Hu Ben, Wang Yan, Chen Dong, Feng Jun, Fan Yinguang, Hou Linlin
Department of Cardiology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China.
The Fifth Clinical Medical School of Anhui Medical University, Hefei, Anhui, China.
Front Cardiovasc Med. 2024 Apr 22;11:1366832. doi: 10.3389/fcvm.2024.1366832. eCollection 2024.
Our objective is to describe the current prevalence and death of ischemic heart disease (IHD) in women of childbearing age (WCBA) at the global, regional, and national levels and to analyze its temporal trends from 1990 to 2019.
WCBA was defined as women aged 15-49 years. Estimates and 95% Uncertainty Intervals (UI) of IHD prevalence and death numbers for seven age groups were extracted from the 2019 Global Burden of Disease Study. The age-standardized prevalence and death rate (ASPR and ASDR) of IHD in WCBA was estimated using the direct age-standardization method. Joinpoint regression analysis was used to calculate average annual percent change (AAPC) to represent the temporal trends from 1990 to 2019.
Between 1990 and 2019, the global ASPR of IHD experienced a 3.21% increase, culminating in 367.21 (95% UI, 295.74-430.16) cases per 100,000 individuals. Conversely, the ASDR decreased to 11.11 (95% UI, 10.10-12.30) per 100,000 individuals. In 2019, among the five sociodemographic index (SDI) regions, the highest ASPR was observed in the high-middle SDI region, whereas the highest ASDR was found in the low-middle SDI region. Regionally, the Caribbean reported the highest ASPR (563.11 per 100,000 individuals; 95% UI, 493.13-643.03), and Oceania reported the highest ASDR (20.20 per 100,000 individuals; 95% UI, 13.01-31.03). At the national level, Trinidad and Tobago exhibited the highest ASPR (730.15 per 100,000 individuals; 95% UI, 633.96-840.13), and the Solomon Islands had the highest ASDR (77.77 per 100,000 individuals; 95% UI, 47.80-121.19). Importantly, over the past three decades, the global ASPR has seen a significant increase [AAPC = 0.11%, 95% Confidence Interval (CI): 0.09-0.13; < 0.001], while the ASDR has demonstrated a significant decreasing trend (AAPC = -0.86%, 95% CI: -1.11 to -0.61; < 0.001). Air pollution, tobacco use, high systolic blood pressure, elevated body mass index, dietary risks, and high LDL cholesterol have been identified as the leading six risk factors for IHD-related deaths among WCBA in 2019.
Despite the significant decline in the global ASDR for IHD among WCBA over the last thirty years, the ASPR continues to escalate. We need to remain vigilant about the increased burden of IHD in WCBA. It calls for aggressive prevention strategies, rigorous control of risk factors, and the enhancement of healthcare coverage to mitigate the disease burden of IHD among WCBA in forthcoming years.
我们的目标是描述全球、区域和国家层面育龄期女性（WCBA）缺血性心脏病（IHD）的当前患病率和死亡率，并分析其1990年至2019年的时间趋势。
WCBA定义为年龄在15 - 49岁的女性。从《2019年全球疾病负担研究》中提取了七个年龄组的IHD患病率和死亡人数的估计值及95%不确定性区间（UI）。采用直接年龄标准化方法估计WCBA中IHD的年龄标准化患病率和死亡率（ASPR和ASDR）。使用Joinpoint回归分析计算平均年度百分比变化（AAPC），以代表1990年至2019年的时间趋势。
1990年至2019年期间，全球IHD的ASPR增长了3.21%，最终达到每10万人367.21例（95% UI，295.74 - 430.16）。相反，ASDR降至每10万人11.11例（95% UI, 10.10 - 12.30）。2019年，在五个社会人口指数（SDI）区域中，高中等SDI区域的ASPR最高，而低中等SDI区域的ASDR最高。在区域层面，加勒比地区的ASPR最高（每10万人563.11例；95% UI，493.13 - 643.03），大洋洲的ASDR最高（每10万人20.20例；95% UI，13.01 - 31.63）。在国家层面，特立尼达和多巴哥的ASPR最高（每10万人730.15例；95% UI，633.96 - 840.13），所罗门群岛的ASDR最高（每10万人77.77例；95% UI，47.80 - 121.19）。重要的是，在过去三十年中，全球ASPR显著上升[AAPC = 0.11%，95%置信区间（CI）：0.09 - 0.13；P < 0.001]，而ASDR呈显著下降趋势（AAPC = -0.86%，95% CI：-1.11至-0.61；P < 0.001）。空气污染、烟草使用、高收缩压、体重指数升高、饮食风险和高LDL胆固醇已被确定为2019年WCBA中IHD相关死亡的六大主要风险因素。
尽管过去三十年全球WCBA中IHD的ASDR显著下降，但ASPR仍在持续上升。我们需要对WCBA中IHD负担的增加保持警惕。这需要积极的预防策略、严格控制风险因素以及加强医疗保健覆盖，以减轻未来几年WCBA中IHD的疾病负担。
