What is the clinical evidence from this study?

Study design: Observational. Population: Cardiovascular diseases. Intervention: Time period (1990 to 2017) vs. 1990 baseline. Primary outcome: Age-standardized mortality rate of cardiovascular diseases (Estimated annual percentage change -1.45%, 95% CI -1.72 to -1.18).

December 13, 2021Journal of Epidemiology and Global Health39 citationsOpen Access

Systematic Analysis of the Global, Regional and National Burden of Cardiovascular Diseases from 1990 to 2017

ZWZhenkun WangHarbin Medical University ADAihua DuZhengzhou City Hospital HLHong LiuChangzhi Medical College

Key Result

Between 1990 and 2017, the global number of deaths from cardiovascular diseases increased by 48.62% to 17.79 million, although the age-standardized mortality rate decreased by an average of 1.45% annually.

Study Design

Type

Observational

Structured PICO

Population

Global population data from 195 countries and territories assessing the mortality and disability-adjusted life years burden of cardiovascular diseases from 1990 to 2017.

Outcome

Mortality and disability-adjusted life years (DALYs) attributed to cardiovascular diseaseshard clinical

The absolute global burden of cardiovascular disease continues to rise due to population growth and aging, despite improvements in age-standardized mortality rates.

Main Result

Effect estimate: Estimated annual percentage change -1.45% (95% CI -1.72 to -1.18)

Absolute Event Rate: 233.07% vs 334.7%

Limitations

Potential systematic biases in vital registration data and redistribution of garbage codes
Incomplete population coverage of civil registration and statistics systems affecting data quality
Possibility of ecological fallacy since population-level results may not apply to individuals
Analysis limited to overall CVDs and three main subtypes, excluding other cardiovascular conditions
Incomplete medically certified cause of death systems in middle- and low-income countries

Abstract

BACKGROUND: Previous studies on the burden of cardiovascular diseases (CVDs) were mainly based on limited data of the study period or area, or did not include detailed risk factor analysis. OBJECTIVE: To investigate up-to-date temporal and regional trends and risk factors of mortality and disability-adjusted life years (DALYs) attributed to CVDs by age, sex, and disease throughout the world. METHODS: Data for the disease burden of CVDs in 195 countries and territories from 1990 to 2017, including mortality, DALYs, age-standardized mortality rates, and age-standardized DALY rates, were estimated from the Global Burden of Disease Study 2017. Risk factors attributable to deaths and DALYs for CVDs were also estimated using the comparative risk assessment framework. RESULTS: The number of deaths from CVDs increased by 48.62%, from 11.94 (95% UI 11.78-12.18) million in 1990 to 17.79 (17.53-18.04) million in 2017. However, the age-standardized mortality rate decreased by an average of - 1.45% (- 1.72% to - 1.18%) annually. After fluctuation in the expected age-standardized mortality rate of CVDs in most of the socio-demographic index (SDI) scale, these rates decrease rapidly for SDI values of 0.7 and higher. In 2017, metabolic risks accounted for 73.48% of deaths and 73.25% of DALYs due to CVDs, behavioral factors accounted for 63.23% of deaths and 66.71% of attributable DALYs. CONCLUSION: CVDs remain a major global health burden due to the increment in death numbers and DALYs. Aging and the main risk factors are the main drivers of mortality and health loss. More attention to main risk factors should be paid with supportive health policies.

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