Background　Cardiovascular　diseases　(CVDs)　represent　a　major　global　health　challenge,　necessitating　up-to-date　data　on　their　burden　for　effective　care　planning　and　resource　allocation.Aim　To　evaluate　the　trends　and　disparities　in　CVD　burden　and　associated　risk　factors　from　1990　to　2021.Design　A　population-based　secondary　analysis　of　global,　regional,　and　national　CVD　burden　using　data　from　the　Global　Burden　of　Disease　(GBD)　2021　study.Methods　We　analyzed　CVD　burden　and　its　risk　factors　using　estimates　from　the　GBD　2021　study.Results　In　2021,　there　were　612　million　cases　of　CVD　globally,　accounting　for　26.8%　of　all　deaths.　From　1990　to　2021,　the　global　age-standardized　prevalence　rate　of　CVD　rose　by　0.88%　to　7179　cases　per　100　000　individuals,　while　mortality　and　DALY　rates　fell　by　34.3%　and　33.0%　to　235　and　5056　cases　per　100　000　individuals,　respectively.　The　highest　CVD　burden　is　seen　in　low-middle　SDI　levels.　Regional　disparities,　differences　in　health　system　outcomes　and　SDI-related　inequalities　persist.　Ischemic　heart　disease　(IHD)　and　stroke　are　significant　contributors　among　CVD　subtypes.　The　burden　is　more　pronounced　in　older　age　groups　and　men.　Notably,　79.5%　of　total　CVD　disability-adjusted　life　years　(DALYs)　were　attributable　to　11　risk　factors,　with　high　body　mass　index　(BMI)　showing　the　most　significant　increase.Conclusion　Despite　advancements,　CVD　remains　a　significant　global　burden,　especially　in　low　and　lower-middle　SDI　regions.　Rising　prevalence　and　the　impact　of　COVID-19　underscore　ongoing　challenges.　The　diverse　burden　across　health　systems　highlights　the　need　for　sustained　investment　in　healthcare　infrastructure　and　targeted　interventions.　Addressing　modifiable　risk　factors　and　socioeconomic　inequalities　is　essential.