Wang Ming-Si, Deng Jing-Wen, Geng Wan-Yue, Zheng Rui, Xu Hui-Lin, Dong Ying, Huang Wei-Dong, Li Yi-Lan
The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China.
College of Health Management of Harbin Medical University, Harbin 150076, China.
Eur J Prev Cardiol. 2025 May 12;32(7):539-552. doi: 10.1093/eurjpc/zwae384.
The ageing global population and overall population growth have significantly increased the burden of cardiovascular diseases (CVDs). This study aims to examine global temporal trends in the incidence, disability-adjusted life years (DALYs), and mortality rates of both overall and type-specific CVDs among adults aged 55 and older from 1990 to 2021, with a focus on identifying changes over time, regional disparities, and the key risk factors contributing to this burden.
We analysed data from the Global Burden of Disease Study 2021, covering 204 countries and territories. Trends in age-standardized rates of incidence, DALY, and mortality for both overall and specific types of CVDs were assessed, alongside the impact of key risk factors. Between 1990 and 2021, global age-standardized incidence, DALY, and mortality rates showed a declining trend, with estimated annual percentage changes of -0.39, -1.30, and -1.11, respectively. However, due to overall population growth and ageing, the absolute number of CVD cases continued to rise. Regions with high-middle socio-demographic index (SDI) exhibited the highest incidence and mortality rates, while high SDI regions saw the greatest declines. Men had higher age-standardized rates of CVD incidence, DALY, and mortality compared with women. The burden increased with age, with the oldest age groups (80+ years) showing the highest rates. High systolic blood pressure was the leading modifiable risk factor, contributing to more than half of the CVD-related DALY globally. Other major risk factors included high LDL cholesterol, smoking, and ambient particulate matter pollution.
While age-standardized rates of CVD incidence, DALY, and mortality have declined over the past three decades, the total burden of CVDs continues to rise due to population ageing and growth. These findings highlight the need for targeted prevention strategies in regions with high CVD burden, particularly those with lower socioeconomic status.
全球人口老龄化和总体人口增长显著增加了心血管疾病（CVD）的负担。本研究旨在探讨1990年至2021年55岁及以上成年人中总体及特定类型心血管疾病的发病率、伤残调整生命年（DALY）和死亡率的全球时间趋势，重点是确定随时间的变化、区域差异以及造成这种负担的关键风险因素。
我们分析了来自全球疾病负担研究2021的数据，涵盖204个国家和地区。评估了总体及特定类型心血管疾病的年龄标准化发病率、DALY和死亡率趋势，以及关键风险因素的影响。1990年至2021年期间，全球年龄标准化发病率、DALY和死亡率呈下降趋势，估计年变化率分别为-0.39、-1.30和-1.11。然而，由于总体人口增长和老龄化，心血管疾病病例的绝对数量持续上升。社会人口学指数（SDI）处于高中水平的地区发病率和死亡率最高，而SDI高的地区下降幅度最大。男性的心血管疾病年龄标准化发病率、DALY和死亡率高于女性。负担随年龄增长而增加，年龄最大的年龄组（80岁以上）发病率最高。高收缩压是主要的可改变风险因素，导致全球超过一半的心血管疾病相关DALY。其他主要风险因素包括高LDL胆固醇、吸烟和环境颗粒物污染。
虽然过去三十年中心血管疾病的年龄标准化发病率、DALY和死亡率有所下降，但由于人口老龄化和增长，心血管疾病的总负担仍在上升。这些发现凸显了在心血管疾病负担高的地区，特别是社会经济地位较低的地区，需要制定有针对性的预防策略。
