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Open access, freely available online Synopses of Research Articles Af?uence and the Worldwide Distribution of Cardiovascular Disease Risks DOI: 10.1371/journal.pmed.0020148 Cardiovascular diseases (CVDs) are responsible for more than 16 million deaths worldwide, about 30% of total global deaths. Many of these deaths could be prevented by tackling major risk factors such as overweight and obesity as a result of unhealthy diet and physical inactivity, and smoking.Traditionally, CVDs have been considered a“Western”disease or a“disease of af?uence”and not a pressing public health concern for low- income populations. However, within upper-middle-income and high-income countries, CVDs and their associated risk factors are increasingly concentrated among the lowest socioeconomic groups, and globally, 80% of all CVD deaths are in low-income and middle-income countries. In this month’s PLoS Medicine, Majid Ezzati and colleagues conclude that a large proportion of the world’s population living in low-income and middle-income countries should indeed be the focus of attention for CVD risk factors. This attention is needed because the aging populations of the currently low-income and middle-income countries are expected to be those among whom major cardiovascular risk factors will increasingly be concentrated. DOI: 10.1371/journal.pmed.0020148.g001 Global burden from cardiovascular disease urban centers, which may be due to changes in patterns of diet and physical activity with city life. For blood pressure and cholesterol, possible contributors to the decline at higher levels of income include dietary changes and use of pharmacological interventions. As more interventions for blood pressure and cholesterol are adopted in high-income societies, the three risk factors will become a feature of low-income and middle-income nations, the authors say. Demographic and technological changes are increasingly modifying the income patterns of cardio