Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine. Key Lab of Cardiovascular Disease of Zhejiang Province, Hangzhou, China.
J Glob Health. 2020 Dec;10(2):020404. doi: 10.7189/jogh.10.020404.
Valvular heart disease (VHD) is expected to cause an increase in public-health problems in the coming years, especially in elderly populations. We aim to estimate the incidence, mortality, and burden of VHD, by age, from 1990 to 2017 in 195 countries and territories.
We estimated the incidence, mortality, and burden of VHD based on the Global Burden of Disease Study 2017. All metrics are presented with their 95% uncertainty intervals (UIs). The Socio-demographic Index was used to identify whether developmental status correlates with health outcomes.
The global incidence of rheumatic heart disease (RHD) decreased by 8.67% between 1990 and 2017, while that of non-rheumatic VHD (NRVHD) increased by 45.10%. There was a 54.00% decrease in age-standardized death rate (ASDR) for RHD, but a small and non-significant decrease (-3.00%) in the ASDR for NRVHD. The global age-standardized disability-adjusted life years (DALY) rate of RHD decreased by 53.52%, while there was a 12.62% reduction in the age-standardized DALY rate of NRVHD.
The burden from different VHDs demonstrated a diverse change at a global level between 1990 and 2017. Although RHD burden has an obvious means of mitigation, a substantially high incidence of NRVHD was observed over this time period, especially in the elderly, which may lead to high health care costs and signify the potential for even higher costs in the future.
预计在未来几年，瓣膜性心脏病（VHD）将导致公共卫生问题增加，尤其是在老年人群中。我们旨在评估 195 个国家和地区 1990 年至 2017 年期间按年龄划分的 VHD 发病率、死亡率和负担。
我们根据 2017 年全球疾病负担研究估计了 VHD 的发病率、死亡率和负担。所有指标均以 95%置信区间（UI）表示。社会人口指数用于确定发展状况是否与健康结果相关。
1990 年至 2017 年期间，风湿性心脏病（RHD）的全球发病率下降了 8.67%，而非风湿性 VHD（NRVHD）的发病率则上升了 45.10%。RHD 的年龄标准化死亡率（ASDR）下降了 54.00%，但 NRVHD 的 ASDR 略有下降（-3.00%）且无统计学意义。RHD 的全球年龄标准化残疾调整生命年（DALY）率下降了 53.52%，而 NRVHD 的年龄标准化 DALY 率则下降了 12.62%。
1990 年至 2017 年期间，全球不同 VHD 的负担呈现出不同的变化趋势。尽管 RHD 的负担有明显的减轻趋势，但在此期间 NRVHD 的发病率仍然很高，尤其是在老年人中，这可能导致医疗保健费用增加，并预示着未来可能会有更高的费用。
