Hu Ben, Feng Jun, Wang Yuhui, Fan Yinguang, Hou Linlin
Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China.
The Fifth Clinical Medical School of Anhui Medical University, Hefei, 230000, Anhui, China.
Heliyon. 2024 Mar 25;10(7):e28526. doi: 10.1016/j.heliyon.2024.e28526. eCollection 2024 Apr 15.
Epidemiological studies on cardiovascular diseases (CVD) among women of childbearing age (WCBA) remain scarce. Our research aims to delineate the prevalence trends of CVD within this population over the past three decades, considering age, period, and birth cohort dynamics.
Estimates of CVD prevalence for WCBA, along with their 95% uncertainty intervals (UI), were extracted from the Global Burden of Diseases 2019 (). An age-period-cohort (APC) model was utilized to assess the annual percentage change (net drifts) in overall prevalence, annual percentage changes in prevalence for individual age groups (local drifts), and fitted longitudinal age-specific rates adjusted for age effects and period/cohort relative risks (period/cohort effect).
In 2019, the global prevalence of CVD among WCBA was 53.42 million (95% UI: 47.77 to 60.18). Eight countries recorded a prevalence exceeding one million, accounting for 54.17% of the global CVD prevalence in WCBA. Over the past 30 years, the annual net drift in CVD prevalence among the global WCBA was 0.27% (95% CI: 0.25 to 0.29). This value was 0.01% (95% CI: 0.04 to 0.06) in regions with a high sociodemographic index (SDI) and 0.21% (95% CI: 0.19 to 0.22) in those with a low SDI. Seventy-seven countries demonstrated an increasing trend in CVD prevalence, while 53 showed a decrease, and 74 remained relatively stable. Notably, as shown in local drift, there was a rise in CVD prevalence among adolescents aged 15-19 and adults aged 40-49 in regions categorized by five distinct SDI levels. This drift varied by SDI regions. Regions with a high SDI consistently had elevated period risks throughout the study duration, while other regions had lower period risks until 2000-2004 and displayed increased adverse period risks. The prevalence in low-middle and low SDI regions manifested detrimental trends, whereas other regions demonstrated an initial decline followed by a surge in successive birth cohorts.
Resources dedicated to CVD care for WCBA are largely insufficient, especially in low SDI regions. Thus, there is an urgent need to allocate cardiovascular healthcare resources variably across different SDI regions, aiming to diminish risks among successively younger birth cohorts. Throughout this endeavor, the formulation of targeted policies and the judicious distribution of resources are essential to reduce risks for women across all age groups.
关于育龄期女性（WCBA）心血管疾病（CVD）的流行病学研究仍然很少。我们的研究旨在描绘过去三十年该人群中CVD的流行趋势，同时考虑年龄、时期和出生队列动态。
从《2019年全球疾病负担》中提取WCBA的CVD患病率估计值及其95%不确定性区间（UI）。利用年龄-时期-队列（APC）模型评估总体患病率的年度百分比变化（净漂移）、各年龄组患病率的年度百分比变化（局部漂移），并拟合经年龄效应和时期/队列相对风险（时期/队列效应）调整的纵向年龄别率。
2019年，全球WCBA中CVD的患病率为5342万（95% UI：4777万至6018万）。八个国家的患病率超过100万，占全球WCBA中CVD患病率的54.17%。在过去30年中，全球WCBA中CVD患病率的年度净漂移为0.27%（95% CI：0.25%至0.29%）。在社会人口学指数（SDI）较高的地区，这一数值为0.01%（95% CI：0.04%至0.06%），在SDI较低的地区为0.21%（95% CI：0.19%至0.22%）。77个国家的CVD患病率呈上升趋势，53个国家呈下降趋势，74个国家相对稳定。值得注意的是，如局部漂移所示，在按五个不同SDI水平分类的地区，15-19岁青少年和40-49岁成年人中的CVD患病率有所上升。这种漂移因SDI地区而异。在整个研究期间，SDI较高的地区始终具有较高的时期风险，而其他地区在2000-2004年之前时期风险较低，随后不良时期风险增加。中低收入和低SDI地区的患病率呈现不利趋势，而其他地区则表现出先下降后在连续出生队列中激增的情况。
用于WCBA心血管疾病护理的资源在很大程度上不足，特别是在低SDI地区。因此，迫切需要在不同的SDI地区差异化分配心血管医疗资源，以降低连续年轻出生队列中的风险。在这一努力过程中，制定针对性政策和合理分配资源对于降低所有年龄组女性的风险至关重要。
