Global, Regional, and National Burden of Ischemic Heart Disease Attributable to 25 Risk Factors and Their Summary Exposure Value Across 204 Countries With Different Socio-Demographic Index Levels, 1990-2021: A Systematic Fixed-Effects Analysis and Comparative Study.

IF 3.4 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology Pub Date : 2025-02-20 eCollection Date: 2025-01-01 DOI:10.2147/CLEP.S510347

Juntao Tan, Min Xue, Huanyin Li, Yang Liu, Yuxin He, Jing Liu, Jie Liu, Luojia Tang, Jixian Lin

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引用次数: 0

Abstract

Background: A systematic relational assessment of the global, regional, and national Ischemic heart disease (IHD) burden and its attributable risk factors is essential for developing more targeted prevention and intervention strategies.

Methods: The GBD 2021 comparative risk assessment framework was employed to evaluate stroke burden attributable to environmental, behavioral, metabolic, and dietary risk factors, and a total of 25 risk factors were included. Specifically, we used the joinpoint regression model, decomposition analysis, and systematic fixed-effects analysis to reveal the global, regional, and national burden of IHD attributable to these 25 risk factors and their exposure value across 204 countries and territories with different socio-demographic index (SDI) levels from different perspectives.

Results: Joinpoint regression revealed similar trends in summary exposure value (SEV) and attributable burdens for 25 IHD risk factors. From 1990 to 2021, SEV rankings increased for 12/25 risk factors, decreased for 10/25, and remained unchanged for 3/25. Decomposition analysis indicated that from 1990 to 2021, low SDI countries experienced the most significant increase in IHD burden attributable to 25 risk factors due to population growth, while upper-middle and high SDI countries were most affected by population aging, and high SDI countries demonstrated the greatest reduction in IHD burden attributed to epidemiological changes. Panel data analysis elucidated the impact of SEV, SDI, and quality-of-care index (QCI) on attributable IHD burden.

Conclusion: This study emphasizing the critical role of risk factor control. Tailored interventions and exploration of country-specific factors are crucial for effectively reducing the global IHD burden.

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1990-2021年204个不同社会人口指数水平国家25种危险因素的全球、地区和国家缺血性心脏病负担及其总暴露值：系统固定效应分析和比较研究

背景：对全球、区域和国家缺血性心脏病（IHD）负担及其归因危险因素进行系统的相关性评估，对于制定更有针对性的预防和干预策略至关重要。方法：采用GBD 2021比较风险评估框架，对环境、行为、代谢和饮食等危险因素导致的卒中负担进行评估，共纳入25个危险因素。具体而言，我们采用联结点回归模型、分解分析和系统固定效应分析，从不同角度揭示了这25个危险因素在204个不同社会人口指数（SDI）水平的国家和地区的全球、区域和国家IHD负担及其暴露值。结果：联合点回归揭示了25个IHD危险因素的总暴露值（SEV）和归因负担的相似趋势。1990 - 2021年，12/25的SEV排名上升，10/25的SEV排名下降，3/25的SEV排名保持不变。分解分析表明，从1990年到2021年，低SDI国家由于人口增长导致的25个危险因素导致IHD负担增加最显著，而中高SDI国家受人口老龄化影响最大，高SDI国家由于流行病学变化导致的IHD负担减少最大。面板数据分析阐明了SEV、SDI和护理质量指数（QCI）对IHD归因负担的影响。结论：本研究强调了危险因素控制的重要性。量身定制的干预措施和探索具体国家因素对于有效减少全球IHD负担至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology Medicine-Epidemiology

CiteScore

6.30

自引率

5.10%

发文量

169

审稿时长

16 weeks

期刊介绍： Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.