Results from studies featured in the November issue of the journal Circulation: Cardiovascular Quality and Outcomes focus on the disparities in cardiovascular care found globally, emphasizing the importance of the American Heart Association's leadership as the world's leading voluntary health organization devoted to fighting cardiovascular disease.

"Cardiovascular diseases remain the single most common cause of death worldwide, outpacing even cancer, tuberculosis, HIV/AIDS, and malaria," said journal editor Brahmajee K. Nallamothu, M.D., MPH. "Yet despite its large presence on the global stage, the amount of attention paid to cardiovascular disease (and noncommunicable diseases overall) is suboptimal.  Work published in this journal and by others can continue to draw attention to this problem and help prioritize its importance to policymakers."

Studies curated in this special global health issue outlined findings in multiple countries, including:

• A large study of Chinese women found that age at menopause and total reproductive years were inversely associated with risks of both fatal and nonfatal cardiovascular disease, as well as with both ischemic and hemorrhagic stroke subtypes, and there was a higher risk of cardiovascular disease mortality among Chinese women with early menopause. The risks for cardiovascular disease were also higher with longer time since menopause among postmenopausal women.

• In Ghana, there is a profound 10-year increased risk of cardiovascular disease among Ghanaians residing in urban Ghana and urbanized cities in Europe. The risk of cardiovascular disease was also observed to be different among similar populations of the same ancestry residing in different industrialized European countries, suggesting the need to take into account the contextual differences in studying the causes of increased cardiovascular disease risk among homogenous migrant populations.

• In the rural area of South Africa, cardiovascular disease is not currently being optimally managed. There are significant disparities in control of cardiovascular disease risk factors by sex, socioeconomic status, and level of disability. Efforts to improve secondary prevention in this population should be focused on females, subjects from lower socioeconomic status, and those with physical disabilities.

Additional studies featured in the issue focus rheumatic heart disease treatment in Uganda, cardioverter defibrillators in Asian patients with heart failure, repeated risk factor measurements for cardiovascular disease prediction in middle-aged Korean adults, and evaluating and improving cardiovascular health system management in low- and middle-income countries. These results underscore the continued need for collaboration and the sharing of best practices.

More than 17.5 million people die from cardiovascular disease every year, making it the leading cause of death and disability in the world today. By 2030, this figure is expected to reach approximately 23 million, with an estimated global cost more than a trillion dollars by 20301. The American Heart Association believes everyone should live longer, healthier lives, and has an international team that focuses exclusively on that effort outside the United States.

"Heart disease is the world's leading killer, so we're working globally to build healthier lives," said John Meiners, the Association's Chief of Mission-aligned Businesses. "Beginning 10 years ago, the organization began a concerted effort to address cardiovascular disease around the world, offering technical support, science exchange and training to governments, healthcare providers, hospital and pre-hospital systems, workplaces and communities."

This Association-led system of care approach "“ in coordination with local cardiovascular societies, heart and brain health advocates, business and government leaders, now drives global heart and brain health at all levels of society around the world. In 2017, American Heart Association programs expanding outside the United States have grown significantly, focusing around hospital quality improvement program Get With The Guidelines, Go Red for Women, science exchange and Emergency Cardiovascular Care.