Objective To analyze the changing trends and attributable risk factors of low back pain disease burden in Chinese population from 1990 to 2023, and to predict the related disease burden of low back pain in 2030. MethodsBased on the 2023 Global Burden of Disease (GBD) study database, the incidence, prevalence, years lived with disability (YLDs), and characteristics and trends of risk factors among Chinese individuals with low back pain from 1990 to 2023 were analyzed, the age and gender differences in disease burden were assessed, and the disease burden in 2030 was jointly predicted by autoregressive integrated moving average model and age-period-cohort model. Results From 1990 to 2023, the number of incident cases, the number of prevalent cases, and YLDs in Chinese low back pain population showed an upward trend, from 29.989 1 million cases, 68.636 3 million cases, and 7.732 4 million person-years to 41.383 6 million cases, 95.324 0 million cases, and 10.635 9 million person-years, respectively. The incidence rate, prevalence rate, and YLDs rate increased from 2 543.31 per 100 000, 5 820.89 per 100 000, and 655.77 per 100 000 to 2 892.65 per 100 000, 6 663.01 per 100 000, and 743.43 per 100 000 respectively. However, the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized YLDs rate showed a downward trend, from 2 859.73 per 100 000, 6 636.60 per 100 000, and 740.83 per 100 000 to 2 164.80 per 100 000, 4 929.78 per 100 000, and 551.92 per 100 000, respectively. The burden of low back pain in women was significantly higher than that in men and increased with age (peak at 50 to 59 years old). Attribution analysis showed that smoking, occupational factors, and high body mass index (BMI) were the main factors leading to the increase of YLDs, and there was a gender difference. The tow model showed that the age-standardized incidence rate, the age-standardized prevalence rate, and the age-standardized YLDs rate for low back pain would decrease year by year from 2023 to 2030. ConclusionThe disease burden of low back pain in China shows that from 1990 to 2023, the burden of low back pain in the Chinese population has been increasing year by year. Smoking, occupational factors, and high BMI are the main risk factors. Interventions targeting these controllable risk factors are crucial for reducing the disease burden. It is expected that by 2030, the disease burden of low back pain is expected to decrease, although the absolute burden will remain high. Greater attention should be paid to the middle-aged and elderly population, especially the female population, who bear a heavier disease burden. Targeted interventions, such as weight control and smoking cessation management, should be actively implemented against these controllable risk factors.
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.