 1998 2234 606Estonia 1998 2747 953 436Finland 1998 4012 1188 819France 1994 2219 490 279Georgia 1998 394 117 45Germany 1997 3072 972 514Hungary 1998 3716Iceland 1995 2182 961 275Ireland 1998 1530 521 245Israel 1996 2159 1039 258Italy 1998 2244 336 430Kazakhstan 1998 1148 422 162Kyrgyzstan 1998 919 268 116Latvia 1998 2885 1195 559Lithuania 1998 3337 1407 595Macedonia, Fmr Yug Rep 1996 1184 321 199Moldova, Rep of 1998 1502 498 292Netherlands 1998 1589 602 200Norway 1996 2194 890 382Poland 1997 2122 625 245Portugal 1997 974Romania 1998 2157 713 300Russian Federation 1998 2398 1002 505Slovakia 1996 2534 1089 491Slovenia 1998 1560 375 220Spain 1995 1015 259 178Sweden 1997 3033 974 634Tajikistan 1998 484 130 25Turkey 1997 638 111 114Turkmenistan 1998 875 304 77Ukraine 1998 2382 1119 481United Kingdom 1995 1607 545 257Uzbekistan 1998 1018 345 89
EU average 1997 2190 629* 356**European average 1997 2134 690 365
*1996 **1994
Source: World Health Organization (1999) European Health for All statistical database. http://www.who.dk/
0
500
1000
1500
2000
2500
Georgia
Albania
Tajikist
an
Azerb
aijan
Spain
Kyrgyzs
tan
Armenia
Turkm
enistan
Mace
donia, Fm
r Yug Rep
Italy
Uzbekist
an
Slovenia
Croatia
Kazakhsta
n
France
Mold
ova, Rep of
Ireland
United Kin
gdom
Bulgaria
Netherla
nds
Denmark
Poland
Belgiu
m
Romania
Norway
Austria
Estonia
Iceland
Germany
Sweden
Russian Federa
tion
Israel
Slovakia
Czech
Republic
Ukrain
e
Finland
Latvia
Lithuania
Belarus
Dis
char
ges
/10
0,0
00
Crude hospital discharge rate
Adjusted hospital discharge rate
Figure 3.1 Rates of hospital discharges for CHD,crude and adjusted for standardisedmortality rates from CHD, in adults aged35-74, latest available year
Europeancardiovascular
disease statistics
42
Table 3.2 Age and sex-standardised rates of variousprocedures for treating CVD, around1995
Implantable Percutaneous Open Coronarycardioverter Coronary coronary Coronary heart artery bypass Valve
Pacemakers defibrillators angiograms interventions stents surgery surgery surgery
Procedures per million
Albania 66Austria 450 8 2657 654 174 682 426 161Belgium 678 18 3608 971 53 979 617 206Bosnia and Herzegovina 0 0 0Bulgaria 202 93 76Croatia 148 1 410 60 4 131 65 37Czech Republic 583 5 984 189 189 415 246 83Denmark 309 13 1098 252 58 531 357 72Estonia 706 158 1 187 91 58Finland 1750 340 936 655 150France 602 4 2733 808 409 571 308 159Germany 438 23 3929 1143 288 813 537 173Greece 290 4 1510 274 274 450 331 85Hungary 187 550 347 204 95Iceland 4782 1499 1071 961 44Ireland 2260 354 716 500 143Italy 3 1116 227 80 411 238 124Latvia 179 32 90 27 41Lithuania 185 0 793 121 3 253 110 77Luxembourg 0 0 0Macedonia, Fmr Yug Rep 0 0 0Moldova, Rep of 46 0Netherlands 347 10 2139 867 162 917 752 97Norway 230 10 1894 610 70 747 596 78Poland 262 1 519 94 310 151 79Portugal 334 1 864 150 22 366 199 119Romania 82 10 10 48 3 24San Marino 0 0 0Slovakia 418 4 5 224 104 48Slovenia 296 2 693 143 4 292 146 67Spain 293 1064 288 101 363 175 140Sweden 346 7 1450 416 103 759 581 92Switzerland 340 10 2837 823 229 767 550 213Turkey 1500 232 33United Kingdom 232 5 1158 251 66 507 362 76Yugoslavia 83 222 167 36
For method of standardisation see source.
Source: European Society of Cardiology (1999) Cardiovascular disease in Europe. ESC: Nice
Figure 3.2 Rates of coronary artery bypass surgery,crude and adjusted for standardisedmortality rates from CHD, in adults aged35-74, around 1995
0
200
400
600
800
1000
1200
Romania
Latvia
Croatia
Estonia
Bulgaria
Slovakia
Lithuania
Slovenia
PolandSpain
Portugal
HungaryIta
ly
Czech
Republic
France
Greece
Denmark
United Kin
gdom
Austria
Ireland
Germany
Switzerla
nd
Sweden
Norway
Belgiu
m
Finland
Netherla
nds
Iceland
Op
erat
ion
s/ m
illio
n
Crude coronary artery bypass surgery rate
Adjusted coronary artery bypass surgery rate
Europeancardiovascular
disease statistics
43
Tabl
e 3.
3R
epor
ted
med
icat
ion,
hos
pita
l pa
tient
s w
ith e
stab
lishe
d C
HD
, ar
ound
199
5, E
UR
OA
SPIR
ESu
rvey
pop
ulat
ions
Ant
ipla
tele
tsBe
ta-b
lock
ers
AC
E in
hibi
tors
Cal
cium
ant
agon
ists
Diu
retic
sD
igita
lis g
lyco
side
sLi
pid-
low
erin
gA
ntid
iabe
tics
Ant
icoa
gula
nts
Nitr
ates
%%
%%
%%
%%
%%
Cze
ch R
epub
lic-P
ilsen
and
Pra
gue
85.2
65.3
28.1
25.1
15.7
7.9
28.7
10.6
3.9
65.7
Finl
and-
Kuo
pio
82.2
77.8
17.4
24.1
12.1
5.1
39.0
7.2
7.5
37.8
Fran
ce-L
ille
82.1
56.3
33.6
33.3
18.7
6.1
41.7
12.1
5.6
72.0
Ger
man
y-M
unst
er82
.943
.631
.436
.014
.512
.235
.28.
96.
145
.4H
unga
ry-B
udap
est
72.0
57.7
46.3
57.0
15.9
5.7
22.3
12.6
13.5
69.1
Ital
y-U
dine
, Fri
uli,
Trev
iso
and
Ver
ona
Prov
ince
s86
.149
.231
.843
.517
.77.
525
.210
.63.
161
.9N
ethe
rlan
ds -
Gre
at R
otte
rdam
77.7
46.9
27.2
22.0
13.7
5.4
36.0
8.3
9.1
12.2
Slov
enia
79.6
51.9
31.3
35.4
14.3
5.1
30.3
7.3
5.8
38.8
Spai
n-Ba
rcel
ona
and
Prov
ince
84.1
34.7
17.7
47.3
15.7
5.7
30.3
16.5
6.9
41.4
25%
of t
he p
atie
nts
wer
e w
omen
; 23%
wer
e <5
0 ye
ars,
33%
wer
e ag
ed 5
1-60
, 43%
wer
e ag
ed 6
1-70
; 25%
had
rec
ently
had
thei
r fir
st c
oron
ary
arte
rty
bypa
ss g
raft
ing
for
CH
D,
24%
had
rec
ently
had
thei
r fir
st p
ercu
tane
ous
tran
slum
inal
cor
onar
y an
giop
last
y fo
r C
HD
, 27%
had
a h
ospi
tal d
iagn
osis
of a
cute
myo
card
ial i
nfar
ctio
n, 2
3% h
ad a
hos
pita
l dia
gnos
is o
f acu
te m
yoca
rdia
l isc
haem
ia w
ithou
t evi
denc
e of
infa
rctio
n.
Sour
ce:
EU
RO
ASP
IRE
Stu
dy G
roup
(199
7) E
UR
OA
SPIR
E. A
Eur
opea
n So
ciet
y of
Car
diol
ogy
surv
ey o
f sec
onda
ry p
reve
ntio
n of
cor
onar
y he
art d
isea
se: P
rinc
ipal
res
ults
. Eur
opea
n H
eart
Jou
rnal
18:
156
9-15
82.
Europeancardiovascular
disease statistics
44
4. SmokingMortality and morbidity attributable to smokingAbout 22% of deaths from CVD in men and about 4% of deaths from CVD in women living in
Europe are due to smoking. (The equivalent figures for the EU are 16% and 4% respectively).
But smoking is a major risk factor for many other diseases other than CVD - notably cancer -
which means that about 26% of all deaths in men living in Europe and about 5% of all deaths in
women are due to smoking (24% and 6% in the EU) (Table 4.1).
In other words about 1 million men and 200,000 women in Europe die from smoking each year
(of which 350,000 men and 80,000 women die from CVD). In the EU 400,000 men and 100,000
women die from smoking each year (of which 100,000 men and 30,000 women die from CVD
(Table 4.1).
The Global Burden of Disease Study estimates that in Established Market Economies 12% of
DALYs are lost due to smoking. In Formerly Socialist Economies of Europe about 8% are lost1.
A study carried out by the National Institute of Public Health in Stockholm (Sweden) for the
European Commission estimates that 9% of DALYs lost in the EU are due to smoking2.
Prevalence of smokingIn most of Europe the prevalence of smoking is higher in men than it is in women. In only two
countries - Ireland and Sweden - do women smoke more than men and in both cases the differences
between the sexes is small (Table 4.2). The smoking prevalence data from the MONICA Project
similarly shows that in most populations men smoke more than women. Only in Iceland and
Northern Sweden do women smoke more than men (Table 4.3).
The prevalence of smoking in men is generally higher in Southern, Central and Eastern European
countries than in Northern and Western countries. For example 63% of men smoke in Turkey
compared with 17% in Sweden. For women the prevalence of smoking is generally higher in
Northern and Western countries than in Southern, Central and Eastern European countries. For
example 33% of women smoke in Norway compared with 5% in Belarus (Table 4.2, Figures
4.2a and 4.2b). The smoking prevalence data from the MONICA Project shows the same
geographical patterns (Table 4.3).
The data on smoking among 15 year olds show that the percentage of boys who smoke at least
once a week ranges from 33% in Latvia to 9% in Israel, while the corresponding range for girls
is from 31% in Austria to 4% in Lithuania. The differences between the sexes in smoking
prevalence rates observed in adults is not found in children. In many populations girls smoke
more than boys (Table 4.4).
Trends in smoking prevalenceOver the past 20 years the prevalence of smoking amongst among men has fallen in many Northern,
Southern and Western European countries. The prevalence of smoking amongst women has also
Europeancardiovascular
disease statistics
45
fallen in some, but not all, of these countries. In the countries where there has been a decline in
the prevalence of smoking amongst women the decline has been less marked. For example between
1980 and 1997 the prevalence of smoking in Swedish men fell by over 50% but in Swedish
women it fell by less than 25%. In men living in the Netherlands it fell by 25% but in women it
fell by only 6%. This has meant that the difference in smoking prevalence between men and
women has become less pronounced in recent years (Table 4.5, Table 4.6 and Figure 4.6).
In many Northern, Southern and Western European countries the decline in the prevalence of
smoking, both amongst men and women, has been less steep in recent years and in some countries
may even be rising again. The data from Central and Eastern European countries are much more
sparse than that from Northern, Southern and Western countries, but suggest that generally
smoking is not declining in these countries and may be increasing - particularly amongst women
(Table 4.5).
In children in Northern, Southern and Western countries the prevalence of smoking seems to be
generally rising both amongst boys and girls but the data are sparse (Table 4.4).
1 Murray JL, Lopez AD (1996) The global burden of disease. WHO: Geneva.
2 National Institute of Public Health, Stockholm (1997) Determinants of the burden of disease in the EuropeanUnion. NIPH: Stockholm.
Europeancardiovascular
disease statistics
46
Tabl
e 4.
1To
tal n
umbe
rs o
f de
aths
and
num
bers
of
deat
hs d
ue t
o sm
okin
g by
cau
se, a
dults
age
d 35
and
over
, by
sex,
199
5A
LL D
EAT
HS
FRO
M:
DEA
TH
S D
UE
TO
SM
OK
ING
FR
OM
:
All
caus
esC
VD
Can
cer
All
caus
esC
VD
Can
cer
Men
Wom
enM
enW
omen
Men
Wom
enM
enW
omen
Men
Wom
enM
enW
omen
Arm
enia
1552
012
016
7072
6685
2567
1977
4053
392
1747
175
1278
93A
ustr
ia32
744
3830
713
975
2020
295
0392
3064
0417
7219
4669
332
7358
2A
zerb
aija
n23
396
1915
910
468
1064
827
5917
8826
880
1335
067
80
Bela
rus
5325
054
186
2101
126
158
1145
885
1215
126
411
5959
180
5615
91Be
lgiu
m48
158
4531
014
566
1720
214
530
1043
414
254
1062
2891
235
6692
383
Bulg
aria
6286
448
214
3698
532
016
9946
6222
1143
042
656
0423
138
1677
Cze
ch R
epub
lic66
162
5825
233
367
3431
916
761
1308
419
525
3231
8677
1709
7829
853
Den
mar
k31
144
3002
912
827
1338
479
5073
5673
1355
7820
4918
6129
8316
51Es
toni
a95
7294
6848
0160
3717
9614
7826
2439
612
9822
092
286
Finl
and
2416
624
985
1014
811
704
4871
4792
4317
758
1563
327
1809
215
Fran
ce23
2709
2101
3557
866
6960
580
845
5092
551
969
2995
8553
535
3043
011
97G
eorg
ia21
735
2179
312
019
1525
128
6724
8831
8932
1574
1710
066
Ger
man
y39
2243
4435
1716
3873
2258
7010
2980
9805
087
942
2049
925
898
7315
3870
560
88G
reec
e48
378
4164
923
752
2483
612
547
7184
1048
912
7337
4560
352
9842
1H
unga
ry78
403
6801
534
772
3812
720
089
1455
925
502
7981
1023
539
2710
688
2160
Irel
and
1576
413
274
6476
5268
3981
3401
3701
2180
1020
682
1414
633
Ital
y25
8274
2318
4689
844
1034
4586
942
5942
967
895
1059
315
601
3195
3611
833
12K
azak
hsta
n66
282
6012
825
046
3257
513
926
1060
820
154
5003
8100
2045
7890
1254
Kyr
gyzs
tan
1694
914
248
5458
6349
2077
1582
2842
820
1026
237
799
119
Latv
ia17
382
1663
780
5310
001
3288
2547
4696
601
2187
317
1632
123
Lith
uani
a21
061
1876
410
386
1233
647
3132
3159
5675
826
1541
023
2614
3Lu
xem
bour
g16
4116
0062
177
248
439
943
934
110
922
316
Mol
dova
, Rep
of
1923
018
623
6243
7438
3829
2812
4078
013
840
1610
0N
ethe
rlan
ds68
000
6492
523
427
2375
720
594
1601
921
170
4075
4843
913
9265
1412
Nor
way
2373
222
973
1069
910
408
5212
4701
3369
1364
1055
464
1376
443
Pola
nd21
7517
1743
7710
4728
1009
1746
939
3326
167
512
1226
929
730
6278
2478
731
80Po
rtug
al57
758
5334
821
640
2576
312
054
5142
8401
022
050
3351
0R
oman
ia13
1729
1100
4968
352
7230
420
163
1438
125
638
3555
1054
616
8183
7273
0R
ussi
an F
eder
atio
n76
4572
8047
2232
7275
5074
1716
7527
1345
7424
1035
3833
110
2813
1877
991
774
7864
Slov
akia
3184
823
269
1548
013
622
6966
4123
8673
845
3961
478
3533
196
Slov
enia
8728
8336
3267
4271
2314
1817
2537
361
697
116
1143
108
Spai
n18
1343
1483
6652
926
6392
753
218
3069
345
700
085
760
2207
30
Swed
en47
027
4596
821
819
2163
610
576
6129
4808
2298
1454
727
2116
804
Switz
erla
nd34
367
3196
213
004
1447
693
1774
1567
6717
0116
1552
430
8350
4Ta
jikis
tan
1861
515
820
6060
6101
1677
1329
867
031
60
219
0Tu
rkm
enis
tan
1425
812
248
5327
5591
1272
1087
1233
058
10
365
0U
krai
ne29
1612
3118
5511
3462
1570
4164
587
4978
489
213
1789
832
541
7270
3440
032
90U
nite
d K
ingd
om28
0597
2932
6711
9481
1273
0781
690
7610
772
657
4870
621
129
1666
732
697
1558
6U
zbek
ista
n68
782
6023
228
432
3071
762
2058
6260
3517
3125
8768
817
4133
2Y
ugos
lavi
a, F
mr
1145
8997
249
5306
156
961
2555
117
510
2998
541
2410
608
1770
1224
094
4
Tota
l EU
1719
946
1686
526
6332
4175
4678
5027
6538
5290
4074
5910
1823
1015
8333
762
1964
4732
300
Tota
l Eur
ope
3912
101
3779
121
1598
069
1972
444
9566
0473
2022
1012
186
2040
5335
0374
8127
842
5569
5489
6
Tota
l EU
(% o
f all
deat
hs fr
om a
ll ca
uses
)24
%6%
6%2%
11%
2%
Tota
l Eur
ope
(% o
f all
deat
hs fr
om a
ll ca
uses
)26
%5%
9%2%
11%
1%
Figu
res
are
indi
rect
est
imat
es fr
om p
roje
cted
Nat
iona
l Vita
l Sta
tistic
s. S
ee s
ourc
e fo
r de
tails
.
Sour
ce: P
eto
R, L
opez
A D
, Bor
eham
J, T
hun
M, H
eath
C (1
994)
Mor
talit
y fr
om s
mok
ing
in d
evel
oped
cou
ntri
es 1
950-
2000
, Oxf
ord
Uni
vers
ity P
ress
: Oxf
ord.
Europeancardiovascular
disease statistics
47
Table 4.2 Prevalence of smoking, adults aged 15and over, by sex, latest available year
Men Women Total
% % %Year
Albania 1990 50 8 30Austria 1992 42 27 35Azerbaijan 1997 27Belarus 1997 53 5 26Belgium 1997 31 22 26Bosnia and Herzegovina 1995 48Bulgaria 1996 41 17 29Czech Republic 1996 33 20 27Denmark 1997 37 33 33Estonia 1996 48 22 33Finland 1996 27 18 22France 1993 36 23 34Germany 1995 33 20 26Greece 1994 46 28 37Hungary 1992 44Iceland 1997 28 26 27Ireland 1994 28 29 29Israel 1997 31 25 28Italy 1997 33 17 25Latvia 1994 49 11 30Lithuania 1992 30Luxembourg 1993 32 26 29Malta 1992 40 18 28Netherlands 1997 39 32 36Norway 1997 35 33 34Poland 1993 51 29 39Portugal 1996 30 7 18Romania 1994 36 11 23Russian Federation 1996 31 7 19Slovakia 1995 24 13 18Slovenia 1994 35 23 28Spain 1997 42 25 33Sweden 1997 17 22 20Switzerland 1992 36 26 30Turkey 1988 63 24 44Turkmenistan 1990 14Ukraine 1990 40United Kingdom 1996 29 28 28
"Smoking" defined as regular daily smoking.
Source: World Health Organization (1999) European Health for All statistical database. http://www.who.dk/
Europeancardiovascular
disease statistics
48
Figure 4.2a Prevalence of smoking, men aged 15 andover, latest available year
Figure 4.2b Prevalence of smoking, women aged 15and over, latest available year
50 - 6340 - 4934 - 3931 - 3317 - 30
% smoking
28 - 3724 - 2719 - 2312 - 18
5 - 11
% smoking
Europeancardiovascular
disease statistics
49
Table 4.3 Prevalence of smoking, adults aged 35-64, by sex, latest available data,MONICA Project populations
MONICA population MONICA Year of survey Men Womenpopulation code % %
Belgium-Charleroi BEL-CHA 1990/93 48 29Belgium-Ghent BEL-GHE 1990/92 43 27Czech Republic CZE-CZE 1992 39 23Denmark-Glostrup DEN-GLO 1991/92 43 45Finland-Kuopio Province FIN-KUO 1992 30 13Finland-North Karelia FIN-NKA 1992 27 11Finland-Turku/Loimaa FIN-TUL 1992 29 19France-Lille FRA-LIL 1995/96 33 17France-Strasbourg FRA-STR 1995/97 23 15France-Toulouse FRA-TOU 1994/96 24 22Germany-Augsburg (rural) GER-AUR 1994/95 24 16Germany-Augsburg (urban) GER-AUU 1995/95 35 25Germany-Bremen GER-BRE 1991/92 45 30Germany-East Germany GER-EGE 1993/94 26 11Iceland ICE-ICE 1993/94 23 31Italy-Area Brianza ITA-BRI 1993/94 34 23Italy-Friuli ITA-FRI 1994 29 22Lithuania-Kaunas LTU-KAU 1992/93 35 4Poland-Tarnobrzeg Voivodship POL-TAR 1992/93 54 21Poland-Warsaw POL-WAR 1993 52 34Russia-Moscow (control) RUS-MOC 1992/95 47 14Russia-Novosibirsk (control) RUS-NOC 1995 60 6Spain-Catalonia SPA-CAT 1994/96 41 15Sweden-Gothenburg SWE-GOT 1994/96 25 29Sweden-Northern Sweden SWE-NSW 1994 21 28Switzerland-Ticino SWI-TIC 1993/93 36 26Switzerland-Vaud/Fribourg SWI-VFA 1992/93 27 25UK-Belfast UNK-BEL 1991/92 29 25UK-Glasgow UNK-GLA 1995 41 41Yugoslavia-Novi Sad YUG-NOS 1994/95 49 30
"Smoking" defined as daily cigarette smoking.
Age-standardised levels; consult WHO MONICA Project for details of measurement and age-standardisation.
Source: WHO MONICA Project, with permission (see Acknowledgements).
Table 4.4 Prevalence of smoking,15 year olds,1989/90 and 1993/94
Boys Girls
1989/90 1993/94 1989/90 1993/94
% % % %
Austria 23 29 20 31Belgium - Flemish speaking 15 32 17 18Belgium - French speaking 23 21Czech Republic 16 12Denmark 14 24Estonia 22 6Finland 33 30 32 26France - Nancy and Toulouse 23 25Germany - Nordrhein Westfalen 21 29Hungary 31 25 20 19Israel 9 9Latvia 33 14Lithuania 15 4Norway 21 20 23 21Poland 20 23 10 13Russian Federation - St. Petersburg 19 10Slovakia 19 5Spain 18 20 27 27Sweden 15 15 20 19United Kingdom - Nothern Ireland 23 25United Kingdom - Scotland 16 21 18 26United Kingdom - Wales 14 18 22 27
"Smoking" defined as smoking at least once a week.
Source: World Health Organization (1997) Smoking drinking and drug taking in the European Region. WHO:Copenhagen.
Europeancardiovascular
disease statistics
50
Tabl
e 4.
5Pr
eval
ence
of s
mok
ing,
adu
lts a
ged
15 a
nd o
ver,
by s
ex, 1
980-
1997
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
MEN
%%
%%
%%
%%
%%
%%
%%
%%
%%
Aus
tria
3436
42Be
laru
s55
5553
Belg
ium
5347
4745
4642
4239
3833
3131
3333
3431
Bulg
aria
4949
4941
Cze
ch R
epub
lic43
33D
enm
ark
5750
4747
4747
3737
4137
Esto
nia
4549
5248
Finl
and
3326
3232
3432
3333
3333
3233
3330
2726
27Fr
ance
4650
5446
4846
4836
Ger
man
y34
33G
reec
e60
46Ic
elan
d36
3331
3131
2826
2827
2828
Irel
and
3937
3634
3032
3130
3031
28Is
rael
4744
3840
4039
3833
3131
Ital
y35
3434
3533
Net
herl
ands
5241
4442
3742
4442
4243
3540
39N
orw
ay42
4141
4142
4140
4039
3836
3637
3735
3334
35Po
rtug
al46
4138
3634
4638
3030
Rus
sia
Fede
ratio
n47
31Sl
ovak
ia33
24Sp
ain
4444
42Sw
eden
3634
3432
3330
2929
2826
2626
2523
2222
2117
Uni
ted
Kin
gdom
4238
3635
3331
2928
29
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
WO
MEN
%%
%%
%%
%%
%%
%%
%%
%%
%%
Aus
tria
1720
27Be
laru
s4
55
Belg
ium
2827
2627
2626
2426
2624
2119
1924
2722
Bulg
aria
1717
1717
Cze
ch R
epub
lic31
20D
enm
ark
4441
4241
4041
4037
3733
Esto
nia
1519
2422
Finl
and
1719
1619
1714
1821
2019
2022
2019
1915
18Fr
ance
1729
3330
3335
3323
Ger
man
y20
20G
reec
e32
28Ic
elan
d31
3233
3030
3027
2627
2826
Irel
and
3232
3231
2727
2927
3026
29Is
rael
2930
2532
3028
2524
2525
Ital
y16
1718
17N
ethe
rlan
ds34
3333
3429
3132
3031
3227
3232
Nor
way
3132
3233
3332
3232
3434
3333
3433
3232
3333
Port
ugal
19
109
512
157
7R
ussi
an F
eder
atio
n12
7Sl
ovak
ia16
13Sp
ain
2125
25Sw
eden
2927
2826
2827
2726
2626
2624
2723
2424
2322
Uni
ted
Kin
gdom
3733
3231
3029
2826
28
"Sm
okin
g" d
efin
ed a
s re
gula
r da
ily s
mok
ing.
Sour
ce:
Wor
ld H
ealth
Org
anis
atio
n (1
999)
Eur
opea
n H
ealth
for
All
stat
istic
al d
atab
ase.
htt
p://w
ww
.who
.dk/
Europeancardiovascular
disease statistics
51
Table 4.6 Prevalence of smoking, adults aged 15and over, by sex, 1974 - 1994
1970s 1980s 1990s% % %
Austria Survey year 1979 1986 1991Men 41 40 36Women 17 21 20
Belgium Survey year 1985 1992Men 45 33Women 27 24
Denmark Survey year 1975 1985 1993Men 60 51 45Women 46 42 39
Finland Survey year 1978/79 1983/85 1995Men 36 32 29Women 18 17 19
France Survey year 1980/81 1986/87 1991/92Men 44 44 39Women 16 20 20
Germany Survey year 1978 1989 1993Men 42 33 32Women 16 18 18
Iceland Survey year 1987 1994Men 36 27Women 32 28
Ireland Survey year 1974/75 1984/85 1993/94Men 45 46 29Women 37 32 28
Italy Survey year 1980 1983 1994Men 54 46 34Women 17 18 17
Netherlands Survey year 1975 1985 1992/93Men 65 43 43Women 40 33 31
Norway Survey year 1975 1985 1994Men 48 42 35Women 33 32 31
Spain Survey year 1987 1993Men 55 44Women 23 21
Sweden Survey year 1977 1984 1994Men 41 33 22Women 32 28 24
United Kingdom Survey year 1974 1984 1994Men 51 36 28Women 41 32 26
For smoking definitions see source.
Source: Statistics Sweden (1997) Tobacco consumption 1970-1994 in the Member states of the European Union andin Norway and Iceland. Statistics Sweden: Stockholm.
Europeancardiovascular
disease statistics
52
Figure 4.6 Prevalence of smoking, adults aged 15and over, by sex, 1974 - 1994
Austria
0
10
20
30
40
50
1975 1980 1985 1990 1995
%
Denmark
0
1020
3040
5060
70
1970 1975 1980 1985 1990 1995
%
Finland
05
10152025303540
1975 1980 1985 1990 1995
%
France
0
10
20
30
40
50
1975 1980 1985 1990 1995
%
Germany
0
10
20
30
40
50
1975 1980 1985 1990 1995
%
Ireland
0
10
20
30
40
50
1970 1975 1980 1985 1990 1995
%
Italy
0
10
20
30
40
50
60
1975 1980 1985 1990 1995
%
Netherlands
0
1020
3040
5060
70
1970 1975 1980 1985 1990 1995
%
Norway
0
10
20
30
40
50
60
1970 1975 1980 1985 1990 1995
%
Sweden
0
10
20
30
40
50
1975 1980 1985 1990 1995
%
United Kingdom
0
10
20
30
40
50
60
1970 1975 1980 1985 1990 1995
%
Men
Women
Europeancardiovascular
disease statistics
53
5. DietMortality and morbidity attritutable to poor dietsIt is now universally recognised that a diet which is high in fat, particularly saturated fat, and low
in complex carbohydrates, fruit and vegetables increases the risk of chronic diseases - particularly
CVD and cancer1,2. However there are no properly worked out estimates of the mortality or
morbidity attributable to such a poor diet. Perhaps the best estimate is that of the National
Institute of Public Health in Stockholm who suggest that 5% of DALYs lost in the EU are lost
due to diets high in saturated fat and low in fruit and vegetables (compared with 9% lost due to
smoking)3.
Prevalence of poor dietsThe data on diets in Europe presented here come from two main sources: a questionnaire based
survey carried out by the World Health Organization (WHO) Regional Office for Europe4 and
food supply data published by the Food and Agriculture Organization of the United Nations
(FAO). Both sources have deficiencies.
The WHO requested data from dietary surveys but these surveys were carried out in different
ways, in different years and with different age groups. The data published by the FAO are calculated
from the food produced in and imported into countries minus the food exported, fed to animals,
or otherwise not available for human consumption, divided by the population size. The FAO
data thus provide information about average availability per person rather than about actual
food consumption. It is therefore likely to give figures which are higher than actual food
consumption in wealthy countries where substantial amounts of food are wasted, and to give
figures which are lower than actual consumption in countries where people grow crops or raise
animals in their back gardens or small holdings. But there are also major differences between the
two sets of data which are not easy to explain.
However both sources of data suggests that diets in Europe are often poor. For example the
WHO recommends that average fruit and vegetable intake should be at least 400g of fruit and
vegetables per person per day5. But the dietary survey data shows that adult intake of fruit and
vegetables is less than 400g of fruit and vegetables per day in 20 of the 25 countries for which
data are available (Table 5.1). The WHO also recommend that fat intake should be less than
30% of total energy but the dietary survey data shows that 21 out of 26 countries fail to meet
this goal (Table 5.2).
In general both the dietary intake and the FAO6 data show that fruit and vegetable intake is
higher in Southern European countries than it is in Northern, Western, Central and Eastern
European countries. For example both sets of data indicate that people in Spain eat twice as
much fruit and vegetables as in the UK and three times as much as in Kazakhstan (Tables 5.1 and
5.2, Figure 5.2).
In general the two sets of data also show that fat intake is higher in Northern and Western
Europeancardiovascular
disease statistics
54
European countries than in Southern, Central and Eastern European countries. For example
both the WHO and the FAO data indicate that fat intake is about 40% lower in Turkey than it
is in Belgium (Tables 5.3 and 5.4, Figure 5.4).
Trends in dietsOnly the FAO data show can show trends in diet. They show for example that there have been
reductions in fat intake and increases in fruit, vegetable and cereal consumption over the past 20
years in many Northern and Western European countries. In Southern, Central and Eastern
European countries where fat intake was historically low, intakes are currently rising. Conversely
fruit, vegetable and cereal consumption is now declining in these countries (or at least not
increasing). In other words the differences in the diets between countries described above were
greater in the past and dietary patterns across Europe are now converging (Tables 5.2, 5.4 and
5.5, Figures 5.2, 5.4 and 5.5).
1 World Health Organization. Study group on diet, nutrition and prevention of non-communicable diseases (1990)Diet, nutrition and the prevention of chronic disease: Report of a World Health Organization Study Group. TechnicalReport Series: 797. WHO: Geneva.
2 European Heart Network (1998) Food, nutrition and cardiovascular disease prevention in the European Union.EHN: Brussels.
3 National Institute of Public Health, Stockholm (1997) Determinants of the burden of disease in the EuropeanUnion. NIPH: Stockholm.
4 The WHO dietary intake data has been supplemented with similar dietary intake data published in a recent supplementof the British Journal of Nutrition (Volume 81, Supplement Number 2). See Tables 5.1 and 5.3.
5 World Health Organization. Study group on diet, nutrition and prevention of non-communicable diseases (1990)Diet, nutrition and the prevention of chronic disease: Report of a World Health Organization Study Group. TechnicalReport Series: 797. WHO: Geneva.
6 FAO data for the availability of fruit and vegetable and of cereals are expressed as a percentage of total availableenergy, because expressing the data in this way reduces the effects of differences in wastage or loss when comparingthe food availability in different countries, or food availability with published dietary goals. 400g of fruit andvegetables per day is equivalent to about 7% of total energy, 100g of cereals is equivalent to about 6% of totalenergy (World Cancer Research Fund and American Institute for Cancer Research (1997) Food, nutrition and theprevention of cancer: a global perspective. AICR: Washington.)
Europeancardiovascular
disease statistics
55
Tabl
e 5.
1Fr
uit a
nd v
eget
able
con
sum
ptio
n, a
dults
by
sex,
late
st a
vaila
ble
year
Vege
tabl
esFr
uit
Frui
t and
veg
etab
les
g/pe
rson
/day
g/pe
rson
/day
g/pe
rson
/day
Year
of s
urve
yA
ge g
roup
sur
veye
dM
enW
omen
Tota
lM
enW
omen
Tota
lM
enW
omen
Tota
l
Aus
tria
*Ea
rly
1990
's19
and
abo
ve14
518
332
8A
zerb
aija
n19
94/9
518
and
abo
ve12
146
166
Belg
ium
*19
80/8
425
-74
139
172
155
207
205
206
346
377
360
Cro
atia
1990
18 a
nd a
bove
157
142
299
Den
mar
k19
9519
-64
109
119
115
142
174
159
251
293
273
Esto
nia
1997
18 a
nd a
bove
241
209
225
249
270
259
380
377
378
Finl
and*
1992
25-6
443
3Fr
ance
*19
93/9
419
-64
9310
920
218
918
418
728
229
328
8G
erm
any
- Wes
t*19
87/8
818
-88
231
257
244
Ger
man
y - E
ast*
1991
/92
18-8
033
835
934
9H
unga
ry19
92/9
419
and
abo
ve20
115
936
0Ic
elan
d19
9018
and
abo
ve72
7172
134
169
152
206
240
224
Irel
and
1990
18 a
nd a
bove
121
114
118
9312
911
121
424
322
9It
aly*
1994
/96
18-6
043
143
443
3K
azak
stan
1996
18 a
nd a
bove
129
130
130
3139
3516
317
216
8La
tvia
1997
19-6
420
116
718
366
9783
267
264
266
Lith
uani
a19
9718
and
abo
ve21
116
818
913
820
217
034
936
935
9M
aced
onia
, Fm
r Y
ug R
ep19
9618
and
abo
ve23
014
437
4N
orw
ay19
93/9
416
-79
125
134
130
209
212
211
334
346
341
Port
ugal
1980
19-6
423
321
922
617
217
417
340
539
339
9Sl
oven
ia19
9718
and
abo
ve33
717
951
6Sp
ain
- Cat
alon
ia*
1992
18-6
045
550
048
0Sw
eden
*19
8915
-74
240
290
265
Ukr
aine
1997
18 a
nd a
bove
190
8728
5U
nite
d K
ingd
om*
1986
/87
16-6
425
324
224
8U
zbek
ista
n19
8418
and
abo
ve35
230
933
079
7878
431
386
408
'Veg
etab
les'
doe
s no
t inc
lude
pot
atoe
s ex
cept
in I
taly
and
Ger
man
y.
Sour
ces:
Wor
ld H
ealth
Org
aniz
atio
n (1
999)
, per
sona
l com
mun
icat
ion;
* B
ritis
h Jo
urna
l of N
utri
tion
(199
9) F
ood-
base
d D
ieta
ry G
uide
lines
- A
Sta
ged
App
roac
h. V
olum
e 81
Sup
plem
ent N
umbe
r 2.
Europeancardiovascular
disease statistics
56
Tabl
e 5.
2Pe
rcen
tage
of t
otal
ene
rgy
from
frui
t and
veg
etab
les,
197
2-19
9719
7219
7319
7419
7519
7619
7719
7819
7919
8019
8119
8219
8319
8419
8519
8619
8719
8819
8919
9019
9119
9219
9319
9419
9519
9619
97
Alb
ania
4.69
4.73
4.62
4.49
4.60
4.32
4.59
4.49
4.15
4.15
4.86
4.71
4.18
4.15
3.96
4.01
3.34
4.04
3.79
3.98
3.34
4.13
4.38
5.53
5.83
5.40
Arm
enia
8.53
6.18
7.78
8.62
7.67
6.28
Aus
tria
5.38
6.10
5.68
6.25
5.93
5.93
5.92
6.42
6.12
5.34
6.44
5.57
5.82
5.51
5.95
5.84
6.44
6.67
6.22
6.23
6.48
7.06
6.63
5.60
5.22
6.03
Aze
rbai
jan
5.61
5.80
6.16
6.34
5.73
5.54
Bela
rus
3.01
3.26
3.13
3.05
3.11
3.06
Belg
ium
-Lux
embo
urg
5.28
5.06
5.11
4.67
4.54
4.91
5.27
4.71
4.75
4.59
4.93
4.55
4.70
4.47
4.69
4.66
5.43
5.66
5.77
6.44
7.35
6.21
6.43
6.15
6.82
6.85
Bosn
ia a
nd H
erze
govi
na5.
084.
814.
555.
195.
535.
44Bu
lgar
ia6.
076.
195.
865.
885.
885.
535.
525.
344.
965.
295.
365.
235.
495.
125.
255.
195.
015.
135.
355.
195.
394.
294.
866.
195.
745.
36C
roat
ia4.
626.
016.
406.
837.
547.
00C
zech
Rep
ublic
4.03
4.13
4.15
4.36
4.28
Cze
chos
lova
kia
2.92
3.27
3.41
3.25
3.11
3.39
3.46
3.27
3.55
3.10
4.32
4.16
4.00
3.99
4.14
4.25
3.87
4.01
3.49
3.73
3.64
Den
mar
k3.
433.
803.
543.
483.
814.
063.
724.
143.
703.
513.
663.
774.
054.
104.
614.
464.
654.
624.
814.
804.
984.
694.
484.
235.
125.
47Es
toni
a2.
693.
342.
803.
713.
684.
10Fi
nlan
d2.
592.
583.
233.
593.
603.
413.
763.
963.
963.
903.
834.
063.
953.
483.
754.
234.
144.
214.
114.
164.
194.
204.
643.
514.
294.
18Fr
ance
5.43
5.34
5.12
4.95
4.77
4.59
4.83
4.62
4.54
4.44
4.77
4.54
4.88
4.86
5.06
4.74
5.00
4.87
4.97
4.81
5.16
4.88
5.05
5.23
5.07
4.68
Geo
rgia
5.15
6.17
5.75
5.53
4.69
5.75
Ger
man
y5.
305.
655.
025.
405.
245.
205.
365.
335.
214.
675.
584.
985.
415.
215.
695.
465.
895.
786.
175.
727.
075.
916.
105.
755.
915.
77G
reec
e8.
779.
149.
839.
248.
427.
898.
638.
449.
4110
.66
9.41
9.50
9.83
9.64
8.73
8.42
10.2
09.
499.
629.
729.
6010
.25
10.3
99.
869.
009.
31H
unga
ry4.
614.
744.
774.
534.
564.
774.
774.
694.
554.
454.
394.
354.
324.
204.
244.
204.
504.
304.
394.
544.
524.
885.
094.
734.
905.
03Ic
elan
d2.
672.
832.
772.
672.
982.
802.
882.
752.
722.
712.
892.
802.
852.
803.
013.
333.
763.
773.
573.
884.
014.
064.
094.
084.
174.
05Ir
elan
d3.
012.
983.
093.
143.
343.
253.
513.
583.
683.
703.
843.
393.
623.
573.
633.
783.
863.
934.
273.
984.
134.
124.
023.
864.
393.
82Is
rael
9.57
8.83
8.74
8.32
8.44
8.07
7.78
8.01
7.57
8.02
8.66
9.11
8.76
8.30
8.73
8.76
8.74
9.29
9.43
7.94
10.2
09.
668.
989.
589.
699.
33It
aly
6.96
6.97
7.06
7.08
7.29
6.66
6.52
6.22
6.65
6.72
7.39
7.46
7.24
7.08
7.11
7.20
7.19
7.45
7.28
7.28
8.23
7.49
7.38
7.07
7.49
7.23
Kaz
akhs
tan
1.73
1.27
1.16
1.34
1.40
1.39
Kyr
gyzs
tan
3.08
1.98
2.40
2.02
1.73
2.18
Latv
ia3.
634.
293.
653.
913.
394.
06Li
thua
nia
2.69
4.01
3.35
3.02
3.49
4.24
Mac
edon
ia, F
mr
Yug
Rep
8.41
7.21
7.45
8.18
8.14
6.97
Mal
ta4.
844.
844.
964.
985.
264.
834.
384.
655.
235.
105.
195.
145.
365.
415.
485.
645.
855.
626.
236.
196.
216.
836.
667.
567.
167.
30M
oldo
va, R
ep o
f4.
665.
165.
255.
414.
775.
64N
ethe
rlan
ds4.
955.
165.
034.
965.
305.
255.
795.
935.
435.
105.
835.
425.
595.
075.
825.
735.
755.
775.
955.
557.
086.
406.
646.
255.
595.
40N
orw
ay4.
514.
364.
744.
424.
634.
444.
604.
344.
444.
574.
924.
574.
794.
824.
794.
835.
375.
245.
015.
055.
115.
305.
255.
135.
145.
11Po
land
2.65
2.83
2.68
2.91
2.98
3.31
3.44
3.55
3.20
3.48
3.73
3.44
3.70
3.20
3.51
2.83
3.36
3.34
3.51
3.91
3.74
4.11
3.75
4.22
4.32
4.32
Port
ugal
6.15
5.86
6.04
6.65
5.32
4.92
5.12
5.08
4.89
4.52
5.19
5.06
5.13
5.26
5.50
5.97
5.47
6.36
7.10
6.56
6.53
6.76
6.51
7.21
6.71
6.47
Rom
ania
3.73
3.89
3.60
3.72
4.55
4.36
4.59
5.00
4.33
5.13
6.88
6.52
6.93
6.50
5.68
5.19
5.66
5.58
5.02
4.37
4.41
5.35
4.86
4.90
5.16
4.77
Rus
sian
Fed
erat
ion
3.31
2.93
2.87
3.11
3.26
3.41
Slov
akia
3.65
3.41
3.68
4.87
4.28
Slov
enia
4.22
4.72
5.24
5.44
5.04
4.81
Spai
n7.
678.
137.
997.
577.
167.
217.
727.
677.
607.
577.
627.
617.
547.
677.
577.
707.
928.
538.
407.
738.
207.
757.
196.
477.
006.
85Sw
eden
4.27
4.19
4.23
4.30
4.33
4.25
4.17
4.45
4.16
4.40
4.27
4.19
4.23
4.52
4.63
4.76
5.36
5.49
5.61
5.62
5.11
4.91
5.12
4.72
4.87
5.05
Switz
erla
nd5.
606.
406.
316.
916.
336.
016.
646.
676.
355.
906.
676.
116.
476.
236.
316.
046.
235.
765.
845.
726.
085.
815.
705.
916.
025.
74Ta
jikis
tan
3.85
3.87
3.79
4.07
3.67
4.02
Turk
ey9.
018.
809.
138.
648.
328.
499.
129.
319.
189.
158.
878.
808.
588.
498.
127.
947.
897.
767.
958.
058.
138.
027.
808.
328.
027.
80Tu
rkm
enis
tan
3.41
3.95
3.74
4.21
4.50
4.75
Ukr
aine
3.10
3.37
2.90
3.57
3.50
3.78
Uni
ted
Kin
gdom
3.96
4.18
4.15
3.79
3.70
4.14
3.95
3.98
3.96
4.02
4.27
4.12
4.26
4.15
4.22
4.23
4.50
4.67
4.61
4.62
4.66
4.86
4.93
4.78
4.86
4.75
USS
R2.
733.
123.
053.
153.
233.
193.
293.
303.
323.
453.
543.
663.
723.
503.
943.
733.
703.
373.
173.
38U
zbek
ista
n3.
663.
463.
733.
723.
963.
75Y
ugos
lavi
a Fm
r4.
014.
363.
964.
194.
544.
643.
984.
254.
394.
113.
964.
073.
923.
443.
723.
553.
573.
713.
973.
93Y
ugos
lavi
a5.
576.
115.
655.
007.
056.
87
FAO
item
cod
es: (
2919
+291
8)/2
901
Sour
ce:
Food
and
Agr
icul
ture
Org
aniz
atio
n of
the
Uni
ted
Nat
ions
(199
9) h
ttp:
//ww
w.fa
o.or
g/
Europeancardiovascular
disease statistics
57
Figure 5.2a Percentage of total energy from fruit andvegetables, 1997
Figure 5.2b Percentage of total energy from fruit andvegetables, 1972-1997, selected countries
6.48 - 9.33
% of totalenergy
5.41 - 6.474.76 - 5.404.06 - 4.751.39 - 4.05
0
2
4
6
8
10
12
72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97Year
% t
ota
l en
erg
y
Greece
Italy
Bulgaria
Ireland
UK
Norway
Europeancardiovascular
disease statistics
58
Table 5.3 Percentage of total energy from fat,adults by sex, latest available year
Year of survey Age group surveyed Men Women Total
Austria* Early 1990's 19 and above 38.2Azerbaijan 1994/95 18 and above 16.4Belgium* 1980/84 18 and above 41.8 42.6 42.2Croatia 1990 18 and above 36.0Denmark* 1995 15-80 37.0 37.0 37.0Estonia 1997 18 and above 36.4 36.2 36.3Finland* 1992 25-64 33.8France* 1993/94 19-64 37.7 40.0 38.9Germany - West* 1987/88 18-88 38.4 39.2 38.8Germany - East* 1991/92 18-80 41.3 43.9 42.6Hungary 1992/94 19 and above 38.1 38.0 38.1Iceland 1990 18 and above 42.6 40.3 41.5Ireland 1990 18 and above 34.8 35.0 34.9Italy* 1994/96 18-60 31.7 33.3 32.6Kazakstan 1996 18 and above 28.0Latvia 1997 19-64 42.7 41.2 42.0Lithuania 1997 18 and above 45.4 42.6 44.0Netherlands 1997/98 22-64 35.9Norway 1993/94 16-79 31.0 30.0 30.5Portugal 1980 19-64 37.5 31.5 34.5Slovenia 1997 18 and above 43.7 44.9 44.3Spain - Catalonia* 1992 18-60 37.5 38.4 38.0Sweden* 1989 15-74 37.0 36.0 36.5Ukraine 1997 18 and above 25.1Turkey 1984 18 and above 24.0United Kingdom* 1986/87 16-64 38.0 39.0 38.5Uzbekistan 1984 18 and above 29.0 28.3 28.7
Sources: World Health Organization (1999), personal communication;*British Journal of Nutrition (1999) Food-based Dietary Guidelines - A Staged Approach. Volume 81Supplement Number 2.
Europeancardiovascular
disease statistics
59
Tabl
e 5.
4Pe
rcen
tage
of t
otal
ene
rgy
from
fat,
1972
-199
719
7219
7319
7419
7519
7619
7719
7819
7919
8019
8119
8219
8319
8419
8519
8619
8719
8819
8919
9019
9119
9219
9319
9419
9519
9619
97
Alb
ania
16.7
518
.10
18.7
419
.53
19.3
619
.28
19.2
421
.10
20.2
920
.40
19.9
020
.70
20.3
920
.33
19.5
321
.05
20.9
121
.81
21.6
526
.31
23.6
724
.35
24.2
227
.06
25.2
623
.96
Arm
enia
14.7
014
.61
17.7
618
.00
20.1
920
.63
Aus
tria
36.1
836
.08
36.0
836
.65
37.8
038
.04
38.6
339
.00
39.5
040
.22
40.1
340
.68
40.4
841
.13
40.7
640
.79
39.5
240
.35
40.3
540
.30
40.8
140
.91
41.4
040
.02
40.1
641
.08
Aze
rbai
jan
15.0
013
.45
14.7
614
.28
14.8
015
.46
Bela
rus
28.3
927
.14
27.0
526
.10
26.5
326
.66
Belg
ium
-Lux
embo
urg
39.3
238
.42
39.3
136
.76
36.4
836
.45
36.5
837
.92
38.0
537
.84
38.7
639
.17
38.8
239
.61
39.7
539
.65
40.6
140
.15
39.4
739
.85
39.1
239
.73
40.2
240
.56
40.0
439
.68
Bosn
ia a
nd H
erze
govi
na16
.87
16.9
013
.57
13.3
217
.46
15.5
1Bu
lgar
ia23
.06
23.3
123
.87
25.2
025
.11
25.8
025
.71
26.5
926
.38
27.0
627
.46
28.2
028
.32
29.2
129
.72
29.6
929
.59
30.3
830
.21
29.6
131
.48
30.0
828
.85
29.3
929
.51
30.1
8C
roat
ia29
.45
26.4
726
.11
26.2
725
.43
25.2
4C
zech
Rep
ublic
34.3
031
.28
30.2
030
.16
30.7
2C
zech
oslo
vaki
a30
.79
30.8
330
.91
31.3
631
.16
31.8
531
.88
32.3
033
.11
33.1
932
.76
33.4
133
.68
34.1
934
.18
34.3
134
.33
34.3
233
.94
31.8
832
.91
Den
mar
k40
.08
38.3
038
.27
38.6
637
.01
38.7
438
.23
39.3
339
.61
38.6
337
.53
36.7
036
.47
37.0
835
.99
36.2
137
.71
37.6
137
.54
36.4
038
.05
36.8
536
.27
36.6
436
.15
34.9
9Es
toni
a27
.27
27.6
028
.63
28.2
628
.67
28.6
0Fi
nlan
d36
.72
36.9
536
.76
38.3
138
.52
38.7
037
.81
38.6
938
.13
38.1
439
.08
38.8
637
.58
37.5
638
.63
37.6
436
.25
36.3
435
.49
36.2
536
.53
37.1
036
.16
37.4
137
.03
36.9
0Fr
ance
35.5
735
.27
35.6
436
.18
37.0
937
.41
38.1
638
.85
39.4
439
.71
39.1
139
.08
39.4
739
.77
40.0
340
.93
40.9
841
.51
41.3
941
.61
41.8
141
.72
41.8
141
.69
41.6
441
.96
Geo
rgia
11.9
612
.88
12.5
513
.53
13.3
713
.44
Ger
man
y36
.52
35.9
936
.15
36.2
236
.14
36.5
936
.18
36.4
936
.67
37.2
436
.76
36.3
636
.28
36.6
236
.08
36.6
136
.60
36.6
038
.36
38.3
837
.95
38.3
738
.30
37.7
439
.00
38.4
4G
reec
e32
.54
33.3
931
.91
32.6
832
.81
33.2
933
.20
33.3
434
.90
32.9
733
.44
34.6
034
.84
35.4
035
.56
35.6
735
.48
36.2
435
.76
36.8
136
.86
35.8
536
.54
37.3
238
.52
37.8
3H
unga
ry31
.32
31.6
331
.82
32.4
032
.85
33.1
233
.41
33.8
733
.74
34.6
034
.54
35.7
736
.04
35.8
335
.98
36.7
037
.29
36.8
237
.13
37.3
936
.45
36.7
437
.02
37.3
336
.87
37.2
4Ic
elan
d37
.48
36.9
136
.51
38.8
136
.12
36.5
536
.38
37.2
238
.82
40.4
838
.25
37.9
937
.93
38.2
038
.01
35.8
836
.01
35.8
336
.67
34.7
935
.33
34.8
235
.26
34.5
034
.31
34.8
0Ir
elan
d33
.10
32.3
732
.53
32.9
734
.01
33.3
933
.86
34.1
735
.81
36.6
636
.16
35.5
235
.60
35.4
335
.00
35.6
635
.19
35.3
033
.91
33.8
133
.41
33.3
132
.96
32.5
132
.39
33.5
2Is
rael
29.8
131
.49
30.7
631
.06
31.4
031
.38
31.9
931
.53
31.3
731
.88
32.5
532
.41
33.9
633
.78
33.7
533
.81
34.5
033
.00
33.0
332
.95
33.7
132
.84
31.1
832
.71
32.1
531
.09
Ital
y30
.26
29.5
530
.34
30.6
530
.64
29.9
832
.11
32.1
432
.34
33.0
834
.13
34.9
534
.67
36.2
136
.75
37.7
037
.62
37.5
937
.87
37.6
936
.85
37.5
137
.91
37.8
537
.58
37.6
8K
azak
hsta
n23
.65
22.7
221
.73
21.7
221
.15
19.3
3K
yrgy
zsta
n19
.27
20.4
619
.32
21.5
417
.89
17.4
2La
tvia
27.0
725
.47
24.5
626
.39
26.0
827
.36
Lith
uani
a25
.36
26.1
123
.32
21.6
322
.54
22.8
2M
aced
onia
, Fm
r Y
ug R
ep21
.37
24.4
024
.87
24.2
126
.36
25.2
4M
alta
28.0
826
.11
26.1
427
.78
28.6
030
.02
30.2
930
.84
30.4
530
.68
31.1
231
.20
31.2
832
.88
31.4
232
.65
30.8
531
.94
30.6
231
.58
31.6
629
.85
28.2
630
.53
29.7
928
.32
Mol
dova
, Rep
of
20.0
618
.05
19.3
419
.60
18.8
816
.75
Net
herl
ands
39.3
238
.61
38.5
138
.62
37.3
737
.74
38.4
237
.70
38.2
839
.27
38.7
138
.05
39.1
238
.44
37.7
638
.50
38.7
438
.42
38.6
337
.33
37.0
938
.53
38.6
540
.95
39.0
638
.52
Nor
way
40.7
940
.86
41.2
342
.46
40.7
939
.95
40.2
439
.25
39.8
738
.12
39.9
338
.49
38.9
038
.21
38.1
937
.90
37.3
536
.73
36.6
636
.87
36.8
736
.95
36.8
037
.20
37.1
536
.35
Pola
nd28
.03
28.6
328
.94
29.5
529
.21
29.7
629
.89
29.8
829
.29
30.4
128
.03
28.6
329
.39
30.1
130
.53
30.5
430
.52
30.7
729
.88
30.7
430
.96
29.8
329
.84
30.2
030
.08
29.8
3Po
rtug
al25
.12
24.9
225
.73
25.8
326
.64
27.9
328
.46
28.9
127
.77
28.6
729
.18
28.8
328
.90
28.7
227
.48
28.5
429
.64
30.1
031
.52
31.9
831
.82
31.7
831
.62
31.5
332
.17
32.3
1R
oman
ia23
.72
23.9
622
.91
25.0
625
.84
26.9
126
.85
27.6
426
.22
25.8
626
.57
26.8
827
.69
27.1
927
.15
27.4
326
.73
25.6
429
.10
27.5
124
.60
23.1
923
.09
24.4
623
.54
22.5
9R
ussi
an F
eder
atio
n25
.69
25.4
325
.53
25.1
924
.78
24.9
7Sl
ovak
ia32
.81
32.0
433
.10
31.1
731
.57
Slov
enia
31.2
831
.76
30.7
630
.29
28.2
629
.49
Spai
n29
.17
29.6
430
.47
30.7
631
.22
31.5
032
.68
32.1
732
.98
34.6
735
.29
35.3
035
.69
35.5
236
.50
36.6
738
.08
37.3
737
.74
38.7
239
.04
39.2
239
.37
39.4
739
.25
39.3
3Sw
eden
35.9
635
.77
35.9
936
.24
36.1
437
.12
37.7
537
.18
37.1
437
.82
36.9
236
.99
36.6
736
.96
37.6
237
.98
37.5
237
.30
37.0
537
.06
35.9
736
.59
37.3
238
.20
36.5
737
.79
Switz
erla
nd38
.28
39.9
939
.40
41.8
540
.86
39.6
640
.06
41.1
841
.28
40.6
341
.28
40.7
941
.03
41.2
341
.21
41.1
541
.05
40.9
540
.78
41.2
540
.20
40.4
341
.20
40.7
840
.12
40.0
9Ta
jikis
tan
18.2
519
.98
19.0
818
.31
17.1
215
.45
Turk
ey23
.66
21.0
321
.80
23.2
723
.77
21.3
022
.21
20.9
523
.56
21.4
522
.30
20.3
322
.17
22.1
522
.57
22.9
724
.57
24.6
423
.51
23.6
323
.57
24.4
224
.21
24.0
224
.53
25.7
5Tu
rkm
enis
tan
24.7
327
.82
26.9
427
.80
25.0
224
.81
Ukr
aine
24.5
023
.28
23.2
123
.21
22.9
323
.06
Uni
ted
Kin
gdom
39.5
438
.37
39.3
238
.21
38.4
937
.19
38.7
938
.29
38.9
538
.92
38.6
538
.86
38.5
138
.46
38.7
638
.64
37.9
637
.92
37.9
738
.13
39.6
038
.94
38.4
739
.21
38.9
838
.75
USS
R23
.64
24.1
324
.56
24.1
324
.86
24.8
424
.92
25.4
225
.28
25.0
124
.87
25.8
226
.24
27.2
027
.02
27.1
827
.86
28.7
928
.03
26.2
8U
zbek
ista
n23
.47
25.2
325
.66
25.4
226
.55
25.9
9Y
ugos
lavi
a Fm
r22
.98
23.7
524
.22
24.7
124
.88
25.3
525
.72
26.1
424
.90
26.0
626
.69
26.0
927
.31
27.4
327
.89
28.9
829
.48
28.3
928
.19
27.5
3Y
ugos
lavi
a36
.45
34.4
836
.55
36.7
637
.05
36.8
2
Sour
ce:
Food
and
Agr
icul
ture
Org
aniz
atio
n of
the
Uni
ted
Nat
ions
(199
9) h
ttp:
//ww
w.fa
o.or
g/
Europeancardiovascular
disease statistics
60
Figure 5.4a Percentage of total energy from fat, 1997
Figure 5.4b Percentage of total energy from fat,1972-1997, selected countries
37.69 - 41.96
% of totalenergy
13.44 - 22.5922.60 - 26.6626.67 - 31.6031.61 - 37.68
0
5
10
15
20
25
30
35
40
45
72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97Year
% t
ota
l en
erg
y
Greece
Italy
Bulgaria
UK
Norway
Ireland
Europeancardiovascular
disease statistics
61
Tabl
e 5.
5Pe
rcen
tage
of t
otal
ene
rgy
from
cer
eals
, 197
2-19
97C
ount
ry19
7219
7319
7419
7519
7619
7719
7819
7919
8019
8119
8219
8319
8419
8519
8619
8719
8819
8919
9019
9119
9219
9319
9419
9519
9619
97
Alb
ania
66.0
365
.08
64.0
263
.79
64.4
865
.46
64.1
061
.90
62.8
462
.94
62.5
762
.90
63.9
163
.12
64.0
861
.43
62.5
859
.75
59.6
554
.67
58.1
256
.93
54.1
246
.38
50.2
152
.78
Arm
enia
61.9
266
.04
57.3
153
.08
54.7
655
.25
Aus
tria
26.0
224
.60
23.8
424
.61
23.1
723
.04
22.2
621
.73
20.8
521
.12
20.2
020
.56
20.8
320
.74
20.1
920
.32
20.0
420
.20
20.3
720
.63
20.3
120
.13
20.6
421
.44
22.3
520
.08
Aze
rbai
jan
64.8
169
.49
67.1
966
.67
65.8
665
.86
Bela
rus
37.3
237
.68
38.2
336
.97
36.5
535
.98
Belg
ium
-Lux
embo
urg
23.0
222
.68
21.5
524
.02
23.8
524
.26
24.0
023
.04
22.6
623
.58
22.4
122
.73
23.8
822
.70
22.5
322
.15
21.6
221
.84
21.6
721
.08
21.2
721
.46
20.9
721
.00
20.3
020
.48
Bosn
ia a
nd H
erze
govi
na59
.38
60.8
866
.90
64.6
057
.86
58.9
2Bu
lgar
ia49
.55
48.7
147
.64
46.3
345
.75
44.8
844
.56
44.3
044
.58
43.4
642
.60
41.6
140
.56
40.2
839
.56
40.0
240
.44
38.9
540
.73
41.3
937
.81
39.5
740
.17
39.3
039
.50
38.1
1C
roat
ia31
.40
31.1
830
.40
29.2
531
.57
30.6
6C
zech
Rep
ublic
24.3
828
.59
30.2
429
.49
30.6
4C
zech
oslo
vaki
a31
.75
30.9
830
.60
30.6
830
.70
30.0
530
.09
29.9
029
.70
29.9
029
.86
29.4
730
.14
30.3
129
.66
30.3
029
.75
30.1
829
.93
31.4
229
.40
Den
mar
k21
.27
20.9
021
.06
20.5
421
.10
21.2
021
.20
20.7
920
.81
21.4
321
.58
22.0
223
.44
22.7
923
.06
23.3
323
.07
23.3
923
.21
23.0
723
.26
24.3
924
.66
25.1
724
.56
25.5
5Es
toni
a32
.03
33.6
731
.94
32.3
334
.45
35.7
5Fi
nlan
d24
.24
23.6
424
.16
23.7
823
.21
23.1
824
.50
24.7
024
.17
24.6
824
.34
23.8
924
.37
24.8
824
.15
24.1
125
.28
25.2
025
.35
24.9
024
.91
23.3
723
.29
24.3
024
.29
25.9
9Fr
ance
22.4
921
.71
22.1
822
.46
22.7
822
.98
22.1
822
.12
22.8
322
.58
23.5
823
.91
23.7
623
.58
23.7
623
.19
23.7
323
.67
23.5
123
.18
22.3
123
.48
23.7
523
.56
23.9
324
.19
Geo
rgia
65.5
760
.87
65.3
364
.81
68.9
263
.91
Ger
man
y22
.35
22.1
422
.43
22.0
422
.14
22.2
122
.20
21.8
322
.02
21.9
921
.73
22.5
123
.03
22.7
922
.62
22.8
222
.60
22.8
421
.89
21.0
420
.60
21.7
822
.54
22.4
622
.42
22.9
0G
reec
e37
.88
35.5
135
.46
35.3
535
.18
35.1
633
.53
32.4
230
.83
31.5
832
.12
30.9
731
.21
30.0
928
.85
30.2
329
.09
28.8
529
.91
29.3
728
.81
29.1
528
.82
29.1
429
.38
29.3
2H
unga
ry36
.74
36.0
135
.57
34.3
934
.83
34.0
533
.34
33.2
232
.01
31.8
631
.00
30.6
030
.61
29.7
629
.41
28.7
528
.96
28.8
728
.84
28.2
328
.28
27.8
327
.00
26.2
025
.21
25.5
1Ic
elan
d21
.18
21.3
122
.03
18.8
621
.42
19.5
919
.07
18.5
817
.88
17.3
518
.49
18.6
219
.69
19.1
219
.79
21.8
722
.25
22.7
821
.85
23.5
023
.50
23.6
322
.13
23.5
621
.39
21.8
9Ir
elan
d26
.28
26.0
226
.08
25.7
925
.96
26.2
424
.15
25.4
523
.92
24.5
426
.36
27.9
726
.86
26.5
126
.72
26.6
226
.85
27.6
427
.58
27.2
727
.71
27.2
927
.55
27.1
327
.68
27.2
3Is
rael
35.7
334
.57
35.1
435
.09
35.3
334
.74
35.1
435
.07
36.5
935
.85
34.6
934
.45
32.7
633
.17
32.9
532
.66
31.5
832
.48
33.2
932
.94
32.4
232
.96
34.3
632
.49
32.5
533
.13
Ital
y37
.79
38.2
936
.94
38.3
337
.27
38.1
137
.16
37.3
136
.36
35.6
533
.40
32.5
833
.96
32.9
432
.98
32.1
632
.52
32.3
431
.80
31.9
531
.58
31.5
331
.18
32.2
732
.24
32.3
4K
azak
hsta
n50
.06
55.1
357
.95
58.1
559
.56
61.3
8K
yrgy
zsta
n53
.34
57.8
357
.54
53.1
759
.98
58.7
5La
tvia
40.6
741
.13
40.4
538
.52
36.2
135
.87
Lith
uani
a45
.97
41.6
046
.89
46.1
843
.78
44.4
1M
aced
onia
, Fm
r Y
ug R
ep49
.14
47.7
443
.58
42.1
238
.90
42.5
9M
alta
38.4
538
.43
40.0
840
.68
38.4
235
.70
35.3
635
.34
34.7
835
.81
34.2
534
.57
33.9
631
.44
33.1
331
.23
32.5
432
.37
33.6
731
.74
31.1
632
.60
33.4
029
.79
32.3
033
.12
Mol
dova
, Rep
of
51.9
152
.08
51.2
452
.36
54.2
256
.13
Net
herl
ands
19.5
220
.56
20.8
920
.57
21.6
520
.56
19.9
420
.49
19.1
219
.71
18.7
319
.82
20.3
919
.76
19.6
219
.42
17.8
317
.52
16.5
317
.21
17.4
317
.18
16.0
214
.61
18.4
317
.75
Nor
way
22.1
722
.76
23.5
223
.76
23.1
423
.51
23.1
224
.08
24.1
826
.39
23.1
325
.50
24.4
024
.65
25.6
126
.32
27.3
527
.66
27.5
527
.68
27.6
327
.68
27.7
027
.06
27.3
227
.64
Pola
nd35
.50
34.6
834
.13
33.1
233
.39
33.1
832
.81
32.8
334
.93
35.2
935
.54
34.1
433
.57
34.1
933
.89
33.7
733
.21
33.0
133
.63
34.4
634
.77
35.0
735
.68
35.6
135
.46
35.1
4Po
rtug
al36
.95
36.9
936
.26
35.5
235
.48
34.4
335
.12
35.8
834
.36
33.7
533
.05
33.2
334
.70
34.5
234
.42
33.1
232
.87
30.6
828
.34
29.0
729
.18
28.9
928
.88
28.0
828
.12
28.3
6R
oman
ia50
.28
49.4
251
.63
47.5
045
.65
44.4
044
.04
41.2
443
.08
43.6
840
.01
40.1
538
.83
38.6
240
.44
41.9
542
.80
43.6
943
.69
46.0
547
.81
48.8
149
.22
48.0
448
.41
51.0
2R
ussi
an F
eder
atio
n41
.96
41.1
742
.00
41.3
542
.12
41.7
3Sl
ovak
ia28
.62
34.4
830
.62
27.1
030
.78
Slov
enia
37.8
934
.94
35.9
033
.62
35.8
133
.82
Spai
n28
.33
28.1
027
.11
27.8
526
.67
26.7
825
.01
24.6
825
.83
24.4
224
.62
24.6
725
.01
24.8
024
.17
23.8
223
.75
23.1
122
.87
22.6
621
.98
23.0
522
.78
22.9
523
.03
23.0
4Sw
eden
20.8
321
.31
21.2
020
.64
21.4
021
.14
20.7
220
.76
21.4
620
.90
21.8
921
.75
22.8
522
.20
21.2
821
.09
21.0
220
.77
21.5
321
.83
23.7
924
.02
22.0
023
.72
23.6
122
.87
Switz
erla
nd23
.43
22.5
921
.38
21.5
521
.71
21.8
322
.84
21.1
121
.36
21.4
920
.32
19.7
519
.74
20.3
120
.00
21.0
720
.79
21.4
021
.55
22.0
822
.32
21.8
622
.45
22.4
021
.35
21.4
7Ta
jikis
tan
67.4
666
.49
67.6
267
.90
69.9
771
.67
Turk
ey51
.12
53.4
551
.79
51.0
950
.11
50.8
750
.20
51.4
850
.79
52.8
251
.64
53.5
251
.20
51.3
850
.55
49.5
549
.12
49.1
449
.41
48.1
649
.45
48.5
250
.17
49.0
849
.13
47.8
8Tu
rkm
enis
tan
58.8
154
.16
56.2
556
.65
58.8
158
.65
Ukr
aine
41.1
343
.17
43.8
743
.59
43.6
944
.11
Uni
ted
Kin
gdom
21.5
721
.10
21.3
422
.28
22.4
922
.39
22.1
021
.16
21.3
721
.15
20.5
121
.37
21.6
722
.77
22.0
522
.59
22.2
522
.37
22.1
922
.68
21.9
622
.05
22.1
122
.58
22.2
622
.43
USS
R41
.36
40.4
139
.65
39.5
338
.97
38.7
038
.88
38.9
238
.65
38.6
638
.46
37.6
237
.28
37.4
837
.64
37.2
337
.02
36.8
637
.24
42.4
1U
zbek
ista
n61
.27
59.0
357
.51
58.3
256
.59
57.3
8Y
ugos
lavi
a Fm
r51
.31
49.4
249
.08
48.3
647
.77
46.9
347
.20
47.0
747
.09
46.7
845
.96
46.7
846
.41
46.7
344
.66
44.6
244
.39
43.8
444
.32
46.6
4Y
ugos
lavi
a32
.76
37.6
331
.40
33.2
830
.63
29.6
1
FAO
item
cod
es: 2
905/
2901
Sour
ce:
Food
and
Agr
icul
ture
Org
aniz
atio
n of
the
Uni
ted
Nat
ions
(199
9) h
ttp:
//ww
w.fa
o.or
g/
Europeancardiovascular
disease statistics
62
Figure 5.5 Percentage of total energy from cereals,1972-1997, selected countries
0
10
20
30
40
50
60
72 73 74 75 78 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97Year
% t
ota
l en
erg
y
Greece
Italy
Bulgaria
UK
Norway
Ireland
Europeancardiovascular
disease statistics
63
6. Physicalactivity
Mortality and morbidity attributable to physicalinactivityAs with diet it is now generally recognised that lack of physical activity increases the risk of CVD
and other chronic diseases1. There have also been some estimates of the mortality and morbidity
attributable to physical inactivity. For example the Global Burden of Disease Study estimates
that in Established Market Economies 5% of DALYs are lost due to physical inactivity and that
in Formerly Socialist Economies of Europe 3% are lost2. The National Institute of Public Health
in Stockholm estimates that 1.4% of DALYs lost in the EU are due to physical inactivity3.
Prevalence of physical inactivityThe data on levels of physical inactivity across Europe are poor. There has only been one multi-
national survey which looked, amongst other things, at levels of physical activity in Europe and
this survey was only carried out in member states of the EU4. Moreover the results of that part of
the survey which were designed to explore levels of physical inactivity are difficult to interpret.
However this survey does show that prevalence of physical inactivity in EU countries is high with
on average 32% of adults carrying out no leisure-time physical activity in a typical week (Tables
6.1 and 6.2). The survey also investigated work-related physical activity and showed that almost
half of the EU population spend 2 - 6 hours daily sitting down at work and one fifth of the
population spend 6 or more hours sitting down at work.
Levels and types of physical activity vary across the member states (Tables 6.1 and 6.2). In
general Southern countries of the EU has higher levels of physical inactivity than Northern and
Western countries (Table 6.2, Figure 6.2).
1 European Heart Network (1999) Physical activity and cardiovascular disease prevention in the European Union.EHN: Brussels.
2 Murray JL, Lopez AD (1996) The global burden of disease. WHO: Geneva.
3 National Institute of Public Health, Stockholm (1997) Determinants of the burden of disease in the EuropeanUnion. NIPH: Stockholm.
4 Institute of European Food Studies, Trinity College, Dublin (1999) A Pan-EU survey on consumer attitudes tophysical activity, body-weight and health. IEFS: Dublin.
Europeancardiovascular
disease statistics
64
Tabl
e 6.
1Pa
rtic
ipat
ion
in v
ario
us p
hysi
cal a
ctiv
ities
in a
typi
cal w
eek,
adu
lts a
ged
15 a
nd o
ver,
1997
, EU
coun
trie
sA
ustr
iaBe
lgiu
mD
enm
ark
Finl
and
Fran
ceG
erm
any
Gre
ece
Irel
and
Ital
yLu
xem
bour
gN
ethe
rlan
dsPo
rtug
alSp
ain
Swed
enU
KTo
tal E
U*
%%
%%
%%
%%
%%
%%
%%
%%
Ath
letic
s3
24
1<1
32
36
33
32
11
3C
yclin
g39
2028
2813
282
157
1753
37
399
17D
anci
ng7
54
102
63
86
66
25
87
5Eq
uest
rian
spo
rt1
12
1<1
1<1
2<1
11
<1<1
2<1
<1Fi
shin
g/an
glin
g2
25
105
24
42
15
43
63
3Fo
otba
ll7
65
25
45
128
58
108
57
6G
arde
ning
3715
3510
1623
1026
1228
323
326
2318
Gol
f<1
<1<1
<1<1
<10
7<1
<1<1
<1<1
54
1H
illw
alki
ng/c
limbi
ng20
1<1
0<1
<11
41
22
<12
<13
2K
eep
fit13
1013
228
715
810
2015
410
2413
10M
artia
l art
s<1
2<1
13
12
2<1
12
21
22
2R
acqu
et s
port
s10
710
76
52
43
68
14
54
5Sw
imm
ing
2010
1015
1012
413
518
174
612
1210
Team
spo
rts
excl
. foo
tbal
l4
35
72
38
64
45
33
63
3W
alki
ng c
ont.
for
30 m
ins
4227
3068
3023
2455
2543
2420
3661
4231
Wat
er s
port
s<1
11
21
<11
<1<1
<12
1<1
1<1
<1W
inte
r sp
orts
152
217
42
1<1
34
31
17
<13
Oth
er2
23
44
62
23
58
3<1
43
4N
one
1338
238
3530
4013
3818
1660
3710
2331
Do
not k
now
<1<1
<1<1
<1<1
<1<1
<1<1
0<1
<1<1
<1<1
* w
eigh
ted
acco
rdin
g to
pop
ulat
ion
size
.
Sour
ce:
Inst
itute
of E
urop
ean
Food
Stu
dies
, Tri
nity
Col
lege
, Dub
lin (1
999)
A P
an-E
U S
urve
y on
Con
sum
er A
ttitu
des
to P
hysi
cal A
ctiv
ity, B
ody-
wei
ght a
nd H
ealth
. IE
FS: D
ublin
.
Europeancardiovascular
disease statistics
65
Table 6.2 Number of hours spent participating invarious physical activities in a typicalweek, adults aged 15 and over, 1997, EUcountries
None <1hour 1-3 hours 3-5 hours > 5hours
% % % % %
Austria 16 4 18 20 42Belgium 42 7 18 15 14Denmark 24 6 16 22 30Finland 10 5 18 26 41France 36 7 20 20 16Germany 31 6 19 19 24Greece 40 4 18 22 16Ireland 14 5 16 28 37Italy 39 7 20 19 14Luxembourg 20 8 19 21 30Netherlands 19 6 18 18 38Portugal 61 7 15 11 5Spain 37 11 17 21 12Sweden 12 4 16 23 45United Kingdom 24 7 17 25 27
EU average* 32 7 18 21 21
* weighted according to population size
Source: Institute of European Food Studies, Trinity College, Dublin (1999). A Pan-EU Survey on Consumer Attitudesto Physical Activity, Body-weight and Health. IEFS: Dublin.
Figure 6.2 Percentage of adults aged 15 and overwho do no physical activity in a typicalweek, 1997
0
10
20
30
40
50
60
70
Fin
lan
d
Swed
en
Irel
and
Au
stri
a
Net
her
lan
ds
Luxe
mb
ou
rg
Den
mar
k
Un
ited
Kin
gd
om
Ger
man
y
EU a
vera
ge
Fran
ce
Spai
n
Ital
y
Gre
ece
Bel
giu
m
Port
ug
al
%
Europeancardiovascular
disease statistics
66
7. AlcoholMortality and morbidity attributable to alcoholconsumptionWhile moderate alcohol consumption reduces the risk of CVD it increases the risk of liver cirrhosis,
injuries and some forms of cancer. On balance, the positive effects of alcohol on the health of
populations are generally outweighed by its negative effects. Overall the Global Burden of Disease
Study estimates that in Established Market Economies 10% of DALYs are lost due to alcohol
consumption and that in Formerly Socialist Economies of Europe 8% are lost1. The National
Institute of Public Health in Stockholm estimates that 8% of DALYs lost in the EU are due to
alcohol consumption2.
Levels of and trends in alcohol consumptionLevels of recorded alcohol consumption vary considerably across Europe3. In general, levels of
consumption are higher in Northern, Southern and Western European countries than in Central
and Eastern European countries (Table 7.1, Figure 7.1).
Levels of alcohol consumption are falling in many Northern, Southern and Western European
countries but rising in a few. For example alcohol consumption in Italy, Spain and France fell by
34%, 32% and 31% respectively between 1986 and 1996, but rose by 7% in the UK. In Central
and Eastern European countries alcohol consumption generally fell rapidly in the mid-to-late
1980s but has begun to rise again since then (Table 7.1).
1 Murray JL, Lopez AD (1996) The global burden of disease. WHO: Geneva.
2 National Institute of Public Health, Stockholm (1997) Determinants of the burden of disease in the EuropeanUnion. NIPH: Stockholm.
3 Levels of actual alcohol consumption may vary less than levels of recorded consumption because there is probablymuch unrecorded consumption in countries with low recorded levels (World Health Organization (1997) Smokingdrinking and drug taking in the European Region. WHO: Copenhagen).
Europeancardiovascular
disease statistics
67
Tabl
e 7.
1A
lcoh
ol c
onsu
mpt
ion,
197
0-19
9719
7019
7119
7219
7319
7419
7519
7619
7719
7819
7919
8019
8119
8219
8319
8419
8519
8619
8719
8819
8919
9019
9119
9219
9319
9419
9519
9619
97
litre
s pu
re a
lcoh
ol p
er y
ear
Aus
tria
10.5
11.7
11.8
12.2
11.5
11.1
11.2
11.2
10.6
11.1
11.0
11.0
9.9
10.2
10.0
9.9
10.0
10.1
10.1
10.3
10.4
10.6
10.0
10.1
9.8
9.8
9.8
Aze
rbai
jan
0.9
Bela
rus
10.2
10.2
9.8
9.6
9.8
8.8
5.8
4.4
4.6
5.4
5.7
6.3
6.1
7.9
7.1
6.7
7.2
7.7
Belg
ium
8.9
9.2
9.3
9.9
9.9
10.1
10.2
10.3
10.3
10.5
10.8
10.5
10.8
10.8
10.6
10.5
10.3
10.7
10.0
9.5
9.9
9.4
9.6
9.6
9.2
9.1
9.0
Bosn
ian
and
Her
zego
vina
Bulg
aria
6.7
7.1
7.4
8.2
8.2
8.2
8.7
8.4
9.0
8.7
8.7
9.1
9.0
8.8
9.2
8.8
9.3
8.9
9.1
9.3
9.3
7.8
8.4
8.2
8.1
8.0
7.8
Cro
atia
7.9
5.5
4.5
5.0
4.7
4.3
4.1
Cze
ch R
epub
lic8.
08.
68.
68.
18.
28.
68.
69.
08.
88.
89.
09.
49.
19.
39.
29.
08.
78.
08.
18.
28.
98.
99.
39.
89.
910
.010
.1D
enm
ark
6.8
7.2
7.7
8.4
8.3
9.1
9.2
8.9
8.5
9.0
9.1
9.6
10.0
10.4
9.9
9.9
10.0
9.6
9.7
9.6
9.7
9.6
9.9
9.7
9.9
10.0
10.0
10.0
Esto
nia
11.2
9.6
7.5
6.0
6.1
6.8
6.0
5.6
2.4
1.9
1.9
2.9
2.3
Finl
and
4.4
4.8
5.2
5.7
6.5
6.3
6.4
6.4
6.3
6.3
6.3
6.4
6.4
6.4
6.5
6.5
6.9
7.1
7.3
7.6
7.7
7.4
7.2
6.8
6.6
6.7
6.7
6.9
Fran
ce16
.216
.116
.016
.215
.916
.116
.215
.815
.415
.114
.914
.414
.414
.013
.513
.313
.213
.012
.612
.812
.611
.911
.811
.511
.411
.411
.1G
erm
any
12.2
11.8
11.3
11.4
11.1
10.9
Gre
ece
8.3
8.7
8.8
9.2
10.2
9.8
8.9
9.6
9.5
8.9
7.3
8.1
8.3
8.4
8.6
8.6
8.5
9.2
8.9
9.0
8.7
Hun
gary
9.1
9.4
9.5
9.5
9.4
10.1
10.7
11.3
11.5
11.1
11.8
11.5
11.6
11.3
11.7
11.6
11.4
10.7
10.4
11.3
11.5
10.6
10.9
10.5
10.1
9.4
9.5
Icel
and
3.2
3.4
3.5
3.7
3.8
3.5
3.5
3.8
3.6
4.0
3.9
4.0
3.9
4.1
4.1
4.0
4.1
4.0
4.1
4.1
3.9
3.9
3.6
3.3
3.5
3.6
3.7
3.9
Irel
and
5.9
6.2
6.7
7.3
7.6
7.7
7.5
7.6
7.7
7.7
7.3
7.0
6.7
6.1
6.5
6.8
6.7
6.6
6.9
7.3
7.6
7.8
8.1
8.3
8.6
9.2
9.1
Isra
el1.
61.
71.
71.
72.
01.
91.
81.
91.
11.
11.
01.
11.
11.
00.
90.
90.
80.
90.
90.
90.
9It
aly
13.7
13.6
13.6
13.9
13.8
12.8
12.4
12.0
12.7
12.7
13.0
11.7
11.4
11.5
11.2
10.6
10.0
9.6
9.4
9.1
9.1
9.0
9.0
8.8
8.6
8.0
8.2
Kyr
gyzs
tan
4.7
2.3
1.8
2.1
2.7
2.8
2.9
1.5
1.9
1.9
2.0
2.1
2.2
Latv
ia11
.311
.010
.610
.510
.59.
26.
54.
64.
95.
75.
35.
35.
26.
47.
88.
06.
77.
1Li
thua
nia
11.1
10.0
8.9
6.2
4.8
5.5
6.3
5.0
4.3
Luxe
mbo
urg
10.0
10.5
10.4
10.5
11.4
10.5
11.2
11.3
10.4
10.0
10.9
10.3
11.1
11.9
12.7
12.1
11.9
12.1
12.0
12.5
12.2
12.5
12.4
12.5
12.3
12.1
11.8
Mac
edon
ia, F
mr
Yug
Rep
2.0
2.3
2.1
2.2
4.8
3.3
3.4
2.9
3.1
3.2
3.5
3.5
4.0
4.1
4.2
3.5
Mol
dova
, Rep
of
6.8
6.9
6.5
6.6
3.8
3.8
1.8
1.6
2.0
2.6
3.3
3.6
3.4
3.2
4.4
4.1
3.0
Net
herl
ands
5.6
6.2
6.8
7.5
8.0
8.7
8.3
8.8
9.1
9.4
8.8
8.8
8.7
8.9
8.6
8.5
8.6
8.3
8.3
8.2
8.1
8.2
8.2
7.9
7.9
8.0
8.0
8.0
Nor
way
3.6
3.7
3.9
4.0
4.2
4.3
4.3
4.4
4.0
4.4
4.6
4.2
3.8
3.8
4.0
4.2
4.2
4.4
4.2
4.2
4.1
4.0
3.8
3.7
3.8
3.9
4.0
4.3
Pola
nd5.
45.
96.
46.
96.
67.
38.
28.
68.
38.
38.
76.
66.
46.
46.
57.
07.
27.
27.
17.
06.
26.
66.
36.
46.
46.
36.
2Po
rtug
al9.
914
.311
.712
.014
.013
.314
.112
.310
.410
.811
.011
.612
.113
.412
.713
.111
.210
.99.
910
.410
.111
.610
.710
.410
.811
.011
.2R
oman
ia6.
34.
03.
85.
65.
17.
67.
37.
48.
18.
78.
07.
77.
67.
67.
67.
67.
87.
87.
96.
67.
36.
48.
88.
06.
59.
08.
7R
ussi
a10
.510
.48.
85.
23.
94.
45.
35.
55.
75.
15.
05.
65.
86.
2Sl
ovak
ia10
.710
.710
.910
.510
.210
.29.
79.
89.
59.
69.
39.
28.
88.
47.
89.
09.
2Sl
oven
ia11
.911
.612
.911
.511
.59.
612
.111
.410
.99.
210
.29.
211
.39.
311
.210
.011
.411
.7Sp
ain
12.1
12.4
12.4
13.7
14.1
14.2
13.7
13.0
14.0
13.6
13.6
13.0
12.7
12.8
11.5
11.6
11.6
11.8
11.1
10.8
10.8
10.7
10.2
9.9
9.7
9.5
9.3
Swed
en5.
85.
75.
95.
76.
16.
36.
46.
15.
85.
95.
75.
45.
55.
25.
25.
25.
55.
45.
55.
65.
55.
55.
45.
35.
45.
24.
9Sw
itzer
land
10.7
10.7
11.0
11.4
11.2
10.5
10.3
10.4
10.6
10.6
10.8
11.1
11.3
11.1
11.1
11.2
11.0
11.0
11.0
10.9
10.8
10.7
10.1
10.0
9.7
9.4
9.3
Turk
ey0.
50.
50.
50.
70.
70.
80.
80.
90.
80.
80.
70.
90.
70.
80.
60.
60.
50.
60.
40.
50.
70.
80.
90.
91.
01.
00.
9Tu
rkm
enis
tan
2.7
2.5
Ukr
aine
6.3
6.2
5.7
5.7
5.7
5.2
3.4
2.9
3.2
3.8
4.1
4.1
3.6
3.3
2.0
1.6
1.0
1.6
Uni
ted
Kin
gdom
5.3
5.6
5.8
6.5
6.8
6.8
7.1
6.8
7.3
7.6
7.3
7.1
6.9
7.2
7.2
7.4
7.4
7.5
7.6
7.6
7.7
7.4
7.3
7.3
7.5
7.3
7.6
Yug
osla
via
6.2
6.2
EU a
vera
ge10
.410
.810
.711
.211
.311
.411
.411
.111
.311
.411
.511
.110
.911
.010
.610
.610
.410
.410
.210
.110
.210
.19.
99.
69.
69.
49.
4Eu
rope
ave
rage
9.2
8.1
7.7
7.8
8.0
8.1
8.0
7.8
7.6
7.6
7.6
7.6
Sour
ce:
Wor
ld H
ealth
Org
aniz
atio
n (1
999)
Eur
opea
n H
ealth
for
All
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Europeancardiovascular
disease statistics
68
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Europeancardiovascular
disease statistics
69
8. Bloodpressure
Raised blood pressure increases the risk of CVD. The Global Burden of Disease Study estimates
that in Established Market Economies 4% of DALYs are lost due to raised blood pressure levels
and that in Formerly Socialist Economies of Europe 6% are lost1. The only reliable data on the
prevalence of raised blood pressure across Europe comes from the MONICA Project. The latest
results of this project show that between 2% (Toulouse, France) and 21% (North Karelia, Finland)
of men aged 35-64 have systolic blood pressure levels of 160mmHg or more (a level generally
considered to be high)2. For women aged 35-64 between 2% (Catalonia, Spain) and 17% (East
Germany) have levels of 160mmHg or more (Table 8.1, Figure 8.1). MONICA Project data on
trends in blood pressure levels await publication.
It should be noted that in 1998 the Second Joint Task Force of the European and other Societies
on Cornonary Prevention recommended that 'in coronary patients the blood pressure goal is
consistently below 140/90 mmHg' (i.e. a systolic blood pressure of 140 mmHg or less, or a
diastolic blood pressure of 90 mmHg or less) and that all individuals with blood pressures above
140/90 may require drug treatment2.
1 Murray JL, Lopez AD (1996) The global burden of disease. WHO: Geneva.
2 See European Society of Cardiology, European Atherosclerosis Society, European Society of Hypertension,International Society of Behavioural Medicine, European Society of General Practice/Family Medicine, EuropeanHeart Network (1998) Prevention of coronary heart disease in clinical practice. Recommendations of the SecondJoint Task Force of European and other Societies on Coronary Prevention. European Heart Journal 19; 1431-1503for recommendations on blood pressure levels.
Europeancardiovascular
disease statistics
70
Table 8.1 Systolic blood pressure levels, adults aged35-64, by sex, latest available data,MONICA Project populations
MEN WOMEN
Systolic blood pressure (mmHg) 120-<160 ≥160 Mean 120-<160 ≥160 Mean
% % mmHg % % mmHgMONICA population MONICA Year of survey
population code
Belgium-Charleroi BEL-CHA 1990/93 73 4 131 50 5 125Belgium-Ghent BEL-GHE 1990/92 70 3 129 49 2 122Czech Republic CZE-CZE 1992 68 14 137 60 13 134Denmark-Glostrup DEN-GLO 1991/92 55 5 126 46 3 121Finland-Kuopio Province FIN-KUO 1992 73 16 140 64 16 139Finland-North Karelia FIN-NKA 1992 69 21 142 63 14 137Finland-Turku/Loimaa FIN-TUL 1992 78 12 139 69 12 135France-Lille FRA-LIL 1995/96 73 10 135 62 6 129France-Strasbourg FRA-STR 1995/97 70 11 135 52 8 127France-Toulouse FRA-TOU 1994/96 57 2 125 34 3 117Germany-Augsburg (rural) GER-AUR 1994/95 74 9 136 56 8 129Germany-Augsburg (urban) GER-AUU 1995/95 74 11 137 58 9 131Germany-Bremen GER-BRE 1991/92 68 8 132 59 8 128Germany-East Germany GER-EGE 1993/94 75 17 141 63 17 137Iceland ICE-ICE 1993/94 57 4 125 44 4 121Italy-Area Brianza ITA-BRI 1993/94 61 8 131 53 7 127Italy-Friuli ITA-FRI 1994 73 14 140 67 10 134Lithuania-Kaunas LTU-KAU 1992/93 71 13 137 58 15 134Poland-Tarnobrzeg Voivodship POL-TAR 1992/93 68 9 134 57 14 134Poland-Warsaw POL-WAR 1993 58 12 132 49 11 128Russia-Moscow (control) RUS-MOC 1992/95 54 10 130 48 14 133Russia-Novosibirsk (control) RUS-NOC 1995 65 9 132 56 11 131Spain-Catalonia SPA-CAT 1994/96 47 2 121 38 2 118Sweden-Gothenburg SWE-GOT 1994/96 68 11 134 60 8 129Sweden-Northern Sweden SWE-NSW 1994 63 7 130 49 8 126Switzerland-Ticino SWI-TIC 1993/93 69 6 132 52 4 124Switzerland-Vaud/Fribourg SWI-VAF 1992/93 75 6 132 53 4 124United Kingdom-Belfast UNK-BEL 1991/92 67 11 135 60 7 130United Kingdom-Glasgow UNK-GLA 1995 69 8 133 52 7 126Yugoslavia-Novi Sad YUG-NOS 1994/95 62 14 136 56 16 137
Age-standardised levels derived from means of two readings; consult WHO MONICA Project for details of measurementand age-standardisation
Source: WHO MONICA Project, with permission (see Acknowledgements).
0
5
10
15
20
25
Fran
ce-T
ou
lou
se
Spai
n-C
atal
on
ia
Bel
giu
m-G
hen
t
Bel
giu
m-C
har
lero
i
Icel
and
Den
mar
k-G
lost
rup
Swit
zerl
and
-Tic
ino
Swit
zerl
and
-Vau
d/F
rib
ou
rg
Swed
en-N
ort
her
n S
wed
en
Ital
y-A
rea
Bri
anza
Un
ited
Kin
gd
om
-Gla
sgo
w
Ger
man
y-B
rem
en
Russ
ia-N
ovo
sib
irsk
(co
ntr
ol)
Ger
man
y-A
ug
sbu
rg (r
ura
l)
Pola
nd
-Tar
no
brz
eg V
oiv
od
ship
Fran
ce-L
ille
Russ
ia-M
osc
ow
(co
ntr
ol)
Swed
en-G
oth
enb
urg
Ger
man
y-A
ug
sbu
rg (u
rban
)
Fran
ce-S
tras
bo
urg
Un
ited
Kin
gd
om
-Bel
fast
Pola
nd
-War
saw
Fin
lan
d-T
urk
u/L
oim
aa
Lith
uan
ia-K
aun
as
Cze
ch R
epu
blic
Ital
y-Fr
iuli
Yu
go
slav
ia-N
ovi
Sad
Fin
lan
d-K
uo
pio
Pro
vin
ce
Ger
man
y-Ea
st G
erm
any
Fin
lan
d-N
ort
h K
arel
ia
%
Men
Women
Figure 8.1 Percentage of adults aged 35-64 withsystolic blood pressure levels ≥160mmHg, latest available data
Europeancardiovascular
disease statistics
71
9. Bloodcholesterol
Although it is recognised that raised blood cholesterol increases the risk of CVD there are no
European wide estimates of the mortality or morbidity attributable to raised cholesterol levels.
As with raised blood pressure, the only reliable information on the prevalence of raised cholesterol
levels in Europe comes from the MONICA Project. The latest results of this project show that
between 1% (Novosibirsk, Russia) and 15% (Vand/Fribourg, Switzerland) of men aged 35-64
have blood cholesterol levels of 7.8mmol/l or more (a level generally considered to be very high).
For women aged 35-64 between 1% (Tarnobrzeg Voivodship, Poland) and 14% (Kaunas,
Lithuania) have levels of 7.8mmol/l or more (Table 9.1, Figure 9.1). MONICA Project data on
trends in blood cholesterol levels await publication.
Europeancardiovascular
disease statistics
72
Table 9.1 Blood cholesterol levels, adults aged 35-64, by sex, latest available data,MONICA Project populations
MEN WOMEN
Total cholesterol (mmol/l) 5.2-<7.8 ≥7.8 Mean 5.2-<7.8 ≥7.8 Mean
% % mmol/l % % mmol/lMONICA population MONICA Year of survey
population code
Belgium-Charleroi BEL-CHA 1990/93 68 9 6.2 67 10 6.1Belgium-Ghent BEL-GHE 1990/92 70 6 6.0 66 6 6.0Czech Republic CZE-CZE 1992 69 11 6.2 67 11 6.1Denmark-Glostrup DEN-GLO 1991/92 72 5 6.0 65 5 5.8Finland-Kuopio Province FIN-KUO 1992 70 7 6.0 66 5 5.8Finland-North Karelia FIN-NKA 1992 74 7 6.0 65 4 5.7Finland-Turku/Loimaa FIN-TUL 1992 71 4 5.9 62 5 5.7France-Lille FRA-LIL 1995/96 72 4 5.8 68 5 5.8France-Strasbourg FRA-STR 1995/97 76 5 6.0 70 5 5.9France-Toulouse FRA-TOU 1994/96 70 4 5.8 66 2 5.6Germany-Augsburg (rural) GER-AUR 1994/95 72 6 6.1 69 5 5.9Germany-Augsburg (urban) GER-AUU 1995/95 71 10 6.2 68 6 5.9Germany-Bremen GER-BRE 1991/92 74 9 6.2 76 8 6.2Germany-East Germany GER-EGE 1993/94 69 4 5.8 64 5 5.8Iceland ICE-ICE 1993/94 70 10 6.2 67 6 6.0Italy-Area Brianza ITA-BRI 1993/94 69 6 5.9 70 5 5.9Italy-Friuli ITA-FRI 1994 65 5 5.9 60 3 5.7Lithuania-Kaunas LTU-KAU 1992/93 68 7 6.0 62 14 6.2Poland-Tarnobrzeg Voivodship POL-TAR 1992/93 63 2 5.6 59 1 5.5Poland-Warsaw POL-WAR 1993 67 3 5.7 62 4 5.6Russia-Moscow (control) RUS-MOC 1992/95 47 2 5.3 53 5 5.6Russia-Novosibirsk (control) RUS-NOC 1995 40 1 5.0 49 2 5.3Spain-Catalonia SPA-CAT 1994/96 63 3 5.6 61 2 5.5Sweden-Gothenburg SWE-GOT 1994/96 52 5 5.6 48 3 5.4Sweden-Northern Sweden SWE-NSW 1994 71 11 6.3 66 11 6.1Switzerland-Ticino SWI-TIC 1993/93 74 15 6.5 70 10 6.2Switzerland-Vaud/Fribourg SWI-VAF 1992/93 75 10 6.3 69 8 6.1United Kingdom-Belfast UNK-BEL 1991/92 71 6 5.9 63 8 5.9United Kingdom-Glasgow UNK-GLA 1995 72 6 6.1 69 8 6.1Yugoslavia-Novi Sad YUG-NOS 1994/95 69 13 6.4 70 9 6.2
Age-standardised levels; consult WHO MONICA Project for details of measurement and age-standardisation.
Source: WHO MONICA Project, with permission (see Acknowledgements).
Figure 9.1 Percentage of adults aged 35-64 withblood cholesterol levels ≥7.8 mmol/l,latest available data
0
2
4
6
8
10
12
14
16
Russ
ia-N
ovo
sib
irsk
(co
ntr
ol)
Russ
ia-M
osc
ow
(co
ntr
ol)
Pola
nd
-Tar
no
brz
eg V
oiv
od
ship
Spai
n-C
atal
on
ia
Pola
nd
-War
saw
Fran
ce-L
ille
Fran
ce-T
ou
lou
se
Ger
man
y-Ea
st G
erm
any
Fin
lan
d-T
urk
u/L
oim
aa
Swed
en-G
oth
enb
urg
Ital
y-Fr
iuli
Den
mar
k-G
lost
rup
Fran
ce-S
tras
bo
urg
Ital
y-A
rea
Bri
anza
Un
ited
Kin
gd
om
-Bel
fast
Un
ited
Kin
gd
om
-Gla
sgo
w
Ger
man
y-A
ug
sbu
rg (r
ura
l)
Bel
giu
m-G
hen
t
Fin
lan
d-N
ort
h K
arel
ia
Fin
lan
d-K
uo
pio
Pro
vin
ce
Lith
uan
ia-K
aun
as
Bel
giu
m-C
har
lero
i
Ger
man
y-B
rem
en
Icel
and
Ger
man
y-A
ug
sbu
rg (u
rban
)
Swit
zerl
and
-Vau
d/F
rib
ou
rg
Cze
ch R
epu
blic
Swed
en-N
ort
her
n S
wed
en
Yu
go
slav
ia-N
ovi
Sad
Swit
zerl
and
-Tic
ino
%
Men
Women
Europeancardiovascular
disease statistics
73
10. Overweight& obesity
Mortality and morbidity attributable to overweightand obesityIt is now generally accepted that overweight and obesity increases the risk of chronic diseases,
particularly CVD, cancer and diabetes1. The National Institute of Public Health in Stockholm
estimates that 4% of DALYs lost in the EU are due to overweight and obesity2.
Prevalence of and trends in overweight and obesityThere has been one multi-national survey of the prevalence of overweight and obesity, but this
was only carried out in EU countries and involved asking people for their weight and height
rather than weighing and measuring them. This survey shows that between 27% and 35% of
adults in the EU are overweight and between 7% and 12% are obese (Table 10.1).
The most reliable data on the prevalence of overweight and obesity across Europe comes from
the MONICA Project. This did involve weighing and measuring subjects. The latest results of
this project show that between 8% (Moscow, Russia) and 24% (Kuopio Province, Finland) of
men aged 35-64 are obese. For women aged 35-64 between 10% (Vaud/Fribourg, Switzerland)
and 36% (Tarnobrzeg Voivodship, Poland) are obese (Table 10.2).
There is little information about trends in overweight and obesity across Europe but a survey of
national studies shows that obesity is rising in all countries for which data are available (Table
10.3, Figure 10.3). MONICA Project data on trends in overweight and obesity await publication.
1 World Health Organization (1998) Obesity. Preventing and managing the global epidemic. Report of a WHOconsultation on obesity. WHO: Geneva.
2 National Institute of Public Health, Stockholm (1997) Determinants of the burden of disease in the EuropeanUnion. NIPH: Stockholm.
Europeancardiovascular
disease statistics
74
Table 10.2 Prevalence of overweight and obesity,adults aged 35-64, by sex, latest availabledata, MONICA Project populations
MEN WOMEN
BMI (kg/m2) 25-<30 ≥30 Mean BMI 25-<30 ≥30 Mean BMI
Overweight Obese Overweight ObeseMONICA population MONICA Year of survey
population code
Belgium-Charleroi BEL-CHA 1990/93 47 19 27.1 33 24 26.8Belgium-Ghent BEL-GHE 1990/92 52 13 26.4 40 16 26.1Czech Republic CZE-CZE 1992 52 23 27.6 35 30 27.8Denmark-Glostrup DEN-GLO 1991/92 41 13 26.0 26 12 24.7Finland-Kuopio Province FIN-KUO 1992 46 24 27.3 34 26 27.1Finland-North Karelia FIN-NKA 1992 49 23 27.5 37 24 27.1Finland-Turku/Loimaa FIN-TUL 1992 46 22 27.1 35 19 26.2France-Lille FRA-LIL 1995/96 40 17 26.4 30 22 26.4France-Strasbourg FRA-STR 1995/97 51 22 27.3 31 19 26.2France-Toulouse FRA-TOU 1994/96 49 13 26.1 24 10 24.5Germany-Augsburg (rural) GER-AUR 1994/95 55 24 27.8 33 23 26.8Germany-Augsburg (urban) GER-AUU 1995/95 54 17 27.1 36 21 26.5Germany-Bremen GER-BRE 1991/92 50 16 26.8 36 19 26.3Germany-East Germany GER-EGE 1993/94 51 18 26.9 37 18 26.4Iceland ICE-ICE 1993/94 50 16 26.8 36 18 26.3Italy-Area Brianza ITA-BRI 1993/94 50 14 26.4 29 18 25.5Italy-Friuli ITA-FRI 1994 51 17 26.9 31 19 25.8Lithuania-Kaunas LTU-KAU 1992/93 47 20 27.1 34 32 28.0Poland-Tarnobrzeg Voivodship POL-TAR 1992/93 41 15 25.9 36 36 28.5Poland-Warsaw POL-WAR 1993 45 22 27.1 35 29 27.5Russia-Moscow (control) RUS-MOC 1992/95 38 8 25.2 33 22 26.5Russia-Novosibirsk (control) RUS-NOC 1995 35 17 25.9 33 35 28.5Spain-Catalonia SPA-CAT 1994/96 53 16 26.7 42 25 27.4Sweden-Gothenburg SWE-GOT 1994/96 47 13 26.2 31 10 24.9Sweden-Northern Sweden SWE-NSW 1994 50 14 26.4 34 14 25.7Switzerland-Ticino SWI-TIC 1993/93 53 13 26.5 27 16 25.3Switzerland-Vaud/Fribourg SWI-VAF 1992/93 47 16 26.5 31 10 24.7United Kingdom-Belfast UNK-BEL 1991/92 49 14 26.3 30 16 25.6United Kingdom-Glasgow UNK-GLA 1995 42 23 26.8 36 23 26.9Yugoslavia-Novi Sad YUG-NOS 1994/95 49 20 27.3 36 32 27.8
Age-standardised levels; consult WHO MONICA Project for details of measurement and age-standardisation.
Source: WHO MONICA Project, with permission (see Acknowledgements).
Table 10.1 Prevalence of overweight and obesity,adults aged 15 and over, 1997, EUcountries
BMI (kg/m2) 25-30 >30Overweight Obese
% %
Austria 32 10Belgium 31 9Denmark 31 8Finland 33 10France 24 7Germany 35 11Greece 35 11Ireland 31 8Italy 30 7Luxembourg 27 9Netherlands 29 10Portugal 33 9Spain 33 11Sweden 33 7United Kingdom 30 12
EU average* 31 10
* weighted according to population size.
Source: Institute of European Food Studies, Trinity College, Dublin (1999). A Pan-EU Survey on Consumer Attitudesto Physical Activity, Body-weight and Health. IEFS: Dublin.
Europeancardiovascular
disease statistics
75
Table 10.3 Prevalence of obesity, adults, by sex,1978-1997
Year of survey Age group Men Women% %
Finland 1978/79 20-75 10 101985/87 12 101991/93 14 11
Germany - East Germany 1985 25-65 13.7 22.21989 13.4 20.61992 20.5 26.8
Germany - West Germany 1985 25-69 15.1 16.51988 14.7 17.21990 17.2 19.3
Netherlands 1987 20-59 6.0 8.51988 6.3 7.61989 6.2 7.41990 7.4 9.01991 7.5 8.81992 7.5 9.31993 7.1 9.11994 8.8 9.41995 8.4 8.3
Sweden 1980/81 16-84 4.9 8.71988/90 5.3 9.1
United Kingdom - England 1980 16-64 6 81986/87 7 121991/92 13 15
1993 13 161994 13 161995 15 171996 16 171997 17 19
Obesity defined as >30 kg/m2, except Sweden where > 30kg/m2 for men but >28.6 kg/m2 for women.
Sources: Seidell JC, Flegal KM (1997) Assessing obesity: classification and epidemiology. British Medical Bulletin 53;238-52; British Heart Foundation (1999) Coronary heart disease statistics. BHF: London.
Figure 10.3 Prevalence of obesity, adults, by sex1978-1997
Finland
02468
10121416
1975 1980 1985 1990 1995
%
Germany - East Germany
0
5
10
15
20
25
30
1984 1986 1988 1990 1992 1994
%
Germany - West Germany
0
5
10
15
20
25
1984 1986 1988 1990 1992
%
Netherlands
0
2
4
6
8
10
1985 1990 1995 2000
%
United Kingdom - England
0
5
10
15
20
1975 1980 1985 1990 1995 2000
%
Men
Women
Europeancardiovascular
disease statistics
76
11. DiabetesThe Global Burden of Disease Study has shown that on average 2.0% of deaths are directly due
to diabetes in Established Market Economies (0.8% in Formerly Socialist Economies of Europe)
and that diabetes directly accounts for 2.4% of DALYs lost in Established Market Economies
(1.1% in Formerly Socialist Economies of Europe)1. (See also Table 2.2).
But diabetes also substantially increases the risk of CVD2 and the majority of the total burden of
disease due to diabetes is through this increased risk of CVD amongst diabetics. The Global
Burden of Disease Study suggests that if the effect of diabetes on risk of CVD is taken into
account then approximately 10% of deaths and 9% of DALYs lost in Established Market
Economies are attributable to diabetes (5% of deaths and 4% of DALYs in Formerly Socialist
Economies of Europe).
Diabetes is increasing in nearly all countries of Europe (Table 11.1).
1. Murray JL, Lopez AD (1996) The global burden of disease. WHO: Geneva.
2. World Health Organisation (1994) Prevention of Diabetes Mellitus. Report of WHO Study Group.Technical ReportSeries: 844. WHO: Geneva.
Europeancardiovascular
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77
Tabl
e 11
.1Pr
eval
ence
of d
iabe
tes,
198
0-19
9719
8019
8119
8219
8319
8419
8519
8619
8719
8819
8919
9019
9119
9219
9319
9419
9519
9619
97
%%
%%
%%
%%
%%
%%
%%
%%
%%
Arm
enia
0.45
0.54
0.55
0.64
0.66
0.72
0.76
0.83
0.90
0.95
1.07
1.05
1.00
1.05
1.09
0.97
0.95
0.92
Aze
rbai
jan
0.63
0.62
0.61
0.56
0.55
0.52
0.55
0.54
Bela
rus
1.19
1.17
1.14
1.14
1.04
Belg
ium
3.45
Bosn
ia a
nd H
ezeg
ovin
a0.
440.
510.
470.
500.
570.
500.
580.
560.
630.
740.
750.
75Bu
lgar
ia0.
830.
951.
021.
081.
071.
101.
191.
201.
191.
131.
141.
121.
151.
301.
311.
321.
511.
58C
zech
Rep
ublic
3.07
3.27
3.42
3.64
3.78
3.83
3.93
4.06
4.24
4.46
4.62
4.76
4.89
4.78
4.86
5.35
5.65
5.83
Den
mar
k0.
260.
482.
40Fi
nlan
d1.
771.
771.
801.
781.
791.
801.
861.
881.
901.
942.
012.
082.
152.
232.
212.
212.
252.
32Fr
ance
0.60
Geo
rgia
0.84
0.95
0.95
0.98
0.94
0.97
Gre
ece
0.16
0.18
0.19
0.20
0.19
0.19
0.20
0.18
0.17
0.17
0.17
0.18
Icel
and
0.12
0.14
0.17
Ital
y3.
70K
azak
hsta
n0.
610.
700.
710.
690.
660.
630.
630.
60K
yrgy
zsta
n0.
190.
240.
270.
290.
310.
330.
350.
380.
390.
390.
390.
400.
370.
390.
400.
390.
42La
tvia
1.06
1.08
1.13
1.19
1.21
1.03
1.04
1.05
1.01
1.05
Lith
uani
a0.
970.
970.
930.
960.
920.
920.
961.
001.
10M
alta
5.20
Mac
edon
ia, F
mr
Yug
Rep
1.01
1.11
1.14
1.17
1.29
1.66
Mol
dova
, Rep
of
0.55
0.57
0.60
0.65
0.70
0.75
0.80
0.86
0.90
0.97
1.01
1.03
1.02
0.98
0.97
0.94
0.93
0.88
Net
herl
ands
2.00
1.90
1.90
1.70
1.80
2.00
2.00
Nor
way
2.90
2.00
Port
ugal
6.14
4.80
Rom
ania
2.03
0.66
0.69
0.76
0.82
0.90
0.98
1.05
Rus
sia
Fede
ratio
n0.
890.
961.
011.
061.
111.
181.
241.
271.
281.
301.
301.
311.
34Sl
ovak
ia2.
452.
783.
063.
133.
213.
293.
433.
553.
703.
763.
82Sl
oven
ia2.
422.
582.
682.
762.
872.
953.
143.
303.
453.
52Sw
eden
3.00
2.90
Tajik
ista
n0.
380.
380.
310.
310.
270.
240.
20Tu
rkm
enis
tan
0.39
0.39
0.39
0.37
0.33
0.32
0.35
Ukr
aine
0.86
0.91
0.97
1.04
1.11
1.18
1.27
1.35
1.42
1.48
1.56
1.68
1.69
1.71
1.73
1.74
1.76
1.76
Cum
ulat
ive
num
ber
of p
atie
nts
with
dia
bete
s (I
CD
-9: 2
50, I
CD
-10:
E10
-E14
) at t
he e
nd o
f the
cal
ende
r ye
ar.
Dat
a fr
om th
e na
tiona
l dia
bete
s re
gist
er, w
hene
ver
avai
labl
e, o
r fr
om r
outin
e re
port
ing
syst
em.
Sour
ce:
Wor
ld H
ealth
Org
aniz
atio
n (1
999)
Eur
opea
n H
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AppendixMember states of the WHO European RegionThere are 51 member states in the WHO European region. These are listed below, with the 1997
mid-year population estimates for males and females. The 15 countries of the European Union
are identified with an asterisk. A map follows, with countries identified by their three letter code.
Country Code WHO Sub-region Male population 1997 Female population 1997
Albania ALB Balkan 1628915 1695402Andorra AND Southern Europe 34067 30826Armenia ARM Commonwealth of Independent States 1835094 1950888Austria* AUT Western Europe 3917300 4154900Azerbaijan AZE Commonwealth of Independent States 3715300 3820900Belarus BLR Commonwealth of Independent States 4769223 5450759Belgium* BEL Western Europe 4993000 5195000Bosnia and Herzegovina BIH Balkan 1873000 1911000Bulgaria BGR Central and Eastern Europe 4061233 4250833Croatia HRV Balkan 2197442 2375032Czech Republic CZE Central and Eastern Europe 5010531 5293111Denmark* DNK Nordic 2599000 2649000Estonia EST Baltic 678674 779313Finland* FIN Nordic 2504800 2635000France* FRA Western Europe 28517000 30026000Georgia GEO Commonwealth of Independent States 2577400 2817500Germany* DEU Western Europe 39989100 42062600Greece* GRC Southern Europe 5176800 5322000Hungary HUN Central and Eastern Europe 4842000 5293000Iceland ISL Nordic 135779 135136Ireland* IRL Western Europe 1777000 1782000Israel ISR Southern Europe 2871000 2910000Italy* ITA Southern Europe 27917000 29579400Kazakhstan KAZ Central Asian Republics and Turkey 7655806 8095504Kyrgyzstan KYR Central Asian Republics and Turkey 2273795 2330802Latvia LVA Baltic 1143347 1325790Lithuania LTU Baltic 1748048 1957540Luxembourg* LUX Western Europe 206800 214200Macedonia, Fmr Yug Rep MKD Balkan 999595 997274Malta MAL Southern Europe 186000 189200Moldova, Rep of MDA Commonwealth of Independent States 2126000 2322000Monaco MON Southern Europe 14000 14000Netherlands* NLD Western Europe 7718400 7892200Norway NOR Nordic 2178625 2226532Poland POL Central and Eastern Europe 18798000 19838000Portugal* PRT Southern Europe 4789080 5156610Romania ROM Central and Eastern Europe 11041414 11504511Russian Federation RUS Commonwealth of Independent States 68560032 77577648San Marino SMR Southern Europe 12750 12750Slovakia SVK Central and Eastern Europe 2620368 2762846Slovenia SVN Balkan 959249 1020751Spain* ESP Southern Europe 19486000 20232000Sweden* SWE Nordic 4370800 4475200Switzerland CHE Western Europe 3608000 3669000Tajikistan TAJ Central Asian Republics and Turkey 3009000 3036000Turkey TUR Central Asian Republics and Turkey 32206000 31539000Turkmenistan TUK Central Asian Republics and Turkey 2280600 2331100Ukraine UKR Commonwealth of Independent States 23432454 27009552United Kingdom* GBR Western Europe 28989700 30019000Uzbekistan UZB Central Asian Republics and Turkey 11819900 11952400Yugoslavia YUG Balkan 5142000 5208000
* Member state of the European Union
The WHO European Region does not include Cyprus, so data for this country are not included in European cardiovasculardisease statistics. In Tables 5.2, 5.4 and 5.5, Belgium and Luxembourg are combined. In Tables 1.4, 1.5, 5.2, 5.4 and 5.5data for the former countries of Czechoslovakia, German Federal Republic, German Democratic Republic, USSR andYugoslavia are included if available.
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ALB
ISL
IRL
ISR
GB
R
NO
R
SWE
FIN
FRA
CH
E
ESP
PR
T
EST
LVA
LTU
PO
LB
LR UK
R
AU
T
LUX
BELNLD
DN
K
CZ
E
TUR
AR
M
RU
S
TUK
TAJ
KA
Z
KY
R
HU
NSVK
RO
M
MD
A
BG
RG
EO
AZ
E
UZ
BSM
R
ITA
MA
L
GR
C
MO
NA
ND
DEU
MK
D
SVN H
RV B
IHY
UG
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AcknowledgementsThe compilers would like to thank Eric Boersma, Graham Cooper, Alice Fuller, Philip Harrison,
Susanne Logstrup, David Mant, Carole Mockford, John Newton, Richard Peto, Vivienne Press,
Hugh Ribbans, Aileen Robertson, Andy Trunkfield, Helen Smith and Martin Vessey for their
help with this publication.
The compilers would also like to thank the WHO MONICA Project for privileged advanced
access to the project database in order to compile Tables 4.3, 8.1, 9.1 and 10.2. It is planned to
make the project data books available through MONICA websites in the first half of 2000.
These sites - http://www.ktl.fi/publications/monica and http://www.ktl.fi/monica - should be
consulted for the definitive versions of the data extracted here, data quality assurance reports
and the MONICA Manual. The manual describes methods of recruitment of participants,
measurement of risk factors and other variables, data handling including age-standardisation,
etc. Access to the survey data book was obtained through Hugh Tunstall-Pedoe and Kari
Kuulasmaa and the good offices of the WHO Project Steering Committee. Some of the data in
Tables 4.3, 8.1, 9.1 and 10.2 will be published in Kuulasmaa K, Tunstall-Pedoe H, Dobson A,
Fortmann S, Sans S, Tolonen H, Evans A, Ferrario M, Tuomilehto J, for the WHO MONICA
Project (2000) Estimating the contribution of changes in classical risk factors to trends in coronary-
event rates across the WHO MONICA Project populations. Lancet (in press).
The production of European cardiovascular disease statistics was funded by the British Heart
Foundation.