Global Trends and Sociodemographic Disparities in LDL-Attributable Cardiovascular Disease: GBD 2021 Analysis (1990–2021)

IF 3.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal Pub Date : 2025-09-15 DOI:10.1016/j.ahj.2025.07.047

Rohan Raj , Ujjwal Mishra , Nikhil Jain , Kanishka Kumar Awasthi

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引用次数: 0

Abstract

Background

Elevated low-density lipoprotein (LDL) cholesterol is a major modifiable risk factor for cardiovascular disease (CVD). While global trends in LDL-attributable CVD have been previously reported, disparities across sociodemographic development levels remain insufficiently explored.

Objective

To assess global, regional, and SDI-specific trends in the CVD burden attributable to high LDL cholesterol from 1990 to 2021.

Methods

We utilized Global Burden of Disease (GBD) 2021 data to evaluate CVD mortality and disability-adjusted life years (DALYs) attributable to high LDL cholesterol. Trends were assessed using annual percentage change (APC) in age-standardized mortality rate (ASMR), age-standardized DALYs rate (ASDR), and age-standardized years lived with disability (ASYLD) by Socio-demographic Index (SDI), sex, and location.

Results

From 1990 to 2021, global ASMR and ASDR attributable to high LDL cholesterol declined. In 2021, ASMR and ASDR were lowest in high SDI regions. Israel recorded the largest decrease in APC for both ASMR and ASDR, while Lesotho exhibited the highest increase. Over the same period, Singapore showed the greatest decline in APC of ASYLD, whereas Tanzania had the most pronounced increase. The greatest reductions in APC of ASMR and ASDR from 1990 to 2021 were observed in high SDI countries, particularly during the decade 2000–2010. Females consistently showed declining APCs of ASMR across all SDI quintiles, whereas in males, APCs declined only in high and high-middle SDI countries.

Conclusion

Persistent disparities in CVD burden attributable to high LDL across SDI quintiles highlight the need for equitable, tailored lipid-lowering and cardiometabolic prevention strategies.

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ldl归因心血管疾病的全球趋势和社会人口差异：GBD 2021分析（1990-2021）

背景低密度脂蛋白（LDL）胆固醇升高是心血管疾病（CVD）的一个主要可改变的危险因素。虽然低密度脂蛋白引起的心血管疾病的全球趋势以前已经报道过，但社会人口发展水平之间的差异仍然没有得到充分的探讨。目的评估1990年至2021年全球、地区和sdi特异性高LDL胆固醇导致的心血管疾病负担趋势。方法利用全球疾病负担（GBD） 2021数据评估高LDL胆固醇导致的CVD死亡率和残疾调整生命年（DALYs）。根据社会人口指数（SDI）、性别和地区，使用年龄标准化死亡率（ASMR）、年龄标准化DALYs率（ASDR）和年龄标准化残疾生活年数（ASYLD）的年百分比变化（APC）来评估趋势。结果从1990年到2021年，全球高LDL胆固醇导致的ASMR和ASDR下降。2021年，高SDI地区的ASMR和ASDR最低。以色列ASMR和ASDR的APC下降幅度最大，而莱索托的APC增长幅度最大。在同一时期内，新加坡的残疾儿童综合福利费用下降幅度最大，而坦桑尼亚的增加幅度最大。从1990年到2021年，高SDI国家的ASMR和ASDR的APC减少幅度最大，特别是在2000-2010十年期间。在所有SDI五分位数中，女性的ASMR apc持续下降，而在男性中，apc仅在高和中高SDI国家下降。结论：高LDL导致的心血管疾病负担在SDI五分位数中持续存在差异，这凸显了制定公平、量身定制的降脂和心脏代谢预防策略的必要性。

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

American heart journal 医学-心血管系统

CiteScore

8.20

自引率

2.10%

发文量

214

审稿时长

38 days

期刊介绍： The American Heart Journal will consider for publication suitable articles on topics pertaining to the broad discipline of cardiovascular disease. Our goal is to provide the reader primary investigation, scholarly review, and opinion concerning the practice of cardiovascular medicine. We especially encourage submission of 3 types of reports that are not frequently seen in cardiovascular journals: negative clinical studies, reports on study designs, and studies involving the organization of medical care. The Journal does not accept individual case reports or original articles involving bench laboratory or animal research.