TRENDS AND CONSIDERATIONS IN GLOBAL CARDIOVASCULAR DRUG DEVELOPMENT | Page 2

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also associated with a nearly-six-times greater risk of CVD mortality. The World
Health Organization (WHO) warns that by 2030, nearly 23.6 million people will die
annually from cardiovascular diseases.

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Heart disease and stroke are no longer “Western” diseases confined to developed
nations. The rapidly growing economies and Westernized lifestyles of emerging
nations in Asia, Latin America and Eastern Europe are characterized by increasing
incidence of chronic diseases. WHO projects that more than 80 percent of CVD
deaths occur in low- and middle-income countries where people are exposed to
more risk factors (such as unhealthy diet and smoking), and have less access to
effective treatments (drugs such as statins and medical devices such as
pacemakers and prosthetic valves). Eastern Mediterranean countries will suffer
the largest percentage increase in CVD deaths in the next 20 years; Southeast Asian
nations will have the largest increase in number of deaths.
In the United States, the Centers for Disease Control and Prevention (CDC) report
more than 800,000 deaths and 2 million heart attacks and strokes annually, with
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costs of more than $444 billion in care services and lost productivity in 2010. CVDs
will take a much greater toll as the aging baby boomer generation doubles the
number of elderly in the U.S.; by 2030, nearly 20 percent of the population—more
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than 72 million people—will be 65 or older. Adding to the demographic burden,
dramatic increases in obesity and diabetes put ever-larger populations at risk.
According to CDC estimates, obesity affects one in three Americans, nearly double
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the number of obese adults in 1980. Worldwide diabetes incidence is projected to
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soar from 366 million people in 2011 to 552 million by 2030. WHO estimates that
CVDs and diabetes will reduce the gross domestic product of emerging nations by 1
percent to 15 percent. Heart disease, stroke and diabetes will cost China $558
billion in national income between 2006 and 2015.

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Cardiovascular therapeutic innovation is clearly a global enterprise. Drug and
device developers must conduct clinical trials and deliver advanced therapies
worldwide to meet the urgent and growing threat of CVDs. Current research
trends include increasing safety regulation, expanding globalization of CV clinical