Jiang Yixuan, Luo Huihuan, Fu Guangguo, Chen Jinmiao, Kan Haidong, Chen Renjie
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
BMC Med. 2025 Aug 12;23(1):472. doi: 10.1186/s12916-025-04309-2.
Fine particulate matter (PM) is linked to early-onset cardiovascular disease (CVD); however, the corresponding disease burden has not been assessed. This study aims to evaluate the global, regional, and national early-onset CVD burden attributable to PM from 1990 to 2021.
We calculated the number, age-standardized rate, and percentage of CVD deaths and disability-adjusted life-years (DALYs) attributable to PM among individuals aged 25-49 years from 1990 to 2021 based on the Global Burden of Disease Study 2021. Stratified analyses were performed by sex, age, disease subtype, sociodemographic index (SDI), and country. We further calculated estimated annual percentage change to assess the temporal trends.
In 2021, the age-standardized death and DALY rates (per 100,000) of early-onset CVD attributable to total PM were 10.93 (95% confidence interval, 10.89-10.97) and 562.12 (561.84-562.39), respectively. The burden was generally higher in males, with age-standardized death and DALY rates approximately double those in females. Individuals living in regions with lower SDI faced substantially greater burden compared to those in higher-SDI regions. Those with ischemic heart disease experienced higher burden than individuals with stroke. From 1990 to 2021, the burden attributable to total and household PM declined consistently, with estimated annual percentage change in age-standardized death rates of - 1.56% (- 1.68% to - 1.45%) and - 3.22% (- 3.48% to - 2.96%), respectively. The burden from ambient PM continued to rise, and only began to decline since the last decade, with an estimated annual percentage change in age-standardized death rates of 0.37% (0.23%-0.52%). In contrast, the late-onset CVD burden decreased for both ambient and household exposures.
Despite significant reduction in early-onset CVD burden attributable to total and household PM from 1990 to 2021, the burden from ambient PM remains a persistent challenge. Males, individuals living in regions with lower SDI, and those with ischemic heart disease face a higher burden. Geographically tailored and population-specific interventions are needed to mitigate early-onset CVD burden.
细颗粒物（PM）与早发性心血管疾病（CVD）相关；然而，相应的疾病负担尚未得到评估。本研究旨在评估1990年至2021年全球、区域和国家因PM导致的早发性CVD负担。
我们根据《2021年全球疾病负担研究》计算了1990年至2021年25至49岁个体中因PM导致的CVD死亡人数、年龄标准化率以及死亡人数和伤残调整生命年（DALYs）的百分比。按性别、年龄、疾病亚型、社会人口指数（SDI）和国家进行分层分析。我们进一步计算了估计的年度百分比变化以评估时间趋势。
2021年，因总PM导致的早发性CVD的年龄标准化死亡率和DALY率（每10万人）分别为10.93（95%置信区间，10.89 - 10.97）和562.12（561.84 - 562.39）。男性的负担总体上更高，年龄标准化死亡率和DALY率约为女性的两倍。与高SDI地区的个体相比，生活在低SDI地区的个体面临的负担要大得多。患有缺血性心脏病的个体比患有中风的个体负担更高。从1990年到2021年，因总PM和家庭PM导致的负担持续下降，年龄标准化死亡率的估计年度百分比变化分别为-1.56%（-1.68%至-1.45%）和-3.22%（-3.48%至-2.96%）。环境PM导致的负担持续上升，直到过去十年才开始下降，年龄标准化死亡率的估计年度百分比变化为0.37%（0.23% - 0.52%）。相比之下，晚发性CVD负担在环境暴露和家庭暴露中均有所下降。
尽管1990年至2021年因总PM和家庭PM导致的早发性CVD负担显著降低，但环境PM导致的负担仍然是一个持续的挑战。男性、生活在低SDI地区的个体以及患有缺血性心脏病的个体面临更高的负担。需要采取因地制宜、针对特定人群的干预措施来减轻早发性CVD负担。
