Section of Cardiovascular Medicine, Department of Internal Medicine Yale School of Medicine New Haven CT USA.
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran.
J Am Heart Assoc. 2024 Jan 16;13(2):e030165. doi: 10.1161/JAHA.123.030165.
The North Africa and Middle East (NAME) region has one of the highest burdens of ischemic heart disease (IHD) worldwide. This study reports the contemporary epidemiology of IHD in NAME.
We estimated the incidence, prevalence, deaths, years of life lost, years lived with disability, disability-adjusted life years (DALYs), and premature mortality of IHD, and its attributable risk factors in NAME from 1990 to 2019 using the results of the GBD (Global Burden of Disease study 2019). In 2019, 0.8 million lives and 18.0 million DALYs were lost due to IHD in NAME. From 1990 to 2019, the age-standardized DALY rate of IHD significantly decreased by 33.3%, mostly due to the reduction of years of life lost rather than years lived with disability. In 2019, the proportion of premature death attributable to IHD was higher in NAME compared with global measures: 26.8% versus 16.9% for women and 18.4% versus 14.8% for men, respectively. The age-standardized DALY rate of IHD attributed to metabolic risks, behavioral risks, and environmental/occupational risks significantly decreased by 28.7%, 37.8%, and 36.4%, respectively. Dietary risk factors, high systolic blood pressure, and high low-density lipoprotein cholesterol were the top 3 risks contributing to the IHD burden in most countries of NAME in 2019.
In 2019, IHD was the leading cause of death and lost DALYs in NAME, where premature death due to IHD was greater than the global average. Despite the great reduction in the age-standardized DALYs of IHD in NAME from 1990 to 2019, this region still had the second-highest burden of IHD in 2019 globally.
北非和中东（NAME）地区是全球缺血性心脏病（IHD）负担最重的地区之一。本研究报告了该地区 IHD 的当代流行病学情况。
我们使用全球疾病负担研究 2019 年的结果，估计了 1990 年至 2019 年 NAME 地区 IHD 的发病率、患病率、死亡率、生命损失年数、失能生命年数、伤残调整生命年数（DALYs）和早逝，以及归因于 IHD 的危险因素。2019 年，NAME 地区因 IHD 导致 0.8 百万人死亡和 18.0 百万人 DALYs 损失。从 1990 年到 2019 年，IHD 的年龄标准化 DALY 率显著下降了 33.3%，这主要是由于生命损失年数的减少，而不是失能生命年数的减少。2019 年，与全球指标相比，NAME 地区归因于 IHD 的过早死亡率更高：女性为 26.8%，男性为 18.4%，而女性为 16.9%，男性为 14.8%。归因于代谢风险、行为风险和环境/职业风险的 IHD 的年龄标准化 DALY 率分别显著下降了 28.7%、37.8%和 36.4%。2019 年，在 NAME 的大多数国家，饮食风险因素、收缩压高和低密度脂蛋白胆固醇高是导致 IHD 负担的前 3 大风险因素。
2019 年，IHD 是 NAME 地区死亡和 DALYs 损失的主要原因，其中因 IHD 导致的过早死亡高于全球平均水平。尽管 1990 年至 2019 年 NAME 地区 IHD 的年龄标准化 DALY 显著下降，但该地区 2019 年仍是全球 IHD 负担第二高的地区。
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