Southeast Asia is now battling a rapidly escalating cardiovascular epidemic, with heart disease becoming the region’s leading cause of death after a 148% increase in cases over the past 30 years, according to research by The Lancet Public Health, as reported by Bloomberg.

The study, reports Bloomberg, led by the Institute for Health Metrics and Evaluation (IHME) and the National University of Singapore (NUS), analyzed health data across all 10 ASEAN member states from 1990 to 2021. The findings show that 37 million people across the region were living with cardiovascular disease in 2021, with 1.7 million deaths recorded in that year alone, making it the top contributor to mortality and disability.

The publication, part of a special edition dedicated to Southeast Asia, outlines what researchers describe as a looming public health and economic threat, compounded by insufficient policy action, aging demographics, and uneven healthcare infrastructure.

“Without immediate action from each of the countries, these preventable health conditions will worsen, causing more death and disability across ASEAN,” said Marie Ng, lead author and affiliate professor at both IHME and NUS, in an interview.

Unmet challenges, mounting costs

The top risk factors driving the surge include high systolic blood pressure, dietary risks, air pollution, elevated LDL cholesterol, and tobacco use, the study found. Public health experts are warning that unless national governments rapidly reallocate resources and introduce scalable prevention programs, health systems will become overwhelmed within the next decade.

Several countries in the region, including Indonesia, Vietnam, and the Philippines, already report significant gaps in access to preventive cardiovascular care. According to internal estimates reviewed by Bloomberg, failure to address non-communicable diseases like heart disease could shave up to 2.5% off GDP growth in some economies by 2035.

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Pandemic fallout and intergenerational risk

According to Bloomberg, COVID-19 intensified the crisis, with cardiovascular-related mortality surpassing projections during the pandemic, particularly among older populations who lost access to routine treatment.

Researchers also flagged long-term risks to children born to mothers infected with COVID during pregnancy, citing a separate 2023 study that suggests heightened susceptibility to heart disease later in life.

Marie Ng emphasized that the convergence of COVID-19 and pre-existing cardiovascular vulnerabilities acted as a “stress test” for the region’s fragmented healthcare infrastructure.

The study also reported a staggering 70% rise in major mental disorders since 1990, affecting more than 80 million people across ASEAN. Youth aged 15 to 19 showed the steepest growth, with nearly 11% now affected, a trend researchers warn could have long-term economic and social consequences without early intervention.

The parallel rise in heart disease and mental illness paints a picture of dual public health emergencies, with significant implications for workforce productivity and regional stability, according to Bloomberg.

Policy urgency amid demographic headwinds

Despite strong post-pandemic economic rebounds in several ASEAN nations, healthcare investment continues to lag behind global averages. Public health experts now say the window for reversing the cardiovascular trend is narrowing.

“We’re seeing a shift where the cost of inaction is no longer theoretical, it’s fiscal, structural, and generational,” Ng said, as reported by Bloomberg.

The researchers are calling for coordinated ASEAN-wide policy responses, including standardized screening, education campaigns, reductions in tobacco use, and targeted improvements in urban air quality, especially in megacities like Jakarta, Bangkok, and Manila.

The Lancet study cited by Bloomberg positions cardiovascular disease in Southeast Asia not just as a health crisis, but as a barometer of state capacity in the face of demographic change, environmental pressures, and long-term health financing risks.