Gao Guoliang, Chen Zhaoyi, Yan Guoping, Bao Minqiang
Department of Electrophysiology, Xuancheng People's Hospital, Affiliated Xuancheng Hospital of Wannan Medical College, Xuancheng, Anhui, China.
Department of Gastroenterology, Xuancheng People's Hospital, Affiliated Xuancheng Hospital of Wannan Medical College, Xuancheng, Anhui, China.
Front Cardiovasc Med. 2024 Jul 18;11:1417523. doi: 10.3389/fcvm.2024.1417523. eCollection 2024.
Hypertensive heart disease (HHD) is a major global public health issue resulting from hypertension-induced end-organ damage. The aim of this study was to examine the global impact, risk factors, and age-period-cohort (APC) model of HHD from 1990 to 2019.
Data from the 2019 Global Burden of Disease were used to assess age-adjusted HHD prevalence, disability-adjusted life years (DALYs), mortality rates, and contributions of HHD risk factors with 95% uncertainty intervals (UIs). APC models were used to analyze global age, period, and cohort mortality trends for HHD.
In 2019, 18.6 million prevalent HHD cases led to 1.16 million fatalities and 21.51 million DALYs. Age-adjusted rates were 233.8 (95%UI = 170.5-312.9) per 100,000 individuals for prevalence, 15.2 (11.2-16.7) for mortality, and 268.2 (204.6-298.1) for DALYs. Regionally, the Cook Islands (703.1), Jordan (561.6), and Kuwait (514.9) had the highest age-standardized incidence of HHD in 2019. There were significant increases in HHD prevalence in Andean Latin America (16.7%), western sub-Saharan Africa (5.6%), and eastern sub-Saharan Africa (4.6%). Mortality rate varied widely among countries. Risk factors like elevated systolic blood pressure and high body mass index significant influenced DALY rates, especially in females. The APC model revealed an association between mortality rates and age, with a decreasing mortality risk over time and improved survival rates for a later birth cohort.
Despite the reduction in prevalence, HHD remains a significant public health issue, particularly in nations with low sociodemographic indices. To alleviate the impact of HHD, prevention efforts should concentrate on the management of hypertension, weight loss, and lifestyle improvement.
高血压性心脏病（HHD）是由高血压引起的终末器官损害导致的一个主要全球公共卫生问题。本研究的目的是探讨1990年至2019年期间HHD的全球影响、风险因素和年龄-时期-队列（APC）模型。
使用来自2019年全球疾病负担的数据来评估年龄调整后的HHD患病率、伤残调整生命年（DALYs）、死亡率以及HHD风险因素的贡献，并给出95%的不确定性区间（UIs）。APC模型用于分析全球HHD的年龄、时期和队列死亡率趋势。
2019年，1860万例HHD现患病例导致116万人死亡和2151万伤残调整生命年。年龄调整率分别为：患病率每10万人中233.8例（95%UI = 170.5 - 312.9），死亡率为15.2（11.2 - 16.7），伤残调整生命年为268.2（204.6 - 298.1）。在区域层面，2019年库克群岛（703.1）、约旦（561.6）和科威特（514.9）的HHD年龄标准化发病率最高。安第斯拉丁美洲（16.7%）、撒哈拉以南非洲西部（5.6%）和撒哈拉以南非洲东部（4.6%）的HHD患病率有显著上升。各国死亡率差异很大。收缩压升高和高体重指数等风险因素对伤残调整生命年率有显著影响，尤其是在女性中。APC模型揭示了死亡率与年龄之间的关联，随着时间推移死亡率风险降低，且较晚出生队列的生存率有所提高。
尽管患病率有所下降，但HHD仍然是一个重大的公共卫生问题，尤其是在社会人口统计学指数较低的国家。为减轻HHD的影响，预防工作应集中在高血压管理、体重减轻和生活方式改善方面。
