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Richard S. Cooper, MD, Pedro Orduñez, MD, Marcos D. Iraola Ferrer, MD, Jose Luis Bernal Munoz, DDs and Alfredo Espinosa-Brito, MD, PhD

Richard S. Cooper is with the Stritch School of Medicine, Loyola University, Maywood, Ill. Pedro Ordunez, Marcos D. Iraola Ferrer, Jose Luis Bernal Munoz, and Alfredo Espinosa-Brito are with the Faculty of Medical Sciences, Hospital Universitario "Dr. Gustavo Aldereguia Lima," Cienfuegos, Cuba.

Correspondence: Requests for reprints should be sent to Richard S. Cooper, MD, Loyola University Medical Center, Maguire Center, 2160 S First Ave, Maywood, IL 60153 (e-mail: rcooper{at}lumc.edu).

Objectives. An adequate description of the trends in cardiovascular disease (CVD) is not available for most of the developing world. Cuba provides an important exception, and we sought to use available data to offer insights into the changing patterns of CVD there.

Methods. We reviewed Cuban public health statistics, surveys, and reports of health services.

Results. CVD has been the leading cause of death since 1970. A 45% reduction in heart disease deaths was observed from 1970 to 2002; the decline in stroke was more limited. There are moderate prevalences of all major risk factors.

Conclusions. The Cuban medical care system has responded vigorously to the challenge of CVD; levels of control of hypertension are the highest in the world. Nonindustrialized countries can decisively control CVD.

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