Huang Hongliang, Tang Liming, Liu Chunjiang, Jin Gan
Division of Vascular Surgery, Shaoxing People's Hospital, 568 Zhongxing Bei Road, Shaoxing, Zhejiang 312000, China.
Eur Heart J Qual Care Clin Outcomes. 2025 Jun 23;11(4):445-455. doi: 10.1093/ehjqcco/qcae084.
This study aims to analyse the variation in mortality burden of aortic aneurysms (AAs) and explore the associated risk factors based on Global Burden of Disease (GBD) 2019 data, investigating the mortality burden of AA in China.
Using GBD 2019 data, the mortality burden of AA in China from 1990 to 2019 was analysed. The age-period-cohort model was utilized to analyse time trends, period, and cohort effects of four attributable risk factors of AA by age. In 2019, the total number of AA deaths in China increased by 136.1% compared to 1990, while the age-standardized mortality rate (ASMR) decreased by 6.8%. Male deaths and ASMR were higher than those of females, and ASMR increased with age. Whether viewed overall [average annual percent change (AAPC): -0.261, 95% confidence interval (CI): -0.383 to -0.138] or by sex (female AAPC: -0.812, 95% CI: -0.977 to -0.646; male AAPC: -0.011, 95% CI: -0.183-0.162), the ASMR for AA in China has shown a declining trend since 1990. Attributable risk factors such as high blood pressure, a diet high in sodium, smoking, and lead exposure increase AA mortality with age. Smoking mortality peaks between ages 80 and 85. The cyclical effect of high blood pressure on AA mortality significantly increases, while the cyclical effects of the other three risk factors decrease. For the population born after 1940, the cohort effect of high systolic blood pressure (SBP), a diet high in sodium, and smoking increased, while the cohort effect of lead exposure decreased. The local drift values of high SBP, a diet high in sodium, and smoking decreased, while the local drift value of lead exposure increased. High SBP was identified as the most significant attributable risk factor for AA mortality burden among both males and females, and smoking was another major attributable risk factor, particularly in males.
From 1990 to 2019, fatality due to AA in China increased notably, but the ASMR showed a decreasing trend. The mortality rate of AA was influenced by age, sex, and attributable risk factors, with elderly male smokers carrying a heavy burden of death. Moreover, tobacco control and treatment of hypertension should be strengthened to reduce the burden and its impact on AA.
本研究旨在基于全球疾病负担（GBD）2019数据，分析主动脉瘤（AA）死亡负担的变化，并探索相关风险因素，调查中国AA的死亡负担。
利用GBD 2019数据，分析了1990年至2019年中国AA的死亡负担。采用年龄-时期-队列模型，按年龄分析AA四个可归因风险因素的时间趋势、时期和队列效应。2019年，中国AA死亡总数较1990年增加了136.1%，而年龄标准化死亡率（ASMR）下降了6.8%。男性死亡人数和ASMR高于女性，且ASMR随年龄增长而增加。无论总体来看[年均变化百分比（AAPC）：-0.261，95%置信区间（CI）：-0.383至-0.138]还是按性别来看（女性AAPC：-0.812，95%CI：-0.977至-0.646；男性AAPC：-0.011，95%CI：-0.183至-0.162），自1990年以来，中国AA的ASMR呈下降趋势。高血压、高钠饮食、吸烟和铅暴露等可归因风险因素会随着年龄增长增加AA死亡率。吸烟死亡率在80至85岁之间达到峰值。高血压对AA死亡率的周期性影响显著增加，而其他三个风险因素的周期性影响则下降。对于1940年后出生的人群，高收缩压（SBP）、高钠饮食和吸烟的队列效应增加，而铅暴露的队列效应下降。高SBP、高钠饮食和吸烟的局部漂移值下降，而铅暴露的局部漂移值增加。高SBP被确定为男性和女性AA死亡负担中最显著的可归因风险因素，吸烟是另一个主要的可归因风险因素，尤其是在男性中。
1从1990年到2019年，中国AA导致的死亡人数显著增加，但ASMR呈下降趋势。AA的死亡率受年龄、性别和可归因风险因素影响，老年男性吸烟者的死亡负担较重。此外，应加强控烟和高血压治疗，以减轻负担及其对AA的影响。
