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19 reviewsBACKGROUND Cardiovascular diseases (CVDs) are the leading cause of mortality and are among the foremost causesof disability globally. CVD burden has continued to increase in most countries since 1990, with trends driven bychanging exposures to harmful risk factors, population growth, and population aging.OBJECTIVES We report estimates of global, national, and subnational CVD burden, including 18 subdiseases and12 associated modifiable risk factors. We analyzed change in CVD burden from 1990 to 2023 and identified drivers ofchange including population growth, population aging, and risk factor exposure.METHODS The Global Burden of Disease (GBD) 2023 study, a multinational collaborative research study, quantifiedburden due to 375 diseases including CVD burden and identified drivers of change from 1990 to 2023 using all availabledata and statistical models. GBD 2023 estimated the population-level burden of diseases in 204 countries and territoriesfrom 1990 to 2023.RESULTS CVDs were the leading cause of disability-adjusted life years (DALYs) and deaths estimated in the GBD. As of2023, there were 437 million (95% UI: 401 to 465 million) CVD DALYs globally, a 1.4-fold increase from the number in1990 of 320 million (292 to 344 million). Ischemic heart disease, intracerebral hemorrhage, ischemic stroke, and hypertensive heart disease were the leading cardiovascular causes of DALYs in 2023 globally. As of 2023, agestandardized CVD DALY rates were highest in low and low-middle Socio-demographic Index (SDI) settings and lowest inhigh SDI settings. The number of CVD deaths increased globally from 13.1 million (95% UI: 12.2 to 14.0 million) in 1990to 19.2 million (95% UI: 17.4 to 20.4 million) in 2023. The number of prevalent cases of CVD more than doubled since1990, with 311 million (95% UI: 294 to 333 million) prevalent cases of CVD in 1990 and 626 million (95% UI: 591 to 672million)