Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China.
Institute of Model Animal, Wuhan University, Wuhan, China.
Ann Med. 2022 Dec;54(1):553-564. doi: 10.1080/07853890.2022.2034932.
Aortic aneurysm (AA) is a serious condition that largely increases the risk of aortic dissection and sudden death. Exploring the global burden of disease and changes in risk factors for AA is essential for public health policy development.
To project the death burden from AA and its attributable risk factors in the following decade based on the epidemiological data over the past 30 years.
We analysed the death burden of AA and trends of four risk factors from 1990-2019 using the updated 2019 Global Burden of Disease study database by Joinpoint regression analysis. Furthermore, we project the AA-related death burden for the next decade using the Bayesian age-period-cohort model. This study discovered that the global burden of death attributable to AA began to increase after decreasing for two decades. This upward trend will continue in the subsequent decade (average annual percent change: 0.318%, 95% CI: 0.288 to 0.348). Meanwhile, the disease burdens in all economic regions except high-middle socio-demographic index (SDI) regions will continuously increase in the next decade, with the fastest acceleration in the low-middle SDI region (average annual percent change: 1.183%, 95% CI: 1.166 to 1.200). Notably, high systolic blood pressure will surpass the contribution of smoking to become the most important risk factor for mortality due to AA.
This study discovered a rebounding trend in the aortic aneurysm-related death burden globally. High systolic blood pressure will be the top risk factor attributed to death from AA. Therefore, it should be considered as the first-degree risk factor in the guidance of AA management and criteria for population-based screening programs.Key messagesThe death burden of aortic aneurysms is beginning to rebound globally, and the trend will continue for the next decade.High systolic blood pressure will replace smoking as the most important risk factor associated with aortic aneurysm death.
主动脉瘤（AA）是一种严重的疾病，会大大增加主动脉夹层和猝死的风险。探索全球疾病负担和 AA 风险因素的变化对于制定公共卫生政策至关重要。
根据过去 30 年的流行病学数据，预测未来十年 AA 的死亡负担及其归因风险因素。
我们使用 2019 年全球疾病负担研究数据库的最新数据，通过 Joinpoint 回归分析，分析了 1990 年至 2019 年 AA 的死亡负担和四个风险因素的趋势。此外，我们使用贝叶斯年龄-时期-队列模型预测未来十年与 AA 相关的死亡负担。本研究发现，全球归因于 AA 的死亡负担在下降二十年之后开始增加。这种上升趋势将在未来十年持续（平均年变化百分比：0.318%，95%CI：0.288 至 0.348）。与此同时，除高-中社会人口指数（SDI）地区外，所有经济区域的疾病负担将在未来十年持续增加，中低 SDI 地区的增速最快（平均年变化百分比：1.183%，95%CI：1.166 至 1.200）。值得注意的是，高收缩压将超过吸烟，成为导致 AA 死亡的最重要风险因素。
本研究发现全球与主动脉瘤相关的死亡负担呈反弹趋势。高收缩压将成为导致 AA 死亡的首要风险因素。因此，在 AA 管理指南和基于人群的筛查计划标准中，应将其视为一级风险因素。
全球主动脉瘤死亡负担开始反弹，未来十年这一趋势将持续。高收缩压将取代吸烟，成为与主动脉瘤死亡相关的最重要风险因素。
