Background: Cardiovascular disease (CVD) remains the leading cause of global mortality and disability. Traditional economic assessments underestimate its true impact by excluding welfare losses associated with health and productivity decline. This study applies a welfare-based economic framework to estimate the global macroeconomic burden of CVD from 1990 to 2023. Methods: Disability-Adjusted Life Years (DALYs) for CVD and its major subtypes—ischemic heart disease, stroke, hypertensive heart disease, and cardiomyopathy were utilized from the Global Burden of Disease 2023 tool. Gross domestic product (GDP) and GDP per capita (PPP-adjusted, constant 2017 USD) were used to derive country-specific Values of Statistical Life (VSL), anchored to the U. S. baseline of 10. 5 million (2017 PPP). The Value of Lost Welfare (VLW) was calculated as the product of age-adjusted VSLY and DALYs. Sensitivity analyses were conducted using income elasticities (IE) of 0. 55, 1. 0, and 1. 5 across seven GBD super-regions. Results: In 2023, the global VLW attributable to CVD totaled 3. 8 trillion (3. 6% of world GDP) at IE = 1. 0. Lower elasticity (IE = 0. 55) yielded 2. 1 trillion (2. 0%), while higher elasticity (IE = 1. 5) increased losses to 5. 6 trillion (5. 2%). Ischemic heart disease accounted for 45% of the total burden, stroke for 27%, and hypertensive heart disease for 11%. The highest VLW/GDP ratios were seen in Eastern Europe (8. 4%), Central Asia (7. 9%), and Sub-Saharan Africa (6. 3%). From 1990–2023, total global VLW more than doubled, despite a 26% decline in age-standardized DALY rates. Conclusions: Despite epidemiological progress, CVD continues to exact an enormous macroeconomic toll equivalent to 3–5% of global GDP annually. Integrating welfare-based economic measures into national health planning underscores that investing in CVD prevention yields both health and economic dividends.
Gopi et al. (2026) studied this question.