Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, NO.37, Lane outside the southern, Chengdu, 610000, Sichuan, China.
BMC Cardiovasc Disord. 2023 Oct 24;23(1):517. doi: 10.1186/s12872-023-03552-w.
This study aimed to describe the temporal trends in age and gender burdens of rheumatic heart disease (RHD) in China from 1990 to 2019, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs), and to compare them with the global burden of the disease.
Using open data from the Global Burden of Disease (GBD) database from 1990 to 2019, this study analyzed the characteristics of RHD burden in China and worldwide, including changes in incidence, prevalence, mortality, and DALYs. Joinpoint was used to calculate the average annual percentage change (AAPC) and the corresponding 95% confidence interval (95% CI) to reflect the trends in the burden of RHD. A comprehensive comparative analysis of the differences in RHD burden between China and the rest of the world was conducted from multiple dimensions, including age, gender, and time periods.
From 1990 to 2019, the age-standardized incidence rate (ASIR) of RHD in China decreased from 29.62/100,000 to 23.95/100,000, while the global ASIR increased from 32.69/100,000 to 37.40/100,000. The age-standardized prevalence rate (ASPR) in China decreased from 446.15/100,000 to 390.24/100,000, while the global ASPR increased from 451.56/100,000 to 513.68/100,000. The age-standardized rates of mortality (ASMR) in China decreased from 18.11/100,000 to 4.04/100,000, while the global ASMR decreased from 8.94/100,000 to 3.85/100,000. The age-standardized DALY rate (ASDR) in China decreased from 431.45/100,000 to 93.73/100,000, while the global ASDR decreased from 283.30/100,000 to 132.88/100,000. The AAPC of ASIR, ASPR, ASMR, and ASDR in China was - 0.73%, -0.47%, -5.10%, and - 5.21%, respectively, while the AAPC of the global burden of RHD was 0.48%, 0.45%, -2.87%, and - 2.58%, respectively. The effects of age and gender on the burden of RHD were different. ASIR generally decreased with increasing age, while ASPR increased first and then decreased. ASMR and ASDR increased with increasing age. Women had higher incidence and mortality rates of RHD than men.
From 1990 to 2019, the incidence, prevalence, mortality, and DALYs of RHD in China decreased, indicating a relative reduction in the burden of RHD in China. The burden of RHD is age-related, with a higher prevalence observed in the younger population, a peak incidence among young adults, and a higher mortality rate among the elderly population. Women are more susceptible to RHD and have a higher risk of mortality than men. Given China's large population and aging population, RHD remains a significant public health challenge in China.
本研究旨在描述 1990 年至 2019 年期间中国风湿性心脏病（RHD）的年龄和性别负担的时间趋势，包括发病率、患病率、死亡率和伤残调整生命年（DALYs），并与全球疾病负担进行比较。
使用全球疾病负担（GBD）数据库 1990 年至 2019 年的公开数据，分析中国和全球 RHD 负担的特征，包括发病率、患病率、死亡率和 DALYs 的变化。采用 Joinpoint 计算平均年变化百分比（AAPC）及其相应的 95%置信区间（95%CI），以反映 RHD 负担的趋势。从多个维度，包括年龄、性别和时间段，对中国和世界其他地区 RHD 负担的差异进行全面比较分析。
1990 年至 2019 年，中国 RHD 的年龄标准化发病率（ASIR）从 29.62/100000 下降到 23.95/100000，而全球 ASIR 从 32.69/100000 上升到 37.40/100000。中国 RHD 的年龄标准化患病率（ASPR）从 446.15/100000 下降到 390.24/100000，而全球 ASPR 从 451.56/100000 上升到 513.68/100000。中国 RHD 的年龄标准化死亡率（ASMR）从 18.11/100000 下降到 4.04/100000，而全球 ASMR 从 8.94/100000 下降到 3.85/100000。中国 RHD 的年龄标准化伤残调整生命年（ASDR）从 431.45/100000 下降到 93.73/100000，而全球 ASDR 从 283.30/100000 下降到 132.88/100000。中国 RHD 的 ASIR、ASPR、ASMR 和 ASDR 的 AAPC 分别为-0.73%、-0.47%、-5.10%和-5.21%，而全球 RHD 负担的 AAPC 分别为 0.48%、0.45%、-2.87%和-2.58%。年龄和性别对 RHD 负担的影响不同。ASIR 通常随年龄增长而下降，而 ASPR 先上升后下降。ASMR 和 ASDR 随年龄增长而增加。女性 RHD 的发病率和死亡率均高于男性。
1990 年至 2019 年期间，中国 RHD 的发病率、患病率、死亡率和 DALYs 下降，表明中国 RHD 的负担有所减轻。RHD 的负担与年龄有关，年轻人群中患病率较高，青年人群中发病率较高，老年人群中死亡率较高。女性比男性更容易患 RHD，死亡率也更高。鉴于中国庞大的人口和老龄化人口，RHD 仍然是中国面临的重大公共卫生挑战。
