Low and middle income countries have seen a rise of nearly five million cardiovascular deaths since 1990, revealed a study published in the Journal of American College of Cardiology (JACC) on Wednesday.

The study found the highest cardiovascular disease death rate in Central Asia, Eastern Europe as well as in countries such as Iraq, Afghanistan and many South Pacific island nations. The study was conducted to understand the change in trend of the disease.Significant declines in cardiovascular disease death rates were observed in all high-income countries such as Japan, Andorra, France, Israel and Spain. "Globally, there were an estimated 422.7 million prevalent cases of cardiovascular disease in 2015 but prevalence varied significantly by country. Countries with the lowest prevalence in 2015, after accounting for population size, included Singapore, Japan, South Korea, Chile, Argentina, Uruguay, Canada, Australia, New Zealand, Ireland, Cyprus, Malta, Italy, Greece and Israel," said the study.

Balbir Singh, Chairman, Department of Cardiology and Electrophysiology, Medanta Heart Institute said that cardiac arrest among other cardiovascular diseases is killing people more, mostly in the middle and low income countries."After a cardiac arrest, there are four to six minutes before brain death... and death occurs. Chances of survival reduce by 7-10 per cent with every passing minute. Unfortunately, most Indians are oblivious to this silent epidemic and succumb to sudden cardiac arrest," said Singh.According to the study, west European countries, as well as the US, the United Arab Emirates and Nepal, all had only a slightly higher prevalence. "The countries with extreme high prevalence include most countries in West Africa, Morocco, Iran, Oman, Zambia, Mozambique and Madagascar. The authors observed that the steep declines in cardiovascular disease prevalence experienced by the US, Canada, Australia, New Zealand, Japan, South Korea and countries in Western Europe over the past two decades have begun to plateau," said Singh.There were an estimated 8.92 million deaths due to ischemic heart disease (IHD) in 2015, making IHD the leading cause of death in the world.