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1990年至2019年全球、区域和国家青年缺血性心脏病及其可归因风险因素的负担:一项全球疾病负担研究。

Global, regional, and national burden of ischaemic heart disease and its attributable risk factors in youth from 1990 to 2019: a Global Burden of Disease study.

作者信息

Li Xiaolu, Jiang Hongfeng

机构信息

Experimental Research Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.

Experimental Research Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.

出版信息

Public Health. 2024 Nov;236:43-51. doi: 10.1016/j.puhe.2024.07.011. Epub 2024 Aug 18.

Abstract

OBJECTIVES

The objective of this study was to analyse the global, regional, and national burdens of ischaemic heart disease (IHD) in adults aged 15-49 years and its attributable risk factors from 1990 to 2019.

STUDY DESIGN

Epidemiological study.

METHODS

Data were obtained from the Global Burden of Disease (GBD) Study 2019. The estimated annual percentage change was used to evaluate temporal trends in incidence, deaths, and disability-adjusted life years (DALYs) of youth IHD. We selected IHD-associated risk factors, including five environmental/occupational factors, 16 behavioural risks, and five metabolic factors. We computed the age-standardised rates and percentage of age-standardised DALY rates attributable to these factors of youth IHD.

RESULTS

Globally, there were 2.26 million cases of incidence, 0.63 million deaths, and 30.58 million DALYs in 2019. The age-standardised incidence, death, and DALY rates decreased from 1990 to 2019, whereas the absolute number of incidences, deaths, and DALYs increased significantly. Globally, approximately 94.1% of age-standardised DALY rates from IHD in youths aged 15-49 years are attributable to risk factors listed in the GBD 2019 dataset. The leading global and regional risk factors for youth IHD in 2019 were high low-density lipoprotein cholesterol (68.9%), high systolic blood pressure (51.2%), high body mass index (33.1%), smoking (30.5%), and ambient particulate-matter pollution (25.4%).

CONCLUSIONS

The burden of IHD among young people is still heavy, and metabolic risk factors are the leading drivers of IHD. Therefore, formulating relevant policies to control and treat cardiovascular risk factors is an effective measure to reduce the IHD burden in youth.

摘要

目的

本研究旨在分析1990年至2019年15至49岁成年人缺血性心脏病(IHD)的全球、区域和国家负担及其可归因风险因素。

研究设计

流行病学研究。

方法

数据来自《2019年全球疾病负担研究》。估计的年度百分比变化用于评估青年IHD发病率、死亡率和伤残调整生命年(DALYs)的时间趋势。我们选择了与IHD相关的风险因素,包括五个环境/职业因素、16个行为风险因素和五个代谢因素。我们计算了年龄标准化率以及青年IHD这些因素所致年龄标准化DALY率的百分比。

结果

2019年,全球有226万例发病、63万例死亡和3058万伤残调整生命年。从1990年到2019年,年龄标准化发病率、死亡率和DALY率有所下降,而发病、死亡和DALY的绝对数量显著增加。在全球范围内,15至49岁青年IHD年龄标准化DALY率中约94.1%可归因于《2019年全球疾病负担》数据集中列出的风险因素。2019年全球和区域青年IHD的主要风险因素是低密度脂蛋白胆固醇高(68.9%)、收缩压高(51.2%)、体重指数高(33.1%)、吸烟(30.5%)和环境颗粒物污染(25.4%)。

结论

年轻人中IHD的负担仍然很重,代谢风险因素是IHD的主要驱动因素。因此,制定相关政策来控制和治疗心血管风险因素是减轻青年IHD负担的有效措施。

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