Zhang M N, Li M T, Zhi X Y, Zhu H, Zhang X, Xie J
School of Public Health, Tianjin Medical University/Tianjin Key Laboratory of Environment, Nutrition and Public Health/Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Oct 10;42(10):1797-1803. doi: 10.3760/cma.j.cn112338-20201208-01390.
To quantitatively analyze the effects of population aging and other risk factors on the burden of atherosclerosis cardiovascular disease (ASCVD) in China from 1990 to 2019. Disability adjusted life years (DALY) and age-standardized rates obtained from the Global Burden of Disease Study 2019 (GBD2019) were used to describe the temporal trend of a burden on ASCVD. And a decomposition method established by Gupta was applied to quantify the burden related to population growth, aging, age-specific prevalence, and the severity of the disease. In 2019, 61.00% of the burden of cardiovascular disease in China was caused by ASCVD. The DALY of ischemic heart disease increased by 133.66% compared with that in 1990, with 29.57% of the increase attributed to population growth, 108.74% due to population aging, and 8.87% due to the rise of age-specific prevalence and -13.53% benefited from changes in disease severity. The DALY of ischemic stroke increased by 138.64% compared with 1990, and the proportions attributable to the above four parts were 30.95%, 123.38%, 55.80%, and -71.49%, respectively. Hypertension remained the leading risk factor for ASCVD in 2019, followed by high LDL cholesterol. The age-standardized DALY rate attributable to drinking had the most significant increase (486.01%) from 1990, with an average annual growth of 10.93%. Aging population seems responsible for the main reason for the considerable increase in the burden of ASCVD in China. Still, the adverse trends of other avoidable risk factors, especially metabolic risk factors, can not be ignored.
定量分析1990年至2019年中国人口老龄化及其他风险因素对动脉粥样硬化性心血管疾病（ASCVD）负担的影响。利用全球疾病负担研究2019（GBD2019）获得的伤残调整生命年（DALY）和年龄标准化率来描述ASCVD负担的时间趋势。并应用古普塔建立的分解方法来量化与人口增长、老龄化、特定年龄患病率和疾病严重程度相关的负担。2019年，中国心血管疾病负担的61.00%由ASCVD引起。与1990年相比，缺血性心脏病的DALY增加了133.66%，其中29.57%的增加归因于人口增长，108.74%归因于人口老龄化，8.87%归因于特定年龄患病率的上升，-13.53%得益于疾病严重程度的变化。与1990年相比，缺血性中风的DALY增加了138.64%，上述四个部分的占比分别为30.95%、123.38%、55.80%和-71.49%。高血压在2019年仍是ASCVD的主要危险因素，其次是高LDL胆固醇。1990年以来，归因于饮酒的年龄标准化DALY率上升最为显著（486.01%），年均增长10.93%。人口老龄化似乎是中国ASCVD负担大幅增加的主要原因。然而，其他可避免的风险因素，尤其是代谢风险因素的不利趋势也不容忽视。
