Chen Yingyi, Deng Binjie, Nie Yeting, Xian Weijin, Li Yubin, Yang Shaojie
Department of Cardiovascular Medicine, The People's Hospital of JiangMen, Jiangmen, Guangdong, China.
Jiangmen Municipal Health Bureau, Jiangmen, China.
BMC Cardiovasc Disord. 2025 Aug 6;25(1):580. doi: 10.1186/s12872-025-05021-y.
This study aims to assess the global burden, trends, and regional variations of rheumatic heart disease (RHD) among women of childbearing age (WCBA), contributing to better-targeted prevention and management strategies.
Data from the Global Burden of Disease Study (GBD) 2021 were analyzed to estimate the incidence, mortality, and disability-adjusted life years (DALYs) due to RHD among WCBA globally and by region from 1990 to 2021. Projections of the RHD incidence rate from 2022 to 2040 were generated using the Bayesian age-period-cohort model.
In 2021, there were 1,248,510 new cases of RHD among WCBA, with an age-standardized incidence rate (ASIR) of 64.31 per 100,000 population. RHD resulted in 40,195 deaths and 3,190,496 DALYs, with age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) of 2.06 and 163.51 per 100,000, respectively. The global burden of RHD showed a slight increase in incidence (0.36% per year) from 1990 to 2021, while mortality and DALYs decreased by 2.85% and 2.04%, respectively. Regionally, Sub-Saharan Africa had the highest ASIR, while high-income regions like Western Europe showed the lowest. RHD burden was more pronounced in low- Sociodemographic Index (SDI) regions, with a declining trend in high-SDI regions. Projections indicate continued increases in ASIR globally, particularly in regions with fluctuating trends like South Asia and Sub-Saharan Africa.
In conclusion, RHD remains a significant health challenge for women of childbearing age, especially in low- and middle-SDI regions where the burden is highest. Despite declines in global mortality and DALYs, incidence continues to rise in several areas, particularly among younger females. We recommend implementing integrated RHD screening programs in primary care, with a focus on adolescent girls and women in low- and middle-income countries.
本研究旨在评估育龄期妇女风湿性心脏病（RHD）的全球负担、趋势及区域差异，以推动制定更具针对性的预防和管理策略。
分析全球疾病负担研究（GBD）2021的数据，以估计1990年至2021年全球及各区域育龄期妇女因风湿性心脏病导致的发病率、死亡率和伤残调整生命年（DALY）。使用贝叶斯年龄-时期-队列模型对2022年至2040年风湿性心脏病发病率进行预测。
2021年，育龄期妇女中有1,248,510例风湿性心脏病新发病例，年龄标准化发病率（ASIR）为每10万人64.31例。风湿性心脏病导致40,195例死亡和3,190,496个伤残调整生命年，年龄标准化死亡率（ASMR）和年龄标准化伤残调整生命年率（ASDR）分别为每10万人2.06例和163.51例。1990年至2021年，全球风湿性心脏病负担的发病率略有上升（每年0.36%），而死亡率和伤残调整生命年分别下降了2.85%和2.04%。在区域方面，撒哈拉以南非洲的年龄标准化发病率最高，而西欧等高收入地区最低。风湿性心脏病负担在社会人口指数（SDI）较低的地区更为突出，在SDI较高的地区呈下降趋势。预测表明，全球年龄标准化发病率将持续上升，特别是在南亚和撒哈拉以南非洲等趋势波动的地区。
总之，风湿性心脏病仍然是育龄期妇女面临的重大健康挑战，尤其是在社会人口指数低和中等的地区，这些地区负担最重。尽管全球死亡率和伤残调整生命年有所下降，但在几个地区，尤其是年轻女性中，发病率仍在上升。我们建议在初级保健中实施综合风湿性心脏病筛查项目，重点关注低收入和中等收入国家的少女和妇女。
