Cardiovascular disease burden, trends, and projections in Vietnam, 1990-2050: a first comprehensive national analysis from the Global Burden of Disease Study 2023
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Introduction
Cardiovascular disease (CVD) remains Vietnam’s leading cause of mortality, yet no comprehensive national analysis of burden trends and future projections exists. This study characterizes Vietnam’s CVD burden from 1990 to 2023 and projects burden through 2050.
Methods
Using Global Burden of Disease 2023 data, we analyzed CVD prevalence, incidence, mortality, and disability-adjusted life years (DALYs) in Vietnam from 1990 to 2023, stratified by sex and age. Joinpoint regression quantified temporal trends. Decomposition analysis separated contributions of population growth, aging, and epidemiological change. ARIMA modeling, validated against pre-pandemic and COVID-19 periods, projected burden through 2050.
Results
Despite age-standardized CVD prevalence below global estimates, stroke mortality and DALYs rates exceeded global benchmarks. Age-standardized CVD mortality (ASMR) declined significantly (average annual percentage change [APC]:-1.34%), yet absolute deaths nearly doubled from 121,611 to 223,068. Population aging contributed 140.9% to observed mortality increases while epidemiological improvements averted over 102,000 deaths. Male age-standardized CVD mortality was approximately twice that of females. High systolic blood pressure remained the leading attributable risk factor, while high BMI and alcohol use showed the largest rank escalations. CVD incidence reversed its declining trend during 2019–2023 (APC:+0.69%). By 2050, ASMR are projected to decline by 51.0% (218.8 to 107.1 per 100,000 [95%CI: 64.1–150.2]), while absolute deaths are projected to increase by 43.4% (206,677 to 296,335 [95%CI: 272,323–320,348]).
Conclusions
Vietnam faces a demographic paradox of improving age-specific outcomes alongside a rising absolute burden driven by population aging, demanding urgent reorientation toward aging-specific prevention, hypertension control, and chronic cardiovascular care.
Key messages
What is already known on this topic
Vietnam’s cardiovascular disease burden has been characterized by stroke dominance over ischemic heart disease, ranking 4th in stroke mortality among Southeast Asian nations, with regional analyses projecting rising crude CVD mortality driven by demographic aging. However, existing evidence has been fragmented — limited to single-metric analyses, stroke-specific reports, or brief country summaries using GBD 2019 data — with no comprehensive national analysis quantifying the contributions of population growth, aging, and epidemiological change to mortality trends, nor validated projections incorporating the COVID-19 period.
What this study adds
This study provides the first comprehensive national analysis of Vietnam’s CVD burden using GBD 2023 data, revealing a demographic paradox wherein a 51.0% projected decline in age-standardized mortality by 2050 coexists with a 43.4% rise in absolute deaths driven overwhelmingly by population aging — which contributed 140.9% to observed mortality increases despite advances in prevention and treatment averting over 102,000 deaths. Decomposition analysis, rigorously validated ARIMA forecasting, and sex-disaggregated analyses collectively demonstrate that Vietnam’s CVD challenge is fundamentally demographic rather than clinical.
How this study might affect research, practice or policy
These findings demand urgent reorientation of Vietnam’s predominantly acute-care cardiovascular infrastructure toward chronic and geriatric care models, population-wide hypertension control, and targeted management of rapidly rising metabolic risks including high BMI, LDL cholesterol, and alcohol use. Sex-specific prevention strategies are needed to address behavioral risks in men and late-life cardiovascular burden in women. This evidence base provides Vietnamese and Western Pacific policymakers with the country-specific projections needed to act before the demographic transition becomes irreversible.
