Why the study?
Analyzing the burden, trends, and inequalities of AF/AFL in China and predicting future trends was needed to raise awareness of risk factors and explore control strategies.
The global and Chinese burden of atrial fibrillation and flutter continues to increase, highlighting the need for effective public health strategies to manage this growing disease burden.
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Supports targeted AF strategies in China; leaves open drivers of divergent global incidence trends.
Background: It is essential to analyze the burden, trends, and inequalities of atrial fibrillation/flutter (AF/AFL) in China and to predict future trends, with the aim of raising awareness about risk factors and exploring strategies to control the significant disease burden. Methods: Data pertaining to AF/AFL were extracted from the comprehensive dataset of the Global Burden of Disease, Injuries, and Risk Factors Study 2021 (GBD 2021). Furthermore, we analyzed the epidemiological characteristics of AF/AFL and compared them to global prevalence trends, employing joinpoint regression, decomposition, age-period-cohort (apc), and cross-country inequality analysis methods. Concurrently, we utilized a Bayesian age-period-cohort (BAPC) analysis to forecast the age-standardized incidence rate (ASIR) of AF/AFL in China over the subsequent 15 years. Results: Globally, in 2021, there were 52.55 million [95% uncertainty interval (UI): 43.14 to 64.96] prevalent cases, 4.48 million (95% UI: 3.61 to 5.71) incident cases, 0.34 million (95% UI: 0.28 to 0.37) deaths, and 8.36 million (95% UI: 6.97 to 10.13) DALYs. In China, during the same year, there were 10.78 million (95% UI: 8.53 to 14.01) prevalent cases, 0.92 million (95% UI: 0.71 to 1.20) incident cases, 0.06 million (95% UI: 0.05 to 0.08) deaths, and 1.65 million (95% UI: 1.30 to 2.06) DALYs. The average annual percentage change (AAPC) in age-standardized incidence and mortality rates for AF/AFL were -0.02 (95% CI: -0.05, 0) and 0.11 (95% CI: 0.03, 0.18) globally, and 0.16 (95% CI: 0.05, 0.26) and -0.45 (95% CI: -0.78, -0.12) in China, respectively. Decomposition analysis revealed epidemiological shifts drive incidence rise, aging affects mortality. The Slope Index of Inequality (SII) 2021 was -35.04, and the Concentration Index (CI) was -0.09. The BAPC results indicated that the ASIR for males and females is expected to rise over the next 15 years. Conclusion: The burden of AF/AFL continues to increase annually. Countries with medium to low Socio-Demographic Index (SDI) have a heavy disease burden. In recent years, the burden in Chinese females has begun to exceed that of males. Without effective measures, the ASIR of AF/AFL is projected to exhibit a continued upward trajectory.
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Wang et al. (2025) studied this question.
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