Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University.
Tianjin Bin Hai New Area Center for Diseases Control and Prevention, Department of STD & AIDS Control and Prevention.
Circ J. 2022 Aug 25;86(9):1437-1443. doi: 10.1253/circj.CJ-21-0749. Epub 2022 May 14.
The disease burden of ischemic heart disease (IHD) continues to increase. This study aimed to assess the age, period, and cohort effects on the long-term trends of IHD incidence and mortality in China from 1990 to 2019.
The data were obtained from the Global Burden of Disease Study (GBD) 2019, and the age-standardized incidence/mortality rate (ASIR/ASMR) was calculated. The age-period-cohort (APC) model, which is a generalized linear model revealing the correlation of disease rate and attained age, period, and cohort, was applied to estimate the net drift (estimated annual percentage change [EAPC]s), the local drifts (age-specific EAPCs), the age, period, and cohort effects. The analyses elucidated that the ASIR and ASMR of IHD declined after 2013. The net drift of incidence was 0.212% in females, and the net drift of mortality was 0.371% in males. The local drifts of mortality were above 0 in males aged 20-84 years and in females aged 65-84 years. The age effects showed elevated trends during the study period. The period effects declined after 2013. The cohort effects of mortality in males were higher than that in females.
The decrease of ASIR and ASMR indicated that measures to prevent IHD have been effective in China. However, the cardiovascular health of the elderly and males should be considered in future policy decisions.
缺血性心脏病（IHD）的疾病负担持续增加。本研究旨在评估年龄、时期和队列效应对中国 1990 年至 2019 年 IHD 发病率和死亡率长期趋势的影响。
数据来自全球疾病负担研究（GBD）2019 年的数据，计算了年龄标准化发病率/死亡率（ASIR/ASMR）。年龄-时期-队列（APC）模型是一种广义线性模型，揭示了疾病率与获得年龄、时期和队列的相关性，用于估计净漂移（估计年百分比变化[EAPC]）、局部漂移（年龄特异性 EAPC）、年龄、时期和队列效应。分析表明，2013 年后 IHD 的 ASIR 和 ASMR 下降。女性的发病率净漂移为 0.212%，男性的死亡率净漂移为 0.371%。20-84 岁男性和 65-84 岁女性的死亡率局部漂移均高于 0。年龄效应在研究期间呈上升趋势。2013 年后，时期效应下降。男性死亡率的队列效应高于女性。
ASIR 和 ASMR 的下降表明中国预防 IHD 的措施已初见成效。然而，未来的政策决策应考虑老年人和男性的心血管健康问题。
