Sun Zhenhai, Zhang Rui, Cong Mingyang, Zhang Menghe, Lv Tailong, Xie Huidan, Chen Shouqiang
Second School of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.
Department of Acupuncture and Tuina, Dongying Shengli Oilfield Central Hospital, Dongying, China.
Front Cardiovasc Med. 2025 Aug 12;12:1570390. doi: 10.3389/fcvm.2025.1570390. eCollection 2025.
As the global population of obese individuals surpasses 878 million, the impact of high body mass index (BMI) on hypertensive heart disease (HHD) has risen to the third position among all diseases. However, the specific contribution of high BMI to the burden of HHD remains unclear.
Data on deaths, disability-adjusted life years (DALYs), and their age-standardized rates (ASR) were obtained from the Global Burden of Disease (GBD) database. Population attributable fractions (PAF) was used to assess the contribution of risk factors. Various analytical methods, including decomposition analysis, cluster analysis, frontier analysis, age-period-cohort (APC) analysis, and Bayesian age-period-cohort (BAPC) analysis, were employed to investigate changes in disease burden.
The results showed an increasing global burden of HHD due to high BMI, with both mortality and DALYs doubling over the past 30 years. Their ASR also continued to rise. By 2021, the PAF for deaths and DALYs reached 44% and 49%, respectively. Population growth and aging were significant contributors to this disease burden. Low- and middle- Socio-Demographic Index (SDI) regions experienced the highest burden, particularly in East Asia, South Asia, North Africa and Middle East. Although the disease burden was lower in high-income areas, the increase was notable, especially in North America. Women and older populations faced higher risks, particularly alarming is the rapid increase in risk among younger populations in high SDI regions.
HHD resulting from high BMI poses a significant global public health challenge, particularly in regions with middle and low SDI. While the heightened risk among women and older individuals has garnered considerable attention, the increasing risk among younger populations also necessitates greater focus. Targeted interventions should prioritize diet, exercise, medical security, and health education, with particular emphasis on enhancing policy support for low-income and high-risk groups. Future policies must integrate the social, economic, and cultural contexts of each region, implement comprehensive prevention and control strategies, and establish a multi-dimensional health promotion system.
随着全球肥胖人口超过8.78亿，高体重指数（BMI）对高血压性心脏病（HHD）的影响在所有疾病中已升至第三位。然而，高BMI对HHD负担的具体贡献仍不清楚。
从全球疾病负担（GBD）数据库中获取死亡、伤残调整生命年（DALYs）及其年龄标准化率（ASR）的数据。人群归因分数（PAF）用于评估危险因素的贡献。采用了各种分析方法，包括分解分析、聚类分析、前沿分析、年龄-时期-队列（APC）分析和贝叶斯年龄-时期-队列（BAPC）分析，以研究疾病负担的变化。
结果显示，由于高BMI导致的全球HHD负担不断增加，过去30年死亡率和DALYs均翻了一番。它们的ASR也持续上升。到2021年，死亡和DALYs的PAF分别达到44%和49%。人口增长和老龄化是这种疾病负担的重要促成因素。社会人口指数（SDI）低和中等的地区负担最高，特别是在东亚、南亚、北非和中东。虽然高收入地区的疾病负担较低，但增长显著，尤其是在北美。女性和老年人群面临更高风险，特别令人担忧的是高SDI地区年轻人群风险的快速上升。
高BMI导致的HHD对全球公共卫生构成重大挑战，特别是在SDI中低的地区。虽然女性和老年人风险增加备受关注，但年轻人群风险增加也需要更多关注。有针对性的干预应优先考虑饮食、运动、医疗保障和健康教育，特别强调加强对低收入和高危群体的政策支持。未来政策必须结合各地区的社会、经济和文化背景，实施全面防控策略，建立多维健康促进体系。
