Nadeem Bilawal, Lorlowhakarn Koravich, Rahman Saad Ur, Talha Muhammad, Ganatra Sarju, Dani Sourbha S
Boston Medical Center Health System - Saint Elizabeth's Medical Center, 736 Cambridge Street, Boston, 02135, MA, USA.
Lahey Hospital and Medical Center, 41 Burlington Mall Road, Burlington, 01805, MA, USA.
Int J Cardiol Cardiovasc Risk Prev. 2025 May 9;26:200425. doi: 10.1016/j.ijcrp.2025.200425. eCollection 2025 Sep.
The impact of metabolic risk factors on ischemic heart disease (IHD) exhibits substantial regional variability. This study aims to analyze three-decade mortality trends in two contrasting regions of North America (NA) and South Asia (SA), focusing on age- and gender-specific variations.
Data from the Global Burden of Disease (GBD) database [1990-2021] were employed in Joinpoint Regression Program to compute the Annual Percent Changes (APC) and Average Annual Percent Changes (AAPC). Mortality rate trends were disaggregated by age and gender and subsequently compared both within and between the NA and SA populations, with statistical significance set at P < 0.05. Results were graphically represented, with mortality rates per 100,000 on the y-axis and years on the x-axis.
An overall decline in mortality rates was noted in NA, whereas SA displayed an overall increase. Age-specific stratification revealed that older adults in NA had a higher baseline mortality rate and experienced a more pronounced decline compared to younger adults. In contrast, older adults in SA exhibited a significant increase in mortality rates, whereas younger adults showed no significant change. Gender-specific analysis indicated substantial reductions in mortality rates for both males and females in NA, while SA males demonstrated a sharper increase, and SA females experienced no significant change.
Our study revealed divergent trends in metabolic risk factor-related IHD mortality between NA and SA, with significant variations observed across age and gender groups emphasizing the necessity of investigating the socioeconomic, environmental, and genetic determinants driving these disparities.
代谢风险因素对缺血性心脏病(IHD)的影响存在显著的地区差异。本研究旨在分析北美(NA)和南亚(SA)两个对比地区三十年的死亡率趋势,重点关注年龄和性别特异性差异。
使用全球疾病负担(GBD)数据库[1990 - 2021年]的数据,通过Joinpoint回归程序计算年度百分比变化(APC)和平均年度百分比变化(AAPC)。死亡率趋势按年龄和性别进行分解,随后在北美和南亚人群内部以及之间进行比较,设定统计学显著性为P < 0.05。结果以图形表示,纵轴为每10万人的死亡率,横轴为年份。
北美地区死亡率总体呈下降趋势,而南亚地区总体呈上升趋势。按年龄分层显示,北美老年人的基线死亡率较高,与年轻人相比下降更为明显。相比之下,南亚老年人的死亡率显著上升,而年轻人则无显著变化。按性别分析表明,北美男性和女性的死亡率均大幅下降,而南亚男性死亡率上升更为明显,南亚女性则无显著变化。
我们的研究揭示了北美和南亚在代谢风险因素相关的缺血性心脏病死亡率方面存在不同趋势,各年龄和性别组均观察到显著差异,强调有必要调查驱动这些差异的社会经济、环境和遗传决定因素。