Chen Huimin, Liu Lu, Wang Yi, Hong Liqiong, Zhong Wen, Lehr Thorsten, Bragazzi Nicola Luigi, Tang Biao, Dai Haijiang
Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China.
State Key Laboratory of Transvascular Implantation Devices, Hangzhou, 310009, China.
Eur Heart J Qual Care Clin Outcomes. 2024 Oct 23. doi: 10.1093/ehjqcco/qcae090.
To evaluate the global cardiovascular disease (CVD) burden attributable to metabolic risks in 204 countries and territories from 1990 to 2021.
Following the methodologies used in the Global Burden of Disease Study 2021, this study analyzed CVD deaths and disability-adjusted life-years (DALYs) attributable to metabolic risks by location, age, sex, and socio-demographic index (SDI). In 2021, metabolic risks accounted for 13.59 million CVD deaths (95% UI 12.01 to 15.13) and 287.17 million CVD DALYs (95% UI 254.92 to 316.32) globally, marking increases of 63.3% and 55.5% since 1990, respectively. Despite these increases, age-standardised mortality and DALY rates have significantly declined. The highest age-standardised rates of metabolic risks-attributable CVD mortality and DALYs were observed in Central Asia and Eastern Europe, while the lowest rates were found in High-income Asia Pacific, Australasia, and Western Europe, all of which are high SDI regions. Among the metabolic risks, high systolic blood pressure emerged as the predominant factor, contributing to the highest numbers of CVD deaths [10.38 million (95% UI 8.78 to 12.03)] and DALYs [14.52 million (95% UI 180.42 to 247.57)] in 2021, followed by high LDL cholesterol.
Our study highlights the persistent and significant impact of metabolic risks on the global CVD burden from 1990 to 2021, emphasizing the need of designing public health strategies that align with regional healthcare capacities and demographic differences to effectively reduce these effects through enhanced international collaboration and specific policies.
评估1990年至2021年期间204个国家和地区因代谢风险导致的全球心血管疾病（CVD）负担。
本研究遵循《2021年全球疾病负担研究》中使用的方法，按地理位置、年龄、性别和社会人口指数（SDI）分析了因代谢风险导致的心血管疾病死亡人数和伤残调整生命年（DALY）。2021年，代谢风险在全球范围内导致了1359万例心血管疾病死亡（95%不确定区间为1201万至1513万）和2.8717亿心血管疾病伤残调整生命年（95%不确定区间为2.5492亿至3.1632亿），自1990年以来分别增加了63.3%和55.5%。尽管有这些增长，但年龄标准化死亡率和伤残调整生命年率显著下降。中亚和东欧的代谢风险归因心血管疾病死亡率和伤残调整生命年的年龄标准化率最高，而高收入亚太地区、澳大拉西亚和西欧的这些率最低，这些地区均为高社会人口指数地区。在代谢风险中，高收缩压成为主要因素，在2021年导致了最多的心血管疾病死亡人数[1038万（95%不确定区间为878万至1203万）]和伤残调整生命年[1452万（95%不确定区间为180.42万至247.57万）]，其次是高低密度脂蛋白胆固醇。
我们的研究强调了1990年至2021年期间代谢风险对全球心血管疾病负担的持续重大影响，强调需要制定与区域医疗能力和人口差异相匹配的公共卫生战略，以通过加强国际合作和具体政策有效减少这些影响。
