1990 年至 2019 年中低收入国家女性缺血性心脏病趋势。
Trends in ischemic heart disease among females in low-and middle-income countries from 1990 to 2019.
机构信息
Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.
Harvard Medical School, Boston, MA, United States of America; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States of America.
出版信息
Int J Cardiol. 2023 Oct 1;388:131113. doi: 10.1016/j.ijcard.2023.06.004. Epub 2023 Jun 7.
BACKGROUND
Ischemic heart disease (IHD) is a major contributor to mortality in low-and middle-income-countries (LMICs). However, trends in IHD in females in LMICs are not well described.
METHODS
We analyzed the Global Burden of Disease (GBD) Study from 1990 to 2019 for males and females with IHD from the ten most-populous LMICs (India, Indonesia, Pakistan, Nigeria, Ethiopia, Philippines, Egypt, Vietnam, Iran, and Afghanistan).
RESULTS
In females, IHD incidence increased from 950,000 cases/year to 1.6 million/year, IHD prevalence increased from 8 million to 22.5 million (181% increase) and IHD mortality from 428,320 to 1,040,817 (143% increase). IHD accounted for 6.2% of all deaths among females in 1990, doubling to 13.2% in 2019. IHD mortality for each country increased with the greatest shift in AAPC seen in the Philippines (5.8%, 95% CI 5.4-6.1) and India (3.7%, 95% CI 3.0-4.4). Notably, reductions in ASMR were greater for males than females in Afghanistan, Iran, Egypt, Ethiopia and Nigeria. (all p < 0.001).
CONCLUSIONS
The burden of IHD among females in LMIC has increased considerably in LMICs from 1990 to 2019. While the ASMR from IHD across most countries is declining, this was not uniformly noted. Furthermore, several countries noted lesser improvement in ASMR among females compared to males.
背景
缺血性心脏病（IHD）是中低收入国家（LMICs）死亡的主要原因。然而，LMICs 女性中 IHD 的趋势尚未得到很好的描述。
方法
我们分析了 1990 年至 2019 年来自十大人口最多的 LMIC（印度、印度尼西亚、巴基斯坦、尼日利亚、埃塞俄比亚、菲律宾、埃及、越南、伊朗和阿富汗）的男性和女性 IHD 的全球疾病负担（GBD）研究。
结果
在女性中，IHD 发病率从 950,000 例/年增加到 160 万例/年，IHD 患病率从 800 万增加到 2250 万（增加 181%），IHD 死亡率从 428,320 例增加到 1,040,817 例（增加 143%）。1990 年，IHD 占女性所有死亡人数的 6.2%，到 2019 年增加到 13.2%。每个国家的 IHD 死亡率都在增加，其中菲律宾（5.8%，95%CI 5.4-6.1）和印度（3.7%，95%CI 3.0-4.4）的 AAPC 变化最大。值得注意的是，在阿富汗、伊朗、埃及、埃塞俄比亚和尼日利亚，男性的 ASMR 下降幅度大于女性。（均<0.001）。
结论
1990 年至 2019 年，LMIC 中女性 IHD 的负担大大增加。尽管大多数国家的 IHD 发病率呈下降趋势，但并非如此。此外，一些国家的女性 ASMR 改善程度低于男性。
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