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全球心血管疾病发病率和死亡率的趋势和区域差异,1990-2019 年:来自 2019 年全球疾病负担研究的发现。

Global trends and regional differences in incidence and mortality of cardiovascular disease, 1990-2019: findings from 2019 global burden of disease study.

机构信息

Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, 2 An Zhen Road, Chaoyang District, Beijing 100029, China.

Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China.

出版信息

Eur J Prev Cardiol. 2023 Feb 14;30(3):276-286. doi: 10.1093/eurjpc/zwac285.

Abstract

AIMS

Cardiovascular disease (CVD) is the main cause of morbidity and mortality worldwide and is linked with a regional economic burden. We analysed and compared global trends as well as regional and sociodemographic differences in CVD incidence and mortality.

METHODS AND RESULTS

We obtained data to annual incident cases, deaths, age-standardized incidence rates (ASIRs), and age-standardized mortality rates (ASMRs) of CVD during 1990-2019 from the 2019 Global Burden of Disease Study. To quantify the temporal trends, we calculated changes in the incident cases and deaths as well as the estimated annual percentage changes (EAPCs) of age-standardized rates. Globally, CVD incident cases increased by 77.12% from 31.31 million in 1990 to 55.45 million in 2019; deaths rose by 53.81% from 12.07 million in 1990 to 18.56 million in 2019. The overall ASIR [EAPC, -0.56; 95% confidence interval (CI), -0.59 to -0.53] and ASMR (EAPC, -1.46; 95%CI, -1.51 to -1.40) decreased in this period. Against the global trend of ASIR falling, an increasing trend was found in Uzbekistan (EAPC, 1.24; 95%CI, 0.97-1.50), Tajikistan (EAPC, 0.49; 95%CI, 0.47-0.52), and Zimbabwe (EAPC, 0.42; 95%CI, 0.33-0.50). The number of CVD incident cases increased remarkably in low (108.3%), low-middle (114.81%), and middle (117.85%) sociodemographic index regions in 1990-2019.

CONCLUSION

Despite the increased number of CVD cases and deaths after adjusting for changes in population age, we observed a consistent decrease in age-standardized incidence and mortality in most countries. However, specific regions-especially low to middle SDI regions-present worrying increases in CVD cases and deaths.

摘要

目的

心血管疾病(CVD)是全球发病率和死亡率的主要原因,与区域经济负担有关。我们分析并比较了 CVD 发病率和死亡率的全球趋势以及区域和社会人口统计学差异。

方法和结果

我们从 2019 年全球疾病负担研究中获得了 1990-2019 年期间 CVD 每年发病例数、死亡例数、年龄标准化发病率(ASIR)和年龄标准化死亡率(ASMR)的数据。为了量化时间趋势,我们计算了发病例数和死亡例数的变化以及年龄标准化率的估计年百分比变化(EAPC)。全球范围内,CVD 发病例数从 1990 年的 3131 万增加到 2019 年的 5545 万,增长了 77.12%;死亡人数从 1990 年的 1207 万增加到 2019 年的 1856 万,增长了 53.81%。这一时期,总体 ASIR[EAPC,-0.56;95%置信区间(CI),-0.59 至-0.53]和 ASMR(EAPC,-1.46;95%CI,-1.51 至-1.40)均下降。在全球 ASIR 下降的趋势下,乌兹别克斯坦(EAPC,1.24;95%CI,0.97-1.50)、塔吉克斯坦(EAPC,0.49;95%CI,0.47-0.52)和津巴布韦(EAPC,0.42;95%CI,0.33-0.50)呈上升趋势。1990-2019 年,低(108.3%)、低中(114.81%)和中(117.85%)社会人口指数地区的 CVD 发病例数显著增加。

结论

尽管调整人口年龄变化后 CVD 病例和死亡人数有所增加,但我们观察到大多数国家的年龄标准化发病率和死亡率持续下降。然而,特定地区,尤其是低至中社会人口指数地区,CVD 病例和死亡人数令人担忧地增加。

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