The rising death burden of atrial fibrillation and flutter in low-income regions and younger populations

Figure 1. Global death cases and death rates of AFF from 1990 to 2019 and projection to 2029. (A) Deaths by sex from 1990 to 2019 and projection to 2029. (B) Deaths in territories with low to high SDIs in 1990, 2019, and 2029. (C) The ASMRs in different SDI regions from 1990 to 2019 and projection to 2029. (D) The death cases in 167 countries and territories in 2019 and 2029. (E) The ASMRs in 167 countries and territories in 2019 and 2029. AFF, atrial fibrillation and flutter; SDI, sociodemographic index; ASMR, age-standardized mortality rate; EAPC, estimated annual percentage change.

Figure 2. Sex differences in trends of AFF death rate in different regions from 1990 to 2019 and projection to 2029. (A) The ASMRs in different SDI regions by sex, from 1990 to 2019 and projection to 2029. (B) The percentage changes in female and male ASMRs in different SDI regions from 1990 to 2019 and projection to 2029. (C) The ASMRs globally, in territories with low to high SDIs, and in 21 GBD regions by sex in 1990, 2019, and 2029. (D) The correlation between the ratios of female to male ASMR in 167 countries and territories and their corresponding SDI levels in 2019 and 2029. AFF, atrial fibrillation and flutter; SDI, sociodemographic index; ASMR, age-standardized mortality rate.

Figure 3. The trends of death cases and rates of AFF by age groups in different regions from 1990 to 2019 and projection to 2029. (A) The death cases and ASMRs in 30–95 plus years groups (5 years an interval) in 1990, 2019 and 2029 globally and in territories with low to high SDIs. (B) The percentage changes in ASMRs in three age groups (30–49 years, 50–69 years, and 70+ years) between 1990 and 2019 and 2019–2029 globally and in territories with low to high SDIs. (C) The premature ASMR (30–69 years old) globally, in territories with low to high SDIs and in 21 GBD regions in 1990, 2019, and 2029. (D) The age composition of (30–49, 50–69, and 70+ years old) globally, in territories with low to high SDIs and in 21 GBD regions in 1990, 2019, and 2029. AFF, atrial fibrillation and flutter; SDI, sociodemographic index; ASMR, age-standardized mortality rate; EAPC, estimated annual percentage change.

Figure 4. The predominant contributions of metabolic risk factors to AFF-related deaths by SDI, sex, and age groups. (A) The ASMRs attributable to main risk factors from 1990 to 2019 and projection to 2029. (B) The ratios of female to male ASMRs attributable to main risk factors from 1990 to 2019 and projection to 2029. (C) The ASMRs attributable to main risk factors in 30–69 years old population from 1990 to 2019 and projection to 2029 globally, in territories with low to high SDIs. (D) The EAPCs of ASMRs attributable to main risk factors in 30–69 years old population between 1990 and 2029 globally, in territories with low to high SDIs. AFF, atrial fibrillation and flutter; SDI, sociodemographic index; ASMR, age-standardized mortality rate; EAPC, estimated annual percentage change; SBP, systolic blood pressure; BMI, body mass index.