Department of Cardiology, Renmin Hospital, School of Basic Medical Sciences, Wuhan University, Wuhan, China; Institute of Model Animal of Wuhan University, Wuhan, China.
Institute of Model Animal of Wuhan University, Wuhan, China; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Atherosclerosis. 2022 Apr;347:17-27. doi: 10.1016/j.atherosclerosis.2022.03.002. Epub 2022 Mar 9.
Peripheral artery disease (PAD) is a prevalent cardiovascular disease. Understanding current and future disease burden of PAD and its attributable risk factors is critical for developing prevention measures targeting PAD and associated complications.
We analyzed the death burden of PAD and the trends of six risk factors from 1990 to 2019 using the updated 2019 Global Burden of Disease study database, and projected the next decade death burden using a Bayesian age-period-cohort (BAPC) model.
The global age-standardized mortality rate (ASMR) of PAD has a modest downward trend from 1990 to 2019. Regionally, ASMRs in higher-sociodemographic index (SDI) areas remained more remarkable than in lower-SDI areas by 2019, while the rate of increase in death burden in the lower-SDI regions increased rapidly over time. ASMR in males was greater than in females. In the population aged older than 40 years, the sex difference in PAD-associated mortality decreased with age. High fasting plasma glucose (FPG) became the primary risk factor for PAD-related death. The contributions of risk factors to PAD-related death varied by age group. Kidney dysfunction was the primary contributor to PAD-related death in people aged 40-59 years, particularly in women.
The global death burden of PAD has not substantially decreased over the three decades. There are large variations in the trend of PAD mortality and its attributable risk factors by SDI regions, sex, and age group. Targeted and effective strategies are needed for the management of PAD-related mortality in specific subgroups.
外周动脉疾病（PAD）是一种常见的心血管疾病。了解 PAD 的当前和未来疾病负担及其归因风险因素对于制定针对 PAD 和相关并发症的预防措施至关重要。
我们使用更新的 2019 年全球疾病负担研究数据库分析了 1990 年至 2019 年 PAD 的死亡负担和六种风险因素的趋势，并使用贝叶斯年龄-时期-队列（BAPC）模型预测未来十年的死亡负担。
全球 PAD 的年龄标准化死亡率（ASMR）从 1990 年到 2019 年呈温和下降趋势。在区域上，到 2019 年，高社会人口指数（SDI）地区的 ASMR 仍比低 SDI 地区更为显著，而低 SDI 地区的死亡负担增长率却在迅速增加。男性的 ASMR 高于女性。在 40 岁以上的人群中，PAD 相关死亡率的性别差异随年龄的增长而减小。高空腹血糖（FPG）成为 PAD 相关死亡的主要危险因素。风险因素对 PAD 相关死亡的贡献因年龄组而异。肾功能不全是 40-59 岁人群 PAD 相关死亡的主要原因，尤其是女性。
在过去的三十年中，PAD 的全球死亡负担并未显著减少。SDI 地区、性别和年龄组之间 PAD 死亡率的趋势及其归因风险因素存在很大差异。需要针对特定亚组的 PAD 相关死亡率制定有针对性和有效的策略。
