Objective To systematically analyze the characteristics of the disease burden of hypertensive heart disease (HHD) in the elderly (≥60 years) globally and in China from 1990 to 2021, and to predict its future trends from 2022 to 2040, with the aim of providing data support for optimizing comprehensive prevention and control strategies for HHD. MethodsBased on the Global Burden of Disease (GBD) 2021 database, the number of prevalent cases and disability-adjusted life years (DALYs) of HHD in the elderly were extracted for the world, China, and five regions categorized by sociodemographic index (SDI). Joinpoint regression was used to analyze the temporal trends of age-standardized prevalence rate and age-standardized DALYs rate of HHD in the elderly. A three-factor decomposition method was applied to evaluate the relative contributions of aging, population growth, and epidemiological changes to the variations in the elderly HHD burden. Additionally, a Bayesian age-period-cohort model was used to predict the elderly HHD burden from 2022 to 2040. ResultsIn 2021, the number of prevalent elderly HHD cases reached 10 283 000 globally and 3 412 400 in China, representing increases of 179.20% and 159.20% respectively, compared with 1990. The DALYs of elderly HHD were 18 812 700 person-years globally and 4 731 400 person-years in China, rising by 76.08% and 29.45% respectively from 1990. Meanwhile, the growth rates of the number of prevalent cases and DALYs of elderly HHD varied across different SDI regions. From 1990 to 2021, the age-standardized prevalence rate of elderly HHD in China, as well as the age-standardized DALYs rate of elderly HHD both globally and in China, showed significant downward trends (all average annual percentage changes<0, all P<0.001). In 2021, the 70-74 years age group accounted for the highest proportion of prevalent cases and DALYs of elderly HHD, both globally and in China. Decomposition analysis revealed that population growth was the dominant factor driving the increase in the elderly HHD burden across all regions. The prediction model results indicated that the number of prevalent cases and DALYs of elderly HHD would continue to rise globally and in China from 2022 to 2040, with the growth rate of the elderly HHD burden in China between 2021 and 2040 expected to exceed the global average. ConclusionOver the past 32 years, although the age-standardized disease rates of elderly HHD have mainly shown a downward trend globally and in China, the absolute number of the disease burden has increased substantially. The projection model indicates a continued upward trajectory, with the growth rate in China higher than the global average. Therefore, there is an urgent need to implement precise prevention and control strategies to effectively mitigate the disease burden of elderly HHD.
Objective To systematically evaluate the incidence and mortality burden of ischemic heart disease (IHD) in the elderly population (aged ≥60 years) globally and in China from 1990 to 2021, utilizing the Global Burden of Disease (GBD) 2021 database, and to predict its future trends, thereby providing data support for precise prevention and control decisions regarding IHD in an increasingly aging society. Methods Data on the incidence and mortality burden of IHD among the elderly globally, in China, and across five sociodemographic regions were extracted from the GBD 2021 database. Joinpoint regression analysis was used to examine the temporal trends of the age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR). A Bayesian age-period-cohort model was employed to predict the trends of IHD burden from 2022 to 2040. Results In 2021, the number of IHD cases among the elderly was 21 975 600 globally and 5 445 100 in China. From 1990 to 2021, the global ASIR showed an overall decreasing trend (AAPC=?0.55%, P<0.001), whereas China exhibited an overall increasing trend (AAPC=0.41%, P<0.001). In 2021, the number of IHD deaths among the elderly was 7 444 000 globally and 1 742 800 in China. Similarly, the global ASDR demonstrated an overall decreasing trend from 1990 to 2021 (AAPC=?1.27%, P<0.001), while China showed an opposite trend (AAPC=0.68%, P=0.001). Additionally, in both 1990 and 2021, the ASIR and ASDR of IHD among elderly males (globally and in China) were higher than those among elderly females in the same period. In 2021, the age groups with the highest proportion of IHD cases among the elderly (both globally and in China) were 65–69 years and 70–74 years, while the 80–84 and 85–89 years groups had the highest proportions of IHD deaths. Predictive analysis indicated that from 2022 to 2040, the number of IHD cases and deaths among the total elderly population, both males and females, is likely to show a continuous upward trend both globally and in China. Conclusions The burden of IHD among elderly population remains substantial and growing globally and in China, in terms of incidence and mortality. Comprehensive strategies are urgently required, including policy guidance and health education to enhance public awareness, as well as early screening, diagnosis, and treatment to reduce the risk of disease progression. Such efforts are essential to effectively mitigate the increasingly heavy disease burden of IHD in the aging population.
ObjectiveTo analyze the global pattern, long-term trends, and regional and population heterogeneity in the burden of 375 diseases and injuries and 88 risk factors from 1990 to 2023 using data from the Global Burden of Disease Study 2023 (GBD 2023). MethodsPublicly available GBD 2023 estimates were extracted for incidence, deaths, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs), and age-standardized rates at the global level and by socio-demographic index (SDI), GBD region, age group, and sex. Descriptive analysis, ranking comparison, stratified analysis, and trend analysis were performed, and 95% uncertainty interval was used to assess the stability of estimates. ResultsIn 2023, non-communicable diseases were the leading contributor to global DALYs, accounting for 64.39% of DALYs across the three major disease and injury groups (communicable, maternal, neonatal, and nutritional diseases, non-communicable diseases, and injuries), and also had the highest age-standardized DALYs rate. From 1990 to 2023, age-standardized DALYs rates declined for three major disease and injury groups, with estimated annual percentage changes of ?2.69%, ?0.78%, and ?1.47%, respectively. Cardiovascular diseases ranked first by both DALYs and deaths in 2023, whereas respiratory infections and tuberculosis ranked first by incidence. Non-communicable diseases were the leading cause of disease burden across all SDI strata. As the SDI level declined, the burden of communicable, maternal, neonatal, and nutritional diseases, as well as injuries, increased markedly. Behavioral and metabolic risks remained the main contributors to attributable deaths and DALYs. ConclusionFrom 1990 to 2023, the global burden of disease continues to shift toward non-communicable diseases; however, some regions still face a double burden of infectious, maternal and child, injury-related, and chronic diseases. Integrating deaths, DALYs, YLLs, YLDs, and risk-attributable burden helps identify priority areas for prevention and resource allocation across regions and populations.