Key result
Global rheumatic heart disease prevalence rose ~0.5% annually from 1990 to 2019 despite falling mortality.
Why the study?
Population growth, aging, and major epidemiological alterations inadvertently modulate RHD epidemiology, prompting an evaluation of RHD burden patterns and temporal trends.
Observational (n=40,502,345)
Rheumatic heart disease remains a major global public health issue, particularly affecting women and populations in lower sociodemographic index regions, despite overall global improvements in mortality and DALYs.
Background Population growth, aging, and major alterations in epidemiologic trends inadvertently modulate the status of rheumatic heart disease (RHD) epidemiology. This investigation predicted RHD burden pattern and temporal trends to provide epidemiologic evidence. Methods and Results Prevalence, mortality, and disability-adjusted life-years data for RHD were obtained from the GBD (Global Burden of Disease) study. We performed decomposition analysis and frontier analysis to assess variations and burden in RHD from 1990 to 2019. In 2019, there were >40.50 million RHD cases worldwide, along with nearly 0.31 million RHD-related deaths and 10.67 million years of healthy life lost to RHD. The RHD burden was commonly concentrated within lower sociodemographic index regions and countries. RHD primarily affects women (22.52 million cases in 2019), and the largest age-specific prevalence rate was at 25 to 29 years in women and 20 to 24 years in men. Multiple reports demonstrated prominent downregulation of RHD-related mortality and disability-adjusted life-years at the global, regional, and national levels. Decomposition analysis revealed that the observed improvements in RHD burden were primarily due to epidemiological alteration; however, it was negatively affected by population growth and aging. Frontier analysis revealed that the age-standardized prevalence rates were negatively linked to sociodemographic index, whereas Somalia and Burkina Faso, with lower sociodemographic index, showed the lowest overall difference from the frontier boundaries of mortality and disability-adjusted life-years. Conclusions RHD remains a major global public health issue. Countries such as Somalia and Burkina Faso are particularly successful in managing adverse outcomes from RHD and may serve as a template for other countries.
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Ruan et al. (2023) conducted an observational in Rheumatic Heart Disease (n=40,502,345). Time period (2019 vs 1990) vs. 1990 baseline was evaluated on Age-standardized prevalence rate (ASPR) per 100,000 population (AAPC 0.47%, 95% CI 0.42-0.51). Between 1990 and 2019, the global age-standardized prevalence of rheumatic heart disease increased by an average of 0.47% annually, reaching 40.50 million cases, though mortality rates significantly declined.
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