Yu Guanghui, Chen Pei, Sun Changhao, Liu Peng
Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China.
PLoS One. 2025 Jul 18;20(7):e0327830. doi: 10.1371/journal.pone.0327830. eCollection 2025.
Hypertension is a major risk factor for aortic aneurysm (AA), but the global, regional, and national patterns of its related disease burden are not well studied. This study uses 2021 GBD data to examine trends in hypertension-related AA from 1990 to 2021, project future trends, and provide evidence for targeted prevention strategies.
This study extracted data on mortality, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) associated with AA attributable to hypertension from the 2021 GBD study. The estimated annual percentage change (EAPC) was employed to assess burden trends from 1990 to 2021.The study utilized the Bayesian Age-Period-Cohort (BAPC) model to project disease trends from 2022 to 2050. Additionally, decomposition analysis and frontier analysis were employed to conduct a more comprehensive examination of the data.
In 2021, 26,782 deaths and 529,977 DALYs were caused by hypertension-related AA globally, reflecting increases of about 49% and 47% since 1990. However, both ASMR and ASDR declined worldwide. From 1990 to 2021, the ASDR for hypertension-related AA decreased by 54.08% and 15.56% in high-SDI and upper-middle-SDI regions, respectively, while it increased by 25.23%, 62.02%, and 17.99% in middle-SDI, lower-middle-SDI, and low-SDI regions. The disease burden is significantly higher in males than in females and increases with age.The findings from the decomposition analysis reveal that population growth and the aging process are the primary contributors to the escalating burden, with varying impacts across different regions. The frontier analysis identified 15 countries with the greatest potential for improvement. According to the BAPC model, the ASDR for females is projected to rise across the 20-80 age group, while for males, the increase is particularly pronounced in the 55-75 age group. Globally, the ASDR is expected to initially decline before gradually rising, reaching 12.07 per 100,000 by 2050, a 5% increase compared to 2021.
While the global number of deaths and DALYs attributable to hypertension-related AA continues to rise, the ASMR and ASDR are showing a declining trend. However, in middle, lower-middle, and low SDI regions, ASMR and ASDR remain on an upward trajectory. Projections indicate that the global ASDR will initially decline before gradually increasing, with an expected rise by 2050.
高血压是主动脉瘤（AA）的主要危险因素，但其相关疾病负担的全球、区域和国家模式尚未得到充分研究。本研究利用2021年全球疾病负担（GBD）数据，研究1990年至2021年高血压相关主动脉瘤的趋势，预测未来趋势，并为有针对性的预防策略提供依据。
本研究从2021年GBD研究中提取了与高血压所致主动脉瘤相关的死亡率、伤残调整生命年（DALYs）、年龄标准化死亡率（ASMR）和年龄标准化DALY率（ASDR）数据。采用估计年度百分比变化（EAPC）评估1990年至2021年的负担趋势。该研究利用贝叶斯年龄-时期-队列（BAPC）模型预测2022年至2050年的疾病趋势。此外，还采用了分解分析和前沿分析对数据进行更全面的检查。
2021年，全球高血压相关主动脉瘤导致26,782人死亡和529,977个伤残调整生命年，自1990年以来分别增加了约49%和47%。然而，全球的年龄标准化死亡率和年龄标准化DALY率均有所下降。1990年至2021年，高社会人口指数（SDI）和上中等SDI地区高血压相关主动脉瘤的年龄标准化DALY率分别下降了54.08%和15.56%，而中等SDI、下中等SDI和低SDI地区则分别上升了25.23%、62.02%和17.99%。男性的疾病负担明显高于女性，且随年龄增长而增加。分解分析结果显示，人口增长和老龄化进程是负担不断加重的主要因素，不同地区的影响各不相同。前沿分析确定了15个最具改善潜力的国家。根据BAPC模型，预计20-80岁年龄组女性的年龄标准化DALY率将上升，而男性在55-75岁年龄组的上升尤为明显。全球范围内，年龄标准化DALY率预计将先下降，然后逐渐上升，到2050年达到每10万人12.07例，比2021年增加5%。
虽然全球高血压相关主动脉瘤导致的死亡人数和伤残调整生命年继续上升，但年龄标准化死亡率和年龄标准化DALY率呈下降趋势。然而，在中等、下中等和低SDI地区，年龄标准化死亡率和年龄标准化DALY率仍呈上升趋势。预测表明，全球年龄标准化DALY率将先下降，然后逐渐上升，预计到2050年上升。
