Cardiovascular disease may account for a relatively small proportion of onboard medical consultations, but serious cases can have a disproportionate clinical and operational impact, according to VIKAND, whose commercial shipping data reinforces findings from the recently published 2026 Gard Crew Claims Report.
Gard's report, based on around 3,000 P&I crew claims, found that illness accounts for around 60% of all crew claims, with cardiovascular disease responsible for both the highest illness costs and the greatest number of fatalities, highlighting a significant crew welfare and operational risk.
Analysis of commercial shipping clinical encounters through OneHealth by VIKAND from 2024-2026 found that cardiovascular conditions represented around 5% of consultations. By comparison, musculoskeletal conditions accounted for approximately 13%, dermatology 11%, injuries 10%, gastrointestinal conditions 9% and infectious diseases 8%.
Despite their lower frequency, cardiovascular illnesses accounted for approximately 10% of all disembarkations, making them the fourth most common reason for crew disembarkation over the same period.
VIKAND's data points to a growing burden of chronic cardiovascular risk factors among crew, particularly older seafarers, rather than clear evidence that cardiovascular emergencies themselves are becoming more frequent. Hypertension, obesity, diabetes and other chronic conditions increase the likelihood of future cardiovascular events if not identified and managed early.
"Gard's findings reflect exactly what our clinicians are seeing across the global fleet," said Ronald Spithout, Managing Director, OneHealth by VIKAND. "The maritime industry has become very good at responding to emergencies but the greater opportunity now is preventing them. If we can identify and manage hypertension before it becomes chest pain, and chest pain before it becomes a medical evacuation, we improve outcomes for crew while reducing operational disruption."
Hypertension remains one of the most significant modifiable cardiovascular risk factors encountered by VIKAND clinicians, alongside obesity, diabetes, tobacco use, poor diet and physical inactivity. Fatigue, shift work, disrupted sleep, prolonged contracts and psychosocial stress can further contribute to risk.
VIKAND believes the greatest opportunity for shipowners lies in proactive chronic disease management, supported by comprehensive pre-employment and pre-embarkation health assessments.
Careful review of PEME results can identify cardiovascular risk factors before deployment, while routine blood pressure monitoring, targeted follow-up, medication adherence and onboard health and wellness initiatives can help prevent deterioration. Encouraging honest disclosure of well-controlled chronic conditions and ensuring crew carry sufficient maintenance medication for potential voyage extensions can further reduce risk.
One recent case demonstrates the value of this approach. A 60-year-old crew member developed chest pain onboard a vessel in a remote region where immediate evacuation was not possible. Working with the ship's command team, VIKAND clinicians established twice-daily monitoring of symptoms, blood pressure and ECG findings, while initiating anti-anginal therapy and adjusting treatment as his condition evolved.
Despite recurring episodes over nearly two weeks, the crew member remained clinically stable and was safely disembarked for specialist assessment at the vessel's scheduled port, avoiding an emergency diversion.
"This outcome demonstrated the value of structured protocols, continuous monitoring and close collaboration between ship and shore,” said Mr Spithout. “Telehealth isn't designed to replace hospitals, it's about bringing expert clinical judgement to the places where hospitals can't reach."
With cardiovascular disease identified as the highest-cost illness category in the Gard report, VIKAND is encouraging shipowners to view cardiovascular health as part of operational resilience. Proactive programmes can also generate measurable data on cardiovascular risk, blood pressure control, teleconsultations, disembarkations and repatriations, helping shipowners assess the impact of preventive interventions.
"Every avoided escalation means less disruption to operations, lower healthcare costs and, most importantly, a better outcome for the individual," concluded Mr Spithout. "The strongest safety cultures don't wait for a crisis, they identify health risks early, encourage crews to speak up and give people access to the support they need before a medical issue becomes an emergency."
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