Amini Maedeh, Zayeri Farid, Salehi Masoud
Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Proteomics Research Center and Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Public Health. 2021 Feb 25;21(1):401. doi: 10.1186/s12889-021-10429-0.
Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the trend in CVD incidence, mortality, and mortality-to-incidence ratio (MIR) across the world over 28 years.
The age-standardized CVD mortality and incidence rates were retrieved from the Global Burden of Disease (GBD) Study 2017 for both genders and different world super regions with available data every year during the period 1990-2017. Additionally, the Human Development Index was sourced from the United Nations Development Programme (UNDP) database for all countries at the same time interval. The marginal modeling approach was implemented to evaluate the mean trend of CVD incidence, mortality, and MIR for 195 countries and separately for developing and developed countries and also clarify the relationship between the indices and Human Development Index (HDI) from 1990 to 2017.
The obtained estimates identified that the global mean trend of CVD incidence had an ascending trend until 1996 followed by a descending trend after this year. Nearly all of the countries experienced a significant declining mortality trend from 1990 to 2017. Likewise, the global mean MIR rate had a significant trivial decrement trend with a gentle slope of 0.004 over the time interval. As such, the reduction in incidence and mortality rates for developed countries was significantly faster than developing counterparts in the period 1990-2017 (p < 0.05). Nevertheless, the developing nations had a more rather shallow decrease in MIR compared to developed ones.
Generally, the findings of this study revealed that there was an overall downward trend in CVD incidence and mortality rates, while the survival rate of CVD patients was rather stable. These results send a satisfactory message that global effort for controlling the CVD burden was quite successful. Nonetheless, there is an urgent need for more efforts to improve the survival rate of patients and lower the burden of this disease in some areas with an increasing trend of either incidence or mortality.
心血管疾病(CVDs)是全球主要的关注原因之一,因为其患病率不断上升,死亡率和残疾后果严重,经济负担沉重。本研究的目的是分析28年来全球心血管疾病发病率、死亡率和死亡率与发病率之比(MIR)的趋势。
从《2017年全球疾病负担(GBD)研究》中检索1990 - 2017年期间每年有可用数据的不同世界超级区域和两性的年龄标准化心血管疾病死亡率和发病率。此外,同时从联合国开发计划署(UNDP)数据库获取所有国家在相同时间间隔的人类发展指数。采用边际建模方法评估195个国家以及分别针对发展中国家和发达国家的心血管疾病发病率、死亡率和MIR的平均趋势,并阐明1990年至2017年这些指数与人类发展指数(HDI)之间的关系。
获得的估计结果表明,全球心血管疾病发病率的平均趋势在1996年之前呈上升趋势,此后呈下降趋势。几乎所有国家在1990年至2017年期间都经历了显著的死亡率下降趋势。同样,在该时间间隔内,全球平均MIR率有显著的轻微下降趋势,斜率为0.004。因此,在1990 - 2017年期间,发达国家发病率和死亡率的下降速度明显快于发展中国家(p < 0.05)。然而,与发达国家相比,发展中国家MIR的下降幅度较小。
总体而言,本研究结果表明,心血管疾病的发病率和死亡率总体呈下降趋势,而心血管疾病患者的生存率相当稳定。这些结果传递了一个令人满意的信息,即全球控制心血管疾病负担的努力相当成功。尽管如此,迫切需要做出更多努力,以提高患者的生存率,并在发病率或死亡率呈上升趋势的某些地区降低这种疾病的负担。