Global trends and patterns in cardiovascular disease burden attributable to low physical activity: A systematic analysis for Global Burden of Disease Study from 1990 to 2021

Figures

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  Fig 1. Global CVD Burden by Age and Sex (2021). Panel A shows the increase in mortality rates with age, particularly in males aged 60-74 and females aged 60-84. Panel B highlights DALY distribution, which increases significantly with age, especially for females post-55. Panel C shows higher mortality rates in females after age 60, while Panel D illustrates a more pronounced rise in DALYs for females. These findings underline the aging-related disparities in CVD burden, with a more substantial impact on females.

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  Fig 2. Global Mortality and DALYs for CVD by Sex (1990-2021). This figure displays global trends in CVD mortality rates and DALYs attributable to low physical activity (LPA) from 1990 to 2021. Both male and female mortality and DALY rates decreased annually, but total deaths and DALYs increased over time. Females experienced a consistently higher burden, with significantly higher age-standardized mortality rates and DALY values compared to males, emphasizing persistent gender disparities in CVD outcomes related to LPA.

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  Fig 3. Burden of CVD due to physical inactivity in 204 countries in 2021. (A) Crude cardiovascular disease mortality rate (CMR) due to physical inactivity for each country in 2021; (B) Crude DALY rate for CVD due to physical inactivity for each country in 2021.CDALY, Crude Disability Adjusted Life Years. This map was created by the authors using R software (ggplot2, sf, and rnaturalearth packages) and public domain data from Natural Earth (https://www.naturalearthdata.com/).

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  Fig 4. Trends in ASDR for CVD by SDI Level (1990-2021). Panel A shows a general decline in age-standardized death rates (ASDR) for CVD attributable to LPA, with the largest reductions seen in high-SDI countries. Panel B highlights that low-SDI countries, like Eritrea, saw an increase in ASDR, while high-SDI nations such as the U.S. and Finland showed significant reductions. War-torn countries such as Afghanistan and Syria still report high ASDR, despite slight improvements, reflecting the relationship between socioeconomic development and CVD burden.

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  Fig 5. Impact of Aging, Epidemiological Shifts, and Population Growth on CVD Burden (1990-2021). This figure illustrates the contributions of aging, epidemiological shifts, and population growth to global disparities in CVD burden over the past 30 years. Aging contributed the most to negative differences (56.36%), especially in males. Epidemiological shifts had the largest negative effect, particularly in males (－472.35%) and females (－237.53%). Population growth mitigated these effects, especially in males (－496.9%) and somewhat in females. These findings emphasize the distinct impacts of demographic factors on the global CVD burden.

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  Fig 6. Projected ASMR for CVD and LPA (2022-2036). This figure shows projected trends in age-standardized mortality rates (ASMR) for cardiovascular diseases attributable to low physical activity (LPA) from 2022 to 2036, based on ARIMA modeling. Global ASMR is expected to decline from 4.48% in 2022 to 3.49% in 2036, with the most significant reductions in high-SDI regions. In contrast, low-SDI regions will experience slower declines. These trends highlight the global efforts to reduce CVD mortality, while disparities remain, particularly in lower-income regions.