Bangladesh’s outstanding fight against heart disease

Up to 80% of premature CVD deaths are preventable through affordable access to care, early screening, and more opportunities to make healthy choices in nutrition and stay active. That is why on World Heart Day, which is on September 29, we unite to raise awareness, inspire action, and celebrate heart health. The theme for World Heart Day 2025 is Don't Miss a Beat. Loved ones around the world are missing out on time they should still have to spend together due to early deaths from CVD.

In June, Bangladesh announced a new wave of measures to tackle its fight against cardiovascular disease (CVD), including lowering stent prices, increasing the number of functional catheterisation labs in district hospitals, expanding coronary care units and creating new cardiologist roles to bring quality cardiac care closer to every citizen. These steps build meaningfully the country's national CVD action plan, one of only 16 globally. With nearly 358,000 annual deaths from CVD and 80% of those preventable through early intervention and affordable care, this renewed commitment offers hope for saving millions of lives.

Yet, even as progress is welcome, we need to work aggressively toward fortifying measures to prevent disease.

At the centre of this are Bangladesh's severe air pollution levels, which are more than double the global mean. Dhaka's ranking as the world's fourth lowest city in the 2024 City Heartbeat Index, which measures air pollution among numerous other heart health indicators, underscores the urgency of tackling this issue.

Prolonged exposure to toxic air, driven by coal-burning brick kilns, industrial processes and vehicles running on low-quality fuels, increases the risk of heart attacks and strokes. This is not a problem confined to the capital; cities such as Gazipur, Noakhali, Cumilla and Tangail also face some of the country's heaviest pollution burdens, meaning that all 164.8 million citizens are exposed year-round to air pollution levels deemed unsafe by the World Health Organisation (WHO).

Long-term exposure to air pollutants directly contributes to hypertension, a major risk factor for CVD, and was linked to over 140,000 CVD-related deaths in Bangladesh in 2021 alone. Hypertension, often dubbed a 'silent killer', affects nearly one in three adults nationally, yet half of those with the condition are unaware, and most do not receive the treatment they need, even though national support is uniquely admirable. With air pollution exacerbating this, the need for action is more urgent than ever, especially in Dhaka and other heavily polluted areas. At the same time, only 40 percent of health facilities outside cities currently provide CVD specialist treatment, and some areas may lack essential medicines or diagnostic equipment.

Despite the challenges, Bangladesh has decidedly proven it can make progress. Tobacco use, the leading risk factor for CVD, has almost halved since 2000, thanks to strong public health action, including the Tobacco Control Act 2005 and mass awareness campaigns that highlighted the dangers of smoking. Additionally, public awareness of the importance of physical activity is growing, especially in urban areas, thanks to initiatives such as the 2024 "Healthier in Motion" campaign in Dhaka, which promoted fitness among women and youth.

Institutions such as the National Institute of Cardiovascular Diseases and the National Heart Foundation are playing key roles in training doctors, supporting hypertension detection, and educating communities on salt reduction and healthier lifestyles.

Most significantly, Bangladesh is one of only 16 countries worldwide to establish a dedicated National Action Plan for cardiovascular disease, putting it ahead of many peers in recognising the urgency of this challenge. These steps show foresight, leadership and a clear commitment to safeguarding the health of its citizens.

Moving forward, a focus on strengthening PREVENTION and improving access to healthcare for all is key.

This includes raising awareness and investing in improving air quality, hypertension detection and treatment in primary care, and ensuring that medicines are available beyond Dhaka, which would go a long way. This would mean continued support to health centres, training for healthcare professionals in rural areas and ensuring the supply of essential drugs.

The responsibility remains on individuals, too, to maintain healthier lifestyles by engaging in more physical activity, adopting balanced diets and quitting unhealthy habits like tobacco use.

Bangladesh has admirably succeeded in lowering its CVD death rate from 392 per 100,000 in 2000 to 319 per 100,000 in 2019. With its national CVD action plan, a growing culture of awareness, and proven capacity to drive change, Bangladesh is laying the foundation for a healthier tomorrow. The progress so far shows that with sustained commitment, millions more lives can be protected.

The writer is the president of the World Heart Federation. Email: [email protected]