Tang Juan, Hu Shaobo, Liu Xiaozhu, Li Huan, Kuang Lirong, Zhang Lei, Cao Wenzhai, Zhang Ting, Guan Xiaoyan, Li Lang, Zhang Yutao, Peng Shengxian, Zhang Qingwei, Zhou Xiaoqian
Scientific Research Department, First People's Hospital of Zigong City, Zigong, China.
Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, China.
Front Cardiovasc Med. 2024 Nov 1;11:1396380. doi: 10.3389/fcvm.2024.1396380. eCollection 2024.
To assess the prevailing trends in the incidence of ischemic heart disease (IHD) across 204 countries and territories from 1990 to 2019, and to elucidate their correlations with age, period, and birth cohort, a comprehensive analysis was conducted.
From 1990 to 2019, we employed the Global Burden of Disease Study (GBD) Results Tool in conjunction with an age-period-cohort model. This approach facilitated the estimation of annual percentage changes in incidence, referred to as net drifts, encompassing the overall population. Additionally, we calculated annual percentage changes spanning ages 15 - 19 to 95 + years, denoted as local drifts. Furthermore, our analysis involved determining period and cohort relative risks, elucidating the effects associated with distinct periods and birth cohorts.
Globally, 21,203,479 [95% uncertainty interval (UI): 18,799,322 - 23,704,124] cases of IHD occurred in 2019. There were 33 countries with at least 100000 cases. Between 1990 and 2019, the net drift of IHD incidence exhibited a range from -1.7% per year [95% confidence interval (CI): -1.79, -1.61] in countries with a high socio-demographic index (SDI) to 0.08% per year (95% CI: 0.05, 0.11) in countries with a low SDI. Age effects across all countries and genders demonstrated an increasing trend over time, indicating age as a significant risk factor for IHD. Moreover, period and cohort effects in higher SDI countries exhibited a more rapid decline in both genders compared to lower SDI countries. The findings indicated that nations with a higher SDI manifested overall favorable trends in the relative risk of IHD incidence, both across time and in successive younger birth cohorts.
The incidence of IHD serves as a valuable and accessible indicator for assessing trends in IHD provision, spanning from early youth through later life. Enhancements in IHD prevention have the potential to mitigate risks for successively younger cohorts and, over time, redistribute the risk across all age groups. Despite global declines in IHD incidence over the last three decades, decreasing trends in incidence have slowed and, in some countries, flattened. Many countries have experienced unfavorable period and cohort effects.
为评估1990年至2019年期间204个国家和地区缺血性心脏病（IHD）发病率的流行趋势，并阐明其与年龄、时期和出生队列的相关性，我们进行了一项全面分析。
1990年至2019年期间，我们使用了全球疾病负担研究（GBD）结果工具并结合年龄-时期-队列模型。这种方法有助于估计发病率的年度百分比变化，即净漂移，涵盖了总体人群。此外，我们计算了15 - 19岁至95岁及以上年龄段的年度百分比变化，称为局部漂移。此外，我们的分析还包括确定时期和队列相对风险，以阐明与不同时期和出生队列相关的影响。
2019年全球发生了21203479例[95%不确定区间（UI）：18799322 - 23704124]缺血性心脏病病例。有33个国家的病例数至少为100000例。1990年至2019年期间，缺血性心脏病发病率的净漂移范围从社会人口学指数（SDI）高的国家每年-1.7%[95%置信区间（CI）：-1.79，-1.61]到SDI低的国家每年0.08%（95%CI：0.05，0.11）。所有国家和性别的年龄效应均显示出随时间的增加趋势，表明年龄是缺血性心脏病的一个重要风险因素。此外，与SDI较低的国家相比，SDI较高的国家中男性和女性的时期和队列效应下降得更快。研究结果表明，SDI较高的国家在缺血性心脏病发病率的相对风险方面，无论是随时间还是在连续的较年轻出生队列中，都呈现出总体有利的趋势。
缺血性心脏病的发病率是评估从青年早期到老年期缺血性心脏病发病趋势的一个有价值且易于获取的指标。改善缺血性心脏病的预防措施有可能降低连续较年轻队列的风险，并随着时间的推移在所有年龄组中重新分配风险。尽管在过去三十年中全球缺血性心脏病发病率有所下降，但发病率的下降趋势已经放缓，在一些国家甚至趋于平稳。许多国家经历了不利的时期和队列效应。
