Data extracted in July 2025.
Planned article update: September 2026.
Highlights
In 2022, the standardised death rate for diseases of the circulatory system in Bulgaria was 6.3 times as high as that in France.
In relative terms, the number of heart bypasses per 100 000 inhabitants decreased in all but 4 EU countries between 2018 and 2023.
Standardised death rates from diseases of the circulatory system, 2022
This article presents an overview of European Union (EU) statistics related to cardiovascular diseases and focuses on cardiovascular mortality and cardiovascular operations and procedures.
Cardiovascular diseases are the leading cause of death in the EU. They cover a broad group of medical problems that affect the circulatory system (the heart and blood vessels), often resulting from atherosclerosis, the abnormal build-up of plaque – that is made of, among other constituents, cholesterol or fatty substances – deposited on the inside walls of a person’s arteries. Some of the most common diseases that affect the circulatory system include ischaemic heart disease (which includes heart attacks) and cerebrovascular diseases (which includes strokes).
This article is included in a set of statistical articles concerning healthcare activities in the EU which forms part of an online publication on Health in the European Union – facts and figures.
Deaths from cardiovascular diseases
There were 1.68 million deaths in the EU from diseases of the circulatory system
Diseases of the circulatory system place a considerable burden on healthcare systems and government budgets. In 2022, there were 1.68 million deaths in the EU resulting from diseases of the circulatory system, which was equivalent to 32.7% of all deaths. This percentage was considerably higher than the 2nd most prevalent cause of death, cancer (malignant neoplasms; 22.3% of all deaths). An article on causes of death statistics looks in more detail at the leading causes of death in the EU.
Source: Eurostat (hlth_cd_aro) and (hlth_cd_asdr2)
Diseases of the circulatory system are among the main causes of mortality in each of the EU countries (as shown in Table 1): in 2022, they accounted for more than half of all deaths in Bulgaria, Romania, Lithuania and Latvia. By contrast, fewer than a quarter of all deaths in Cyprus, Belgium, the Netherlands, France and Denmark were caused by diseases of the circulatory system, with Denmark recording lowest share, at 20.5%.
The largest gaps between the sexes in relation to the share of people dying from diseases of the circulatory system were recorded in the 3 Baltic countries as well as Romania, Slovenia and Croatia. In these EU countries, the proportions of females dying from diseases of the circulatory system in 2022 were between 9.6 and 12.9 percentage points higher than those for males; these were the only EU countries to report an imbalance in excess of 9.0 percentage points. There were 5 EU countries where a higher proportion of males died from diseases of the circulatory system compared with females: in Finland and Denmark, the shares of male deaths were, respectively, 2.3 and 2.1 percentage points higher than those for females; smaller differences were observed in Ireland, Sweden and Cyprus.
Cyprus recorded the narrowest sex difference in standardised death rates for diseases of the circulatory system
Standardised death rates are calculated as a weighted average of age-specific death rates and therefore improve comparability both over time and between countries. The EU’s standardised death rate for diseases of the circulatory system was 336.4 deaths per 100 000 inhabitants in 2022, with the rate for males some 1.4 times as high as that for females. In the same year, the standardised death rate for cancer in the EU was 234.7 deaths per 100 000 inhabitants.
Standardised death rates for diseases of the circulatory system were systematically higher for males than for females in 2022 across all of the EU countries, although the differences between the sexes were relatively low compared with many other causes of death. The lowest absolute difference between males and females for standardised death rates for diseases of the circulatory system was recorded in Cyprus, at 62 deaths per 100 000 inhabitants; the next smallest differences (between 70 and 80 deaths per 100 000 inhabitants) were reported in the Netherlands, Luxembourg, Portugal and Belgium. The largest differences were recorded in Bulgaria (449 deaths per 100 000 inhabitants) and Latvia (423 deaths per 100 000 inhabitants); these were the only countries to record a sex difference of more than 400 deaths per 100 000 inhabitants.
Table 1 shows that deaths from diseases of the circulatory system become more common at advanced ages. While this is true for the vast majority of causes of death, the standardised death rate for diseases of the circulatory system among those aged 65 years and over in the EU in 2022 was 39 times as high as the standardised death rate for people aged less than 65 years; this can be compared with the same ratio for all causes of death, where the standardised death rate for those aged 65 years and over was 22 times as high as for people aged less than 65 years. For more information see the article on causes of death statistics by age group. Note that the risk of females dying from diseases of the circulatory system before the age of 65 years was particularly low.
Within the EU as a whole, standardised death rates for males were consistently higher than those for females for all forms of diseases of the circulatory system
A more detailed analysis of causes of death for diseases of the circulatory system is presented in Table 2. EU standardised death rates for males in 2022 were higher than those for females for each of the 6 causes of death presented. For ischaemic heart diseases (International Classification of Diseases, 10th revision (ICD-10) codes I20 to I25), the standardised death rate for males in the EU was 1.9 times as high as the corresponding rate for females. The difference between the sexes was less marked for other heart diseases (ICD-10 codes I30 to I51), cerebrovascular diseases (ICD-10 codes I60 to I69) and other diseases of the circulatory system (the remainder of ICD-10 codes I00 to I99, not elsewhere covered).
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Source: Eurostat (hlth_cd_asdr2)
Some of the highest standardised death rates for ischaemic heart diseases were recorded in 2 of the Baltic countries: Lithuania had the highest rate in 2022 for males (622.4 per 100 000 male inhabitants) and for females (378.5 per 100 000 female inhabitants), followed by Latvia, Hungary, Slovakia and Romania for males, and Slovakia, Hungary, Latvia and Romania for females. The lowest standardised death rates for males for ischaemic heart diseases were recorded in France, followed by Luxembourg and the Netherlands. For females, the lowest standardised rates were recorded in France, followed by Spain, Belgium, the Netherland, Portugal and Luxembourg.
The standardised death rate for cerebrovascular diseases in Bulgaria was 7.7 times as high as the rate in France
In 2022, the highest standardised death rates for cerebrovascular diseases were recorded in Bulgaria, Latvia, Romania and Lithuania. The lowest rate was recorded in France. As for all diseases of the circulatory system, there were large variations across the EU countries in 2022, with the standardised death rate in Bulgaria (where the highest rate was recorded) 7.7 times as high as that in France (where the lowest rate was registered).
The EU standardised death rate for cerebrovascular diseases was 1.2 times higher among males than females; this pattern was observed across all EU countries, with the exception of Ireland where the rate for females (44. 1 per 100 000 female inhabitants) was slightly higher than the rate for males (43.8 per 100 000 male inhabitants). The largest sex difference was observed in Estonia, where the rate was 1.6 times higher among males than among females.
Cardiovascular healthcare
Changes in the number of deaths associated with diseases of the circulatory system may occur for a variety of reasons. This includes preventive measures such as, lifestyle changes in the population (for example, a reduction in the number of smokers), among others, the improvement of screening for risk factors, as well as developments in treatment such as new surgical procedures or forms of medication.
Transluminal coronary angioplasty was a common form of intervention for patients treated for cardiovascular diseases
Table 3 provides an overview of the rates (number of surgical operations and procedures conducted, both for in-patients and day cases, in hospitals per 100 000 inhabitants) for 2 procedures related to cardiovascular diseases. The more common of the 2 was transluminal coronary angioplasty, which is a non-surgical procedure used to treat coronary arteries that have narrowed where a deflated balloon is fed through blood vessels until it reaches the site of the blockage before inflating the balloon to open up the artery (allowing blood to flow normally).
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Source: Eurostat (hlth_co_proc3)
A relatively common operation for patients treated for cardiovascular diseases was a bypass anastomosis for heart revascularisation – also referred to as a coronary artery bypass graft or heart bypass. This is a surgical procedure whereby arteries to the heart are replaced by blood vessels from another part of the body. In 2023, there were around 140 100 heart bypass operations conducted across the EU (2022 data for Luxembourg and Malta; 2021 data for the Netherlands; no recent data for Greece), approximately 17 000 operations fewer than in 2018. In relative terms, the number of heart bypasses per 100 000 inhabitants decreased in all but 4 EU countries between 2018 and 2023: Cyprus, Ireland (note both have a break in series), Luxembourg (2018–2022) and Romania.
Germany recorded the highest number of heart bypass operations (over 38 000) and had the 5th highest frequency when taking account of population size (45.7 operations per 100 000 inhabitants), behind Cyprus (68.8 times per 100 000 inhabitants; data for the public sector only), Croatia (63.9 times per 100 000 inhabitants), Belgium (55.5 times per 100 000 inhabitants) and Lithuania (51.9 times per 100 000 inhabitants). This procedure was least common in Spain, where it was performed on average 15.5 times per 100 000 inhabitants and was the only country to record less than 20 procedures per 100 000 inhabitants.
326 500 coronary angioplasties were conducted in Germany in 2023
Across the 26 EU countries for which data are available (2022 data for Luxembourg and Malta; 2021 data for the Netherlands; no recent data for Greece), there were approximately 1.11 million transluminal coronary angioplasty procedures conducted in 2023; this was more than 51 600 procedures more than in 2018 (excluding Latvia and Slovakia, for which 2018 data are not available). In relative terms, the number of transluminal coronary angioplasty procedures per 100 000 inhabitants increased in 13 EU countries. Aside from Cyprus (which has a break in series), the highest increase was recorded in Bulgaria, where the number of transluminal coronary angioplasty procedures increased by 184.6 procedures per 100 000 inhabitants between 2018 and 2023. The biggest decrease was jointly recorded in Denmark (note there is a break in series) and Lithuania, down 38.9 procedures per 100 000 inhabitants.
With over 326 500 coronary angioplasties performed in 2023, Germany accounted for around 29% of the total number of procedures carried out in the EU, considerably more than in any other EU country; France and Italy were the only other EU countries to report more than 100 000 procedures. The highest rate was per 100 000 inhabitants (see Table 3) was 545.0 in Croatia, followed by 432.0 in Bulgaria and by 392.1 in Germany. This procedure was least common in Portugal where it was conducted 108.0 times per 100 000 inhabitants, while relatively low rates were also recorded in Luxembourg (2022 data) and Spain, both under 130 per 100 000 inhabitants.
Source data for tables and graphs
Data sources
Key concepts
The number of deaths from a particular cause of death can be expressed relative to the size of the population. A standardised (rather than crude) death rate can be compiled which is independent of the age and sex structure of a population: this is done as most causes of death vary significantly by age and according to sex and the standardisation facilitates comparisons of rates over time and between countries.
Healthcare resources and activities
Statistics on healthcare resources (such as personnel and medical equipment) and healthcare activities (such as information on surgical operations and procedures and hospital discharges) are documented in a background article on the methodology of healthcare non-expenditure statistics. This provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions.
For surgical operations and procedures, the International Classification of Diseases – clinical modification (ICD-9-CM) is used
- operations on the cardiovascular system (35 to 39)
- transluminal coronary angioplasty (36.01, 36.02 and 36.05)
- bypass anastomosis for heart revascularisation (36.1).
For country specific notes on these data collections, please refer to the annexes at the end of the national metadata reports accessible from links at the beginning of the European metadata report.
The Healthcare non-expenditure statistics manual provides an overview of the classifications, both for mandatory variables and variables provided on a voluntary basis.
Eurostat is in the process of updating the technical requirements for countries to submit hospital discharge data in line with Commission Regulation (EU) 2294/2022. Therefore, hospital discharge data on cardiovascular diseases are not presented in this year’s edition of this article. Causes of death
Statistics on causes of death provide information on mortality patterns, supplying information on developments over time in the underlying causes of death. This source is documented in more detail in a background article on the methodology of causes of death statistics. This provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions. Under Commission Regulation (EU) 0328/2011, countries provide causes of death data to Eurostat within 24 months (T+24) after the end of the reference year.
Causes of death are classified according to the 86 causes in the European shortlist, which is based on the International Statistical Classification of Diseases and Related Health Problems (ICD). Chapter IX of the ICD covers diseases of the circulatory system
- acute rheumatic fever (I00 to I02)
- chronic rheumatic heart diseases (I05 to I09)
- hypertensive diseases (I10 to I15)
- ischaemic heart diseases (I20 to I25)
- pulmonary heart disease and diseases of pulmonary circulation (I26 to I28)
- other forms of heart disease (I30 to I52)
- cerebrovascular diseases (I60 to I69)
- diseases of arteries, arterioles and capillaries (I70 to I79)
- diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80 to I89)
- other and unspecified disorders of the circulatory system (I95 to I99).
Symbols
In tables, a colon ':' is used to show where data aren’t available. Data in italics are estimates or provisional.
Context
Statistics concerning cardiovascular diseases are of particular significance because these diseases are the principal cause of death within the EU. Increased prevention, especially for heart disease and strokes, has resulted in decreases across most EU countries concerning the number of people who face disability, reduced quality of life and premature death. Nevertheless, cardiovascular diseases continue to touch the lives of millions of Europeans each year.
According to the World Heart Federation, modifiable risk factors for cardiovascular diseases include hypertension, diabetes, obesity, hypercholesterolemia, tobacco and related products use, stress, sleep disorders, sedentary lifestyle, harmful alcohol consumption and unhealthy eating.
Cardiovascular diseases are included as 1 of the 5 main strands covered by the European Commission’s Healthier together – EU non-communicable diseases (NCD) initiative. The initiative was launched in December 2021 and aims to support EU countries in identifying and implementing effective policies and actions to reduce the burden of major NCDs and improve citizens’ health and well-being.
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Other articles
Online publications
Causes of death
Healthcare activities
Methodology
General health statistics articles
Database
- Health (hlth), see
- Health status (hlth_state)
- Self-reported chronic morbidity (hlth_srcm)
- Persons reporting a chronic disease, by disease, sex, age and educational attainment level (hlth_ehis_cd1e)
- Self-reported chronic morbidity (hlth_srcm)
- Health care (hlth_care)
- Health care activities (hlth_act)
- Operations, procedures and treatment (hlth_oper)
- Health care activities (hlth_act)
- Causes of death (hlth_cdeath)
- General mortality (hlth_cd_gmor)
- Causes of death - deaths by country of residence and occurrence (hlth_cd_aro)
- Causes of death - standardised death rate by NUTS 2 region of residence (hlth_cd_asdr2)
- General mortality (hlth_cd_gmor)
Thematic section
Publications
Selected datasets
- Health (t_hlth), see
- Causes of death (t_hlth_cdeath)
- Death due to other ischaemic heart diseases, by sex (tps00119)
- Death due to ischaemic heart diseases by NUTS 2 regions (tgs00059)
Methodology
Manuals and guidelines
Metadata
- Causes of death (SIMS metadata file – hlth_cdeath_sims)
- Health care resources (ESMS metadata file – hlth_res_esms)