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1990年至2019年美国和全球因风险因素导致的心血管疾病死亡率趋势比较分析:全球疾病负担研究2019分析

A comparative analysis of cardiovascular disease mortality trends attributable to risk factors in the United States and globally from 1990 to 2019: an analysis of the Global Burden of Disease Study 2019.

作者信息

Hafzalla George W, Abramov Dmitry, Shapiro Michael D, Minhas Abdul Mannan Khan

机构信息

Department of Medicine, Loma Linda University Health, Loma Linda, CA, USA.

Division of Cardiovascular Medicine, Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA.

出版信息

Am J Prev Cardiol. 2025 Jul 19;23:101064. doi: 10.1016/j.ajpc.2025.101064. eCollection 2025 Sep.

Abstract

BACKGROUND

Trends in cardiovascular disease (CVD) mortality from key risk factors both in the United States (US) and globally have not been well characterized.

METHODS

This analysis utilized Global Burden of Disease (GBD) 2019 data to determine age-standardized mortality rates (ASMR) and disability-adjusted life years (DALYs) for CVDs attributed to risk factors in the US and globally. Total percentage change (TPC, 95 % CI) was calculated to assess temporal trends in CVD mortality and disease burden related to key risk factors, examining two periods: 1990-2010 and 2010-2019.

RESULTS

Overall CVD mortality declined in the US and globally from 1990-2019. CVD mortality declined globally by a TPC of -0.24 (-0.26 to -0.22) between 1990-2010 but only by -0.11 (-0.15 to -0.07) between 2010-2019. Similar changes were seen in the US. CVD mortality attributed to common risk factors, including dietary risks, high LDL-c, kidney dysfunction, smoking, and secondhand smoking, changed significantly between 2010-2019 compared to the prior two decades, with slower declines in CVD mortality both globally and in the US. Furthermore, CVD mortality attributed to high body mass index, elevated fasting plasma glucose, and elevated systolic blood pressure in the US plateaued from 2010-2019. Trends in DALYs attributed to these risk factors paralleled those observed for mortality.

CONCLUSIONS

Despite major reductions in CVD mortality and disease burden from 1990 to 2010, mortality linked to key risk factors plateaued globally and in the US after 2010. Continued public health efforts targeting key risk factors are needed to further reduce CVD-related mortality and disability.

摘要

背景

美国和全球主要风险因素导致的心血管疾病(CVD)死亡率趋势尚未得到充分描述。

方法

本分析利用全球疾病负担(GBD)2019数据,确定美国和全球因风险因素导致的CVD的年龄标准化死亡率(ASMR)和伤残调整生命年(DALYs)。计算总百分比变化(TPC,95%CI)以评估CVD死亡率和与主要风险因素相关的疾病负担的时间趋势,考察两个时期:1990 - 2010年和2010 - 2019年。

结果

1990 - 2019年期间,美国和全球的总体CVD死亡率均有所下降。1990 - 2010年期间,全球CVD死亡率的TPC下降了 -0.24(-0.26至 -0.22),但在2010 - 2019年期间仅下降了 -0.11(-0.15至 -0.07)。美国也出现了类似变化。与前二十年相比,2010 - 2019年期间,包括饮食风险、高LDL - c、肾功能不全、吸烟和二手烟在内的常见风险因素导致的CVD死亡率发生了显著变化,全球和美国的CVD死亡率下降速度均放缓。此外,2010 - 2019年期间,美国因高体重指数、空腹血糖升高和收缩压升高导致的CVD死亡率趋于平稳。这些风险因素导致的DALYs趋势与死亡率观察到的趋势相似。

结论

尽管1990年至2010年期间CVD死亡率和疾病负担大幅下降,但2010年后,全球和美国与主要风险因素相关的死亡率趋于平稳。需要继续开展针对主要风险因素的公共卫生工作,以进一步降低CVD相关的死亡率和残疾率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fded/12318287/30b0918aece4/gr1.jpg

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