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Atherosclerotic cardiovascular disease is the world's number one cause of death and disability, and disproportionately affects individuals living in low-income and middle-income countries (LMICs).1Cardiovascular disease was recognised as common in high-income countries in the 1960s and 1970s,2 but the age-standardised mortality from cardiovascular disease has halved since then, through better prevention (such as lifestyle changes and risk factor control) and wider use of simple but effective treatments for acute events and secondary prevention.3 However, the use of these proven strategies, even in wealthy countries, is far from optimum and more widespread implementation could further reduce the rates of cardiovascular disease in the next two decades in most high-income countries.
By contrast, cardiovascular disease was thought to be uncommon in LMICs in the 1950s and 1960s, but increased substantially over the past three decades. Nowadays, more than 80% of the global burden of cardiovascular disease occurs in these countries.1 This high percentage is partly due to the much larger populations in these countries, progress in avoidance of deaths from childhood diseases so that now more individuals live to older ages when they are at risk of developing cardiovascular disease, and increased tobacco use, decreased physical activity, increased consumption of animal products, and increased obesity (with resultant elevations in blood pressure, cholesterol, and diabetes),4 especially in LMICs. Additionally, many factors have delayed or even prevented the implementation of the lessons learnt from experiences in high-income countries to LMICs./.../