Department of Endocrinology and General Medicine, The First Hospital of Fangshan District, Beijing, China.
Front Public Health. 2022 Nov 3;10:973317. doi: 10.3389/fpubh.2022.973317. eCollection 2022.
The aim of this study was to identify the disease burden and risk factors of ischemic heart disease (IHD) in China, during 1990-2019, through a systematic analysis using the Global Burden of Disease (GBD) 2019 report in order to provide first-hand information for primary and secondary prevention of IHD in China.
Data on the rates of incidence, death, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) of IHD were obtained from GBD2019 to determine the disease burden and risk factors of IHD in China.
The rates of incidence, death, YLLs, YLDs, and DALYs of IHD in China increased at different levels during 1990-2019. The annual rate of change in incidence, death, YLLs, YLDs, and DALYs of IHD were 1.31%, 1.57%, 0.93%, 1.14%, and 0.94%, respectively. In 2019, the YLDs of IHD in Chinese women were higher, while the rates of incidence and death, YLLs, and DALYs were lower in Chinese women than in Chinese men. The disease burden of IHD had significant age differences, and people aged ≥70 years had the highest disease burden. A total of 24 risk factors were associated with the rates of death and DALYs of IHD, and the five most significant risk factors were high systolic blood pressure, high LDL cholesterol (LDL-C), smoking, ambient particulate matter pollution, and intake of a high-sodium diet. From 1990 to 2019, a high annual rate of change in IHD-related deaths and DALYs was observed due to ambient particulate matter pollution, high body mass index (BMI), and intake of a diet high in processed meat.
The results of the study revealed that the disease burden of IHD in China was on the rise, especially in people aged ≥70 years. The main disease burden of IHD in male patients was premature death and that in female patients was disability. Environmental, behavioral, and metabolic factors were considered the three main risks of the disease burden of IHD, with metabolic factors having the greatest impact. Therefore, periodic health check-ups and high-risk factor interventions for key populations should be strengthened from the grassroots level, which are conducive to further reducing the disease burden of IHD in China.
本研究旨在通过使用全球疾病负担（GBD）2019 报告进行系统分析，确定中国 1990-2019 年缺血性心脏病（IHD）的疾病负担和风险因素，为中国 IHD 的一级和二级预防提供第一手资料。
从 GBD2019 中获取 IHD 的发病率、死亡率、寿命损失年（YLLs）、失能寿命年（YLDs）和伤残调整寿命年（DALYs）数据，以确定中国 IHD 的疾病负担和风险因素。
1990-2019 年期间，中国 IHD 的发病率、死亡率、YLLs、YLDs 和 DALYs 呈不同程度上升趋势。IHD 的发病率、死亡率、YLLs、YLDs 和 DALYs 的年变化率分别为 1.31%、1.57%、0.93%、1.14%和 0.94%。2019 年，中国女性的 YLDs 较高，而中国女性的发病率和死亡率、YLLs 和 DALYs 均低于中国男性。IHD 的疾病负担具有显著的年龄差异，≥70 岁的人群疾病负担最高。共有 24 个风险因素与 IHD 的死亡率和 DALYs 相关，其中五个最重要的风险因素为收缩压高、低密度脂蛋白胆固醇（LDL-C）高、吸烟、环境颗粒物污染和高钠饮食摄入。1990-2019 年，由于环境颗粒物污染、高体质指数（BMI）和高加工肉类饮食摄入，IHD 相关死亡和 DALYs 的年变化率较高。
研究结果表明，中国 IHD 的疾病负担呈上升趋势，特别是≥70 岁人群。男性患者的主要疾病负担是早逝，女性患者的主要疾病负担是残疾。环境、行为和代谢因素被认为是 IHD 疾病负担的三个主要风险因素，其中代谢因素的影响最大。因此，应从基层加强对重点人群的定期健康检查和高危因素干预，有利于进一步降低中国 IHD 的疾病负担。
