Wang Yifei, Li Qing, Bi Lei, Wang Bin, Lv Tingting, Zhang Ping
Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
School of Clinical Medicine, Tsinghua University, Beijing, China.
Tob Induc Dis. 2025 Jan 29;23. doi: 10.18332/tid/199931. eCollection 2025.
Ischemic heart disease (IHD) remains a leading cause of death and disability worldwide. This study evaluates the trends in IHD burden attributable to smoking, utilizing Global Burden of Disease Study 2021 (GBD 2021) data, across 204 countries and territories from 1990 to 2021. By examining age-standardized death rates (ASDR) and disability-adjusted life years (ASRDALYs), the study provides insights into the spatiotemporal variations associated with smokingattributable IHD in different sociodemographic regions.
Data on smoking-attributable IHD mortality and DALYs were obtained from the GBD 2021 database. This secondary analysis examined ASDR and ASRDALYs for IHD as primary outcomes, with active smoking as the primary exposure. Temporal trends were analyzed using estimated annual percentage changes (EAPCs). The burden was stratified by age, sex, and sociodemographic index (SDI) to identify disparities across regions.
Over the last three decades, global ASDR and ASRDALYs for smokingrelated IHD have generally declined. High-SDI regions had the largest reductions, with EAPCs of -4.31 (95% CI: -5.73 - -2.87) and -4.02 (95% CI: -5.40 - -2.62), respectively. In contrast, low-SDI regions experienced slower declines, with EAPCs of -0.54 (95% CI: -1.41-0.33) and -0.80 (95% CI: -1.52 - -0.08), respectively. Older age groups and males consistently had a higher burden across all regions. Global death rates for populations aged 15-49, 50-74, and ≥75 years were 4.31, 46.57, and 142.52 per 100000, respectively. The global ASDR for males (30.24) was 8.54 times higher than that for females (3.54). Regional disparities were most pronounced in low- and middle-income areas, particularly in Eastern Europe and Central Asia, where smoking related IHD burden remains high.
While global reductions in smoking-related IHD burden are encouraging, sustained disparities remain, particularly in low-SDI regions. Males and older populations continue to have a disproportionately higher burden, emphasizing the need for targeted interventions and sustained efforts to address these inequities.
缺血性心脏病（IHD）仍是全球死亡和残疾的主要原因。本研究利用2021年全球疾病负担研究（GBD 2021）的数据，评估了1990年至2021年期间204个国家和地区因吸烟导致的IHD负担趋势。通过检查年龄标准化死亡率（ASDR）和伤残调整生命年（ASRDALYs），该研究深入了解了不同社会人口学区域与吸烟所致IHD相关的时空变化。
从GBD 2021数据库中获取因吸烟导致的IHD死亡率和伤残调整生命年的数据。这项二次分析将IHD的ASDR和ASRDALYs作为主要结果进行检查，将当前吸烟作为主要暴露因素。使用估计的年度百分比变化（EAPCs）分析时间趋势。将负担按年龄、性别和社会人口学指数（SDI）进行分层，以确定各区域之间的差异。
在过去三十年中，全球与吸烟相关的IHD的ASDR和ASRDALYs总体呈下降趋势。高SDI区域下降幅度最大，EAPCs分别为-4.31（95%CI：-5.73--2.87）和-4.02（95%CI：-5.40--2.62）。相比之下，低SDI区域下降较慢，EAPCs分别为-0.54（95%CI：-1.41-0.33）和-0.80（95%CI：-1.52--0.08）。在所有区域中，老年人群体和男性的负担一直较高。15-49岁、50-74岁和≥75岁人群组每10万人的全球死亡率分别为4.31、46.57和142.52。男性的全球ASDR（30.24）比女性（3.54）高8.54倍。区域差异在低收入和中等收入地区最为明显，特别是在东欧和中亚，吸烟相关的IHD负担仍然很高。
虽然全球与吸烟相关的IHD负担的下降令人鼓舞，但持续存在的差异仍然存在，特别是在低SDI区域。男性和老年人群体的负担仍然过高，这突出表明需要有针对性的干预措施并持续努力解决这些不平等问题。
