The study examines the global trends in cardiovascular mortality from 1990 to 2013, focusing on the drivers of these trends: population growth, population aging, and epidemiologic changes. Using data from the Global Burden of Disease Study 2013, the authors developed counterfactual scenarios to disentangle the effects of these drivers. They found that global deaths from cardiovascular disease increased by 41% between 1990 and 2013, despite a 39% decrease in age-specific death rates. This increase was primarily driven by a 55% increase in mortality due to population aging and a 25% increase due to population growth. The relative contributions of these drivers varied by region, with only Central Europe and Western Europe showing a decline in cardiovascular deaths. The study also found that changes in gross domestic product per capita were weakly correlated with changes in age-specific death rates, except in upper-middle-income countries. The findings highlight the importance of understanding these demographic and epidemiologic trends for planning healthcare systems and setting goals for reducing cardiovascular disease.The study examines the global trends in cardiovascular mortality from 1990 to 2013, focusing on the drivers of these trends: population growth, population aging, and epidemiologic changes. Using data from the Global Burden of Disease Study 2013, the authors developed counterfactual scenarios to disentangle the effects of these drivers. They found that global deaths from cardiovascular disease increased by 41% between 1990 and 2013, despite a 39% decrease in age-specific death rates. This increase was primarily driven by a 55% increase in mortality due to population aging and a 25% increase due to population growth. The relative contributions of these drivers varied by region, with only Central Europe and Western Europe showing a decline in cardiovascular deaths. The study also found that changes in gross domestic product per capita were weakly correlated with changes in age-specific death rates, except in upper-middle-income countries. The findings highlight the importance of understanding these demographic and epidemiologic trends for planning healthcare systems and setting goals for reducing cardiovascular disease.