Cardiovascular disease has now become the leading cause of death and disability in Southeast Asia, according to a recent study published in the May 2025 special edition of The Lancet Public Health.
The study found that the number of people affected by heart and blood vessel diseases in the ASEAN region increased by a staggering 148% between 1990 and 2021, an alarming and concerning surge.
By 2021, an estimated 36.86 million people in Southeast Asia were living with cardiovascular disease. Of this number, 1.66 million died due to the condition. Collectively, the burden of heart disease accounted for 42.4 million disability-adjusted life years (DALYs) lost due to illness or premature death across the region.
Countries with the Highest Burden
The study, conducted by a team from the Institute for Health Metrics and Evaluation (IHME) in Seattle and the National University of Singapore (NUS), covered all ten ASEAN member states. The findings revealed a wide variation in cardiovascular disease burden across countries.
Malaysia recorded the highest age-adjusted prevalence of cardiovascular disease, followed by Indonesia, which ranked second in both prevalence and overall disease burden. Lao PDR had the highest age-adjusted mortality rate from CVD. In contrast, Singapore showed the most favorable outcomes, with significantly lower rates of death and disability compared to other ASEAN nations.
Key Risk Factors
The six leading risk factors contributing to heart disease in Southeast Asia are:
- High systolic blood pressure
- Unhealthy diet
- Air pollution
- High LDL cholesterol
- Smoking
- High blood sugar due to diabetes
The combination of these risk factors has exacerbated the situation amid an aging population, rapid urbanization, and lifestyle changes occurring across the region.
Surge in Deaths During the Pandemic
The study also noted that during the COVID-19 pandemic, deaths from heart disease exceeded previous projections. While the long-term effects are still being studied, a follow-up study in 2023 even linked COVID-19 infection during pregnancy to an increased risk of heart disease in children.
According to Dr. Marie Ng, the study’s lead researcher, the aging population in Southeast Asia is a major driver of the rising number of cases. “Without immediate action from each of the countries, these preventable health conditions will worsen, causing more death and disability,” she stated.
A Double Threat: Smoking and Pollution
The rise in cardiovascular disease does not occur in isolation. The study also highlighted the significant burden caused by smoking, which has increased by 63% in absolute numbers since 1990. Although smoking prevalence has declined in some countries, the total number of smokers across ASEAN has still surged to 137 million people.
Meanwhile, air pollution, both outdoor and indoor, continues to be a major risk factor, especially in countries with high urbanization rates and widespread use of solid fuels for cooking.
A Call to Action
This study serves as a stark warning for a region experiencing rapid economic growth but lagging in preventive healthcare systems. Without meaningful changes, millions of people will lose productive years of life to conditions that are largely preventable.
Protecting heart health means protecting life expectancy, families, and the future of Southeast Asia.
