1980 - 2021年心血管疾病死亡率的全球趋势与地区差异及其对预期寿命的影响：基于2021年全球疾病负担研究的年龄 - 时期 - 队列分析与预期寿命分解

Global trends and regional differences in mortality of cardiovascular disease and its impact on longevity, 1980-2021: Age-period-cohort analyses and life expectancy decomposition based on the Global Burden of Disease study 2021.

作者信息

Xia Xue, Tian Xue, Xu Qin, Zhang Yijun, Zhang Xiaoli, Li Jing, Wang Anxin

机构信息

Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

出版信息

Ageing Res Rev. 2025 Jan;103:102597. doi: 10.1016/j.arr.2024.102597. Epub 2024 Nov 29.

DOI:10.1016/j.arr.2024.102597

PMID:39617057

Abstract

OBJECTIVE

To investigate the temporal trend in cardiovascular disease (CVD) mortality and its impact on life expectancy (LE) gains across different Socio-demographic Index (SDI) regions.

METHODS

Cause-specific mortality estimates during 1980-2021 were obtained from the Global Burden of Disease 2021 study. An age-period-cohort (APC) analysis was adopted to estimate the net/local drifts and the age/period/cohort effects of CVD mortality. CVD-specific contributions to LE gains were estimated with Arriaga's method.

RESULTS

The global age-standardized mortality rate of CVD declined remarkably from 416.1 to 235.2 per 100,000 during 1980-2021, with slight increase in the proportion of CVD death to all-cause mortality. The net drift of CVD mortality was -1.25 % per year during 1980-2019, and we observed negative local drifts across all age groups, among which middle-aged individuals experienced more rapid declines in CVD mortality than their younger counterparts. Favorable period and cohort effects were generally noted, particularly in high SDI countries. Globally, CVD mortality improvements accounted for an increase of 2.28 years (38.89 %) in LE at 20 years during 1980-2019, with relative contributions increasing from 15.18 % in low SDI region (mostly intracerebral hemorrhage) to 64.66 % in high SDI countries (mostly ischemic heart disease). Notably, LE gaps between low and high SDI countries further widened over study period, and the corresponding proportion attributable to CVD increased remarkably.

CONCLUSION

Process in reducing CVD mortality contributed to longevity improvements over the past four decades globally, with expanded cardiovascular health disparities across various SDI regions. More attention should be paid to CVD epidemic in low SDI countries to mitigate regional inequalities.

摘要

目的

探讨心血管疾病（CVD）死亡率的时间趋势及其对不同社会人口指数（SDI）地区预期寿命（LE）增长的影响。

方法

1980 - 2021年特定病因死亡率估计值来自《2021年全球疾病负担》研究。采用年龄 - 时期 - 队列（APC）分析来估计CVD死亡率的净/局部趋势以及年龄/时期/队列效应。用阿里亚加方法估计CVD对LE增长的特定贡献。

结果

1980 - 2021年期间，全球CVD年龄标准化死亡率从每10万人416.1显著下降至235.2，CVD死亡占全因死亡率的比例略有增加。1980 - 2019年期间CVD死亡率的净趋势为每年 - 1.25%，我们观察到所有年龄组的局部趋势均为负，其中中年个体的CVD死亡率下降速度比年轻个体更快。总体上观察到有利的时期和队列效应，尤其是在高SDI国家。在全球范围内，1980 - 2019年期间CVD死亡率的改善使20岁时的预期寿命增加了2.28年（38.89%），相对贡献从低SDI地区（主要是脑出血）的15.18%增加到高SDI国家（主要是缺血性心脏病）的64.66%。值得注意的是，在研究期间，低SDI国家和高SDI国家之间的预期寿命差距进一步扩大，且归因于CVD的相应比例显著增加。