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全球、区域和国家心血管疾病负担的系统分析:1990-2017 年

Systematic Analysis of the Global, Regional and National Burden of Cardiovascular Diseases from 1990 to 2017.

机构信息

Department of Scientific Research, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.

出版信息

J Epidemiol Glob Health. 2022 Mar;12(1):92-103. doi: 10.1007/s44197-021-00024-2. Epub 2021 Dec 13.

Abstract

BACKGROUND

Previous studies on the burden of cardiovascular diseases (CVDs) were mainly based on limited data of the study period or area, or did not include detailed risk factor analysis.

OBJECTIVE

To investigate up-to-date temporal and regional trends and risk factors of mortality and disability-adjusted life years (DALYs) attributed to CVDs by age, sex, and disease throughout the world.

METHODS

Data for the disease burden of CVDs in 195 countries and territories from 1990 to 2017, including mortality, DALYs, age-standardized mortality rates, and age-standardized DALY rates, were estimated from the Global Burden of Disease Study 2017. Risk factors attributable to deaths and DALYs for CVDs were also estimated using the comparative risk assessment framework.

RESULTS

The number of deaths from CVDs increased by 48.62%, from 11.94 (95% UI 11.78-12.18) million in 1990 to 17.79 (17.53-18.04) million in 2017. However, the age-standardized mortality rate decreased by an average of - 1.45% (- 1.72% to - 1.18%) annually. After fluctuation in the expected age-standardized mortality rate of CVDs in most of the socio-demographic index (SDI) scale, these rates decrease rapidly for SDI values of 0.7 and higher. In 2017, metabolic risks accounted for 73.48% of deaths and 73.25% of DALYs due to CVDs, behavioral factors accounted for 63.23% of deaths and 66.71% of attributable DALYs.

CONCLUSION

CVDs remain a major global health burden due to the increment in death numbers and DALYs. Aging and the main risk factors are the main drivers of mortality and health loss. More attention to main risk factors should be paid with supportive health policies.

摘要

背景

以前关于心血管疾病(CVD)负担的研究主要基于研究期间或地区的有限数据,或者没有包括详细的风险因素分析。

目的

调查全球范围内 CVD 死亡率和伤残调整生命年(DALYs)的最新时间和区域趋势及风险因素,分析这些因素按年龄、性别和疾病的分布情况。

方法

使用全球疾病负担研究 2017 年的数据,对 1990 年至 2017 年 195 个国家和地区的 CVD 疾病负担数据(包括死亡率、DALYs、年龄标准化死亡率和年龄标准化 DALY 率)进行了估计。还使用比较风险评估框架估计了 CVD 死亡和 DALY 的归因风险因素。

结果

CVD 死亡人数增加了 48.62%,从 1990 年的 1194 万人(95%UI 1178-1218 万人)增加到 2017 年的 1779 万人(1753-1804 万人)。然而,年龄标准化死亡率平均每年下降 1.45%(-1.72%至-1.18%)。在社会人口指数(SDI)尺度的大多数中,CVD 的预期年龄标准化死亡率波动后,SDI 值为 0.7 及更高时,这些死亡率迅速下降。2017 年,代谢风险占 CVD 死亡人数的 73.48%和 DALYs 的 73.25%,行为因素占 CVD 死亡人数的 63.23%和归因 DALYs 的 66.71%。

结论

由于死亡人数和 DALYs 的增加,CVD 仍然是全球主要的健康负担。老龄化和主要风险因素是死亡率和健康损失的主要驱动因素。应更加关注主要风险因素,并制定支持性卫生政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/8907368/e8ebc49674db/44197_2021_24_Fig1_HTML.jpg

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