Worldwide burden of metabolic risk-related cardiovascular disease from 1990 to 2021, with projections to 2050: A systematic analysis for the Global Burden of Disease Study 2021.
Xinjiang Dong, Jia Wang, Chao Wang, Beibei Wang, Gang Li, Jiefu Yang, Tong Zou
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Abstract
Aims: This study presents a detailed examination of specific metabolic risk factors for various types of cardiovascular disease (CVD) from 1990 to 2021, stratified by sex, age and socio-demographic index (SDI) levels, and to predict the future trajectory up to 2050.
Materials and methods: Data from the Global Health Data Exchange were utilized to estimate the burden of metabolic risk-related CVD, including high low-density lipoprotein cholesterol (LDL-c), high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high body mass index (BMI) and kidney dysfunction, across different types of CVD. The study employed the age-standardized death rate (ASDR)/crude death rate and its estimated annual percentage change (EAPC) to measure the burden, and a Bayesian age-period-cohort model (BAPC) to forecast future trends.
Results: Globally, in 2021, the ASDR for high SBP-related CVD was 125.33 per 100 000 population, with the largest share attributed to ischaemic heart disease (IHD) (56.73) and ischaemic stroke (IS) (25.57). The ASDR for high BMI-related CVD was 22.77 per 100 000 population, with the largest share attributed to IHD (11.71) and hypertensive heart disease (HHD) (7.21). The ASDR for high FPG-related CVD was 26.85 per 100 000 population, with the largest share attributed to IHD (16.27) and IS (8.11). The ASDR for high LDL-c-related CVD was 43.67 per 100 000 population, including IHD (32.29) and IS (11.38). The ASDR for kidney dysfunction-related CVD was 25.55 per 100 000 population, with the largest share also attributed to IHD (17.18) and IS (4.24). From 1990 to 2021, the EAPCs for high BMI-related HHD, intracerebral haemorrhage, subarachnoid haemorrhage and atrial fibrillation/flutter, as well as high FPG-related lower extremity peripheral arterial disease, increased. However, the EAPCs for most metabolic risk-related CVD declined, with varying EAPCs across different risk factors, sexes, age groups and SDI levels. Projected increases in CVD deaths related to all metabolic risks are expected by 2050, with significant variations in ASDR trends.
Conclusions: This study provides a comprehensive analysis of the historical and projected burden of metabolic risk-related CVD, highlighting the need for targeted interventions to mitigate the escalating challenges posed by these diseases and their impact on global health systems.
目的：本研究详细分析了1990年至2021年间不同类型心血管疾病（CVD）的特定代谢危险因素，按性别、年龄和社会人口指数（SDI）水平分层，并预测了到2050年的未来轨迹。材料和方法：利用全球健康数据交换（Global Health Data Exchange）的数据来估计代谢风险相关CVD的负担，包括不同类型CVD的高低密度脂蛋白胆固醇（LDL-c）、高收缩压（SBP）、高空腹血糖（FPG）、高体重指数（BMI）和肾功能障碍。该研究采用年龄标准化死亡率(ASDR)/粗死亡率及其估计年百分比变化（EAPC）来衡量负担，并采用贝叶斯年龄-时期-队列模型（BAPC）来预测未来趋势。结果：在全球范围内，2021年，高sbp相关CVD的ASDR为每10万人125.33例，其中缺血性心脏病（IHD）（56.73例）和缺血性卒中（IS）（25.57例）所占比例最大。高bmi相关心血管疾病的ASDR为每10万人22.77例，其中IHD（11.71例）和高血压性心脏病（7.21例）占比最大。高血压相关心血管疾病的ASDR为每10万人26.85例，其中IHD（16.27例）和IS（8.11例）占比最大。高ldl -c相关心血管疾病的ASDR为43.67 / 10万人，包括IHD（32.29）和IS（11.38）。肾功能障碍相关心血管疾病的ASDR为每10万人25.55例，IHD（17.18例）和IS（4.24例）也占最大份额。从1990年到2021年，高bmi相关HHD、脑出血、蛛网膜下腔出血和心房颤动/扑动以及高bmi相关下肢外周动脉疾病的EAPCs增加。然而，大多数代谢风险相关心血管疾病的EAPCs下降，不同风险因素、性别、年龄组和SDI水平的EAPCs有所不同。预计到2050年，与所有代谢风险相关的心血管疾病死亡人数将增加，ASDR趋势将出现显著变化。结论：本研究对代谢风险相关心血管疾病的历史和预测负担进行了全面分析，强调需要有针对性的干预措施，以减轻这些疾病带来的不断升级的挑战及其对全球卫生系统的影响。
期刊介绍：
Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.
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