Table 1. Cardiovascular Case Definitions.

GBD Cause	Definition
Rheumatic heart disease	Diagnosis by a physician with use of echocardiography. This case definition for echocardiographic confirmation of rheumatic heart disease follows the World Heart Federation criteria for echocardiographic diagnosis.12
Ischemic heart disease	Myocardial infarction as defined in the Fourth Universal Definition of Myocardial Infarction.13 Coronary artery disease defined as at least moderate (>50%) stenosis of an epicardial coronary vessel based on angiographic or functional diagnostic testing.14,15 Heart failure due to ischemic heart disease defined as a clinical diagnosis based on structured criteria as described.4
Ischemic stroke	Brain imaging showing blood flow to part of the brain being occluded and according to WHO criteria of rapidly developing clinical signs of disturbance of cerebral function lasting >24 h or leading to death.16,17
Intracerebral hemorrhage	Brain imaging showing bleeding into the tissue of the brain and according to WHO criteria of rapidly developing clinical signs of disturbance of cerebral function lasting >24 h or leading to death. Only nontraumatic events were included.16,17
Subarachnoid hemorrhage	Brain imaging or lumbar puncture indicating the rupture of a blood vessel resulting in bleeding into the subarachnoid space and according to WHO criteria of rapidly developing clinical signs of disturbance of cerebral function lasting >24 h or leading to death. Only nontraumatic events were included.16,17
Hypertensive heart disease	Heart condition caused by long-term high blood pressure, resulting in left ventricular hypertrophy, diastolic dysfunction, and clinical heart failure with either preserved or reduced systolic function of the left ventricle. Clinical diagnosis of heart failure is based on structured criteria as described.4
Non-rheumatic calcific aortic valve disease	Diagnosis by a physician based on echocardiographic findings of stenosis or regurgitation caused by progressive calcification of the valve, excluding congenital, rheumatic, or infectious causes but including stenosis of a bicuspid aortic valve.18
Non-rheumatic degenerative mitral valve disease	Diagnosis by a physician based on echocardiographic findings of myxomatous degeneration or prolapse of the mitral valve leading to at least moderate mitral regurgitation, excluding disease due to annular dilation, congenital, rheumatic, or infectious causes.18
Other non-rheumatic valve diseases	Residual category capturing diagnosis by a physician based on echocardiographic findings of stenosis or regurgitation of pulmonary and tricuspid valves. Valve dysfunction due to congenital, infectious, or rheumatic causes was estimated separately.18
Myocarditis	Acute myocarditis is defined by symptoms, clinical examination, cardiac imaging such as cardiac MRI, or endomyocardial biopsy.19 Heart failure due to myocarditis is a clinical diagnosis of heart failure based on structured criteria as described with a history of myocarditis.4
Alcoholic cardiomyopathy	Clinical diagnosis of heart failure based on structured criteria as described due to the toxic effects of ingested alcohol.4
Other cardiomyopathy	Residual category capturing a clinical diagnosis of heart failure based on structured criteria as described without a history of other potential causes of heart failure.4
Pulmonary arterial hypertension	Diagnosis by a physician based on findings of restricted blood flow and elevated pressure in the pulmonary arteries based on right heart catheterization or echocardiography.20
Atrial fibrillation and flutter	ECG studies demonstrating irregularly irregular RR intervals; and no P waves.21,22
Aortic aneurysm	Abdominal or thoracic aorta is abnormally enlarged and weakened due to atherosclerosis, high blood pressure, or inflammation, which can lead to tearing or rupture of the blood vessel.23 Prevalence and YLDs are not currently estimated for aortic aneurysm.
Lower-extremity peripheral artery disease	An ankle-brachial index ≤0.90.24
Endocarditis	Acute infective endocarditis was diagnosed defined as a clinical diagnosis clinically via based on the Duke Criteria, which includes confirmation through clinical signs and blood tests.25 Heart failure due to endocarditis was based on a clinical diagnosis of heart failure based on structured criteria as described with a history of acute infective endocarditis.4
Other cardiovascular and circulatory diseases	This aggregate cause incorporates less common cardiovascular diseases that are not modelled independently; for example, pericarditis. Diagnostic criteria vary based on the underlying condition.

ECG = echocardiogram; MRI = magnetic resonance imaging; WHO = World Health Organization; YLDs = years lived with disability.