Zhuang Zhenhua, Wang Qiuju, Li Haifeng, Lan Shenghong, Su Yanru, Lin Yue, Guo Peng
Department of Cardiovascular Medicine, Guigang City People's Hospital, Guigang, Guangxi, China.
Health Management Center, Guigang City People's Hospital, Guigang, Guangxi, China.
PLoS One. 2025 Jun 12;20(6):e0324073. doi: 10.1371/journal.pone.0324073. eCollection 2025.
To comprehensively assess the global, regional, and national burden of ischemic heart disease (IHD) attributable to high systolic blood pressure (HSBP).
Using the Global Burden of Disease (GBD) 2021 dataset, we conducted a systematic analysis of mortality, disability-adjusted life years (DALYs), and their age-standardized rates (ASRs) for HSBP-related IHD from 1990 to 2021. We stratified data by sex, age (25-95 + years), and sociodemographic index (SDI) categories (Low, Low-Middle, Middle, High-Middle, and High), and examined geographic disparities across 21 regions and 204 countries. Temporal trends were assessed using estimated annual percentage change (EAPC), and smoothed curve modeling and Spearman's correlation were applied to evaluate associations between SDI and ASRs.
Globally, the absolute number of DALYs attributable to HSBP-related IHD rose substantially from 1990 to 2021, although ASRs decreased over the same period. Males consistently shouldered a larger proportion of the burden, yet women experienced a relatively faster decline in DALY and mortality ASRs. Notable regional disparities were observed, with Central Asia, Eastern Europe, and North Africa & Middle East demonstrating higher burdens despite downward trends, whereas certain low-to-middle SDI regions and select Asian and African countries exhibited rising ASRs. Variations in SDI also correlated with shifting patterns in HSBP-related IHD burden, highlighting the importance of socioeconomic factors.
This study underscores the significant global burden of IHD attributable to HSBP, with substantial heterogeneity by sex, age, and geographic setting. The findings emphasize the need for context-specific public health interventions, such as intensified hypertension screening, early detection, and management strategies.
全面评估归因于高收缩压（HSBP）的缺血性心脏病（IHD）的全球、区域和国家负担。
利用全球疾病负担（GBD）2021数据集，我们对1990年至2021年期间与HSBP相关的IHD的死亡率、伤残调整生命年（DALYs）及其年龄标准化率（ASRs）进行了系统分析。我们按性别、年龄（25 - 95 +岁）和社会人口指数（SDI）类别（低、低中、中、高中和高）对数据进行分层，并研究了21个地区和204个国家的地理差异。使用估计年百分比变化（EAPC）评估时间趋势，并应用平滑曲线建模和Spearman相关性来评估SDI与ASRs之间的关联。
在全球范围内，尽管同期ASRs有所下降，但1990年至2021年期间归因于与HSBP相关的IHD的DALYs绝对数量大幅上升。男性始终承担着较大比例的负担，但女性的DALY和死亡率ASRs下降相对较快。观察到显著的区域差异，中亚、东欧以及北非和中东尽管呈下降趋势，但负担仍然较高，而某些低至中等SDI地区以及部分亚洲和非洲国家的ASRs呈上升趋势。SDI的变化也与与HSBP相关的IHD负担的变化模式相关，凸显了社会经济因素的重要性。
本研究强调了归因于HSBP的IHD在全球的重大负担，在性别、年龄和地理环境方面存在显著异质性。研究结果强调了针对具体情况的公共卫生干预措施的必要性，例如加强高血压筛查、早期检测和管理策略。
