Age-Period-Cohort Analysis of Ischemic Heart Disease Morbidity and Mortality in China, 1990–2019

Wei, Danmei; Xiao, Wenbo; Zhou, Lihui; Guo, Jian; Lu, Wenli; Wang, Yuan

doi:10.1253/circj.cj-21-0749

Cited by 12 publications

(8 citation statements)

References 29 publications

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“…The improvement of the healthcare level has shown to prolong the survival period of patients with heart disease. It can be inferred from the aforementioned results that the incidence and severity of IHD increase with age ( 17 ). Our study also found age differences in the disease burden of IHD in China, and the overall trend of the disease burden of IHD due to controllable risk factors increases with age.…”

Section: Discussionmentioning

confidence: 94%

Disease burden and risk factors of ischemic heart disease in China during 1990–2019 based on the Global Burden of Disease 2019 report: A systematic analysis

Li¹,

Zhang²

2022

Front. Public Health

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ObjectiveThe aim of this study was to identify the disease burden and risk factors of ischemic heart disease (IHD) in China, during 1990–2019, through a systematic analysis using the Global Burden of Disease (GBD) 2019 report in order to provide first-hand information for primary and secondary prevention of IHD in China.MethodsData on the rates of incidence, death, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) of IHD were obtained from GBD2019 to determine the disease burden and risk factors of IHD in China.ResultsThe rates of incidence, death, YLLs, YLDs, and DALYs of IHD in China increased at different levels during 1990–2019. The annual rate of change in incidence, death, YLLs, YLDs, and DALYs of IHD were 1.31%, 1.57%, 0.93%, 1.14%, and 0.94%, respectively. In 2019, the YLDs of IHD in Chinese women were higher, while the rates of incidence and death, YLLs, and DALYs were lower in Chinese women than in Chinese men. The disease burden of IHD had significant age differences, and people aged ≥70 years had the highest disease burden. A total of 24 risk factors were associated with the rates of death and DALYs of IHD, and the five most significant risk factors were high systolic blood pressure, high LDL cholesterol (LDL-C), smoking, ambient particulate matter pollution, and intake of a high-sodium diet. From 1990 to 2019, a high annual rate of change in IHD-related deaths and DALYs was observed due to ambient particulate matter pollution, high body mass index (BMI), and intake of a diet high in processed meat.ConclusionThe results of the study revealed that the disease burden of IHD in China was on the rise, especially in people aged ≥70 years. The main disease burden of IHD in male patients was premature death and that in female patients was disability. Environmental, behavioral, and metabolic factors were considered the three main risks of the disease burden of IHD, with metabolic factors having the greatest impact. Therefore, periodic health check-ups and high-risk factor interventions for key populations should be strengthened from the grassroots level, which are conducive to further reducing the disease burden of IHD in China.

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Section: Discussionmentioning

confidence: 94%

Disease burden and risk factors of ischemic heart disease in China during 1990–2019 based on the Global Burden of Disease 2019 report: A systematic analysis

Li¹,

Zhang²

2022

Front. Public Health

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“…In consistent with previous studies ( 22 , 24 , 28 , 29 ), we found that male patients had higher direct medical costs than female patients. The possible reasons might be the higher IHD burden ( 13 ), higher morbidity of IHD ( 8 ), and more consumption of drinking and smoking ( 66 ) for male patients than female patients, and thus male patients may suffer from more serious cardiovascular disease and incurred higher expenditures.…”

Section: Discussionmentioning

confidence: 99%

“…In China, the incidence of IHD was ~59.1/100,000 in 2012 ( 6 ), and it was predicted that there would be 38.6 million IHD events from 2010 to 2030 ( 7 ). The morbidity and mortality of IHD have been continuously increasing ( 8 ). In 2015, the total mortality of IHD in China was 22,117/100,000, accounting for 1.51 million deaths ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Direct medical costs of ischemic heart disease in urban Southern China: a 5-year retrospective analysis of an all-payer health claims database in Guangzhou City

Xie,

Li,

Guo

et al. 2023

Front. Public Health

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IntroductionThis study aimed to estimate the direct medical costs and out-of-pocket (OOP) expenses associated with inpatient and outpatient care for IHD, based on types of health insurance. Additionally, we sought to identify time trends and factors associated with these costs using an all-payer health claims database among urban patients with IHD in Guangzhou City, Southern China.MethodsData were collected from the Urban Employee-based Basic Medical Insurance (UEBMI) and the Urban Resident-based Basic Medical Insurance (URBMI) administrative claims databases in Guangzhou City from 2008 to 2012. Direct medical costs were estimated in the entire sample and by types of insurance separately. Extended Estimating Equations models were employed to identify the potential factors associated with the direct medical costs including inpatient and outpatient care and OOP expenses.ResultsThe total sample included 58,357 patients with IHD. The average direct medical costs per patient were Chinese Yuan (CNY) 27,136.4 [US dollar (USD) 4,298.8] in 2012. The treatment and surgery fees were the largest contributor to direct medical costs (52.0%). The average direct medical costs of IHD patients insured by UEBMI were significantly higher than those insured by the URBMI [CNY 27,749.0 (USD 4,395.9) vs. CNY 21,057.7(USD 3,335.9), P < 0.05]. The direct medical costs and OOP expenses for all patients increased from 2008 to 2009, and then decreased during the period of 2009–2012. The time trends of direct medical costs between the UEBMI and URBMI patients were different during the period of 2008-2012. The regression analysis indicated that the UEBMI enrollees had higher direct medical costs (P < 0.001) but had lower OOP expenses (P < 0.001) than the URBMI enrollees. Male patients, patients having percutaneous coronary intervention operation and intensive care unit admission, patients treated in secondary hospitals and tertiary hospitals, patients with the LOS of 15–30 days, 30 days and longer had significantly higher direct medical costs and OOP expenses (all P < 0.001).ConclusionsThe direct medical costs and OOP expenses for patients with IHD in China were found to be high and varied between two medical insurance schemes. The type of insurance was significantly associated with direct medical costs and OOP expenses of IHD.

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“…Standardised populations were referenced to the global population of the GBD 2019 data. The specific calculation formula for the statistical indicators is as follows [ 21 ]: where a is the age-specific incidence/DALY rate, b is the age-specific population number, and i is age class.…”

Section: Methodsmentioning

confidence: 99%

Trends in the disease burden of anxiety disorders in middle-aged and older adults in China

Zhi,

Yan,

Yijuan

et al. 2024

BMC Psychol

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Background Anxiety disorders in middle-aged and older adults are an important public health concern in China. Based on the data in the global disease burden (GDB) research database, this study evaluated and analyzed the trend of the disease burden of middle-aged and older patients living with anxiety in China in the past 30 years. Methods The incidence and disability-adjusted life years (DALYs) data of anxiety disorders in China for individuals aged 45–89 years were collected from the Global Burden of Disease Study 2019, and the effects of age, period, and cohort on the incidence of and DALY rate for anxiety disorders were analysed using an age-period-cohort model. Because of the COVID-19 pandemic, the global disease burden research database has not been updated since 2019. However, this did not affect the analysis of future trends in this study, which combined data in the past three decades from 1990 to 2019. Results (1) The overall age-standardised incidence rate (ASIR) and age-standardised DALY rate (ASDR) for anxiety disorders in middle-aged and older adults in China decreased by 4.0 and 7.7% from 1990 to 2019, respectively, and the ASIR and ASDR were always higher in women than in men. (2)Age-period-cohort analysis showed that the net drifts for incidence and DALY rate were − 0.27% and − 0.55% per year, respectively. For both genders, the local drifts for incidence were lower than zero in those aged 45–79 years and higher than zero in those aged 80–89 years; the local drifts for the DALY rate were lower than zero in all groups. (3) From the 1990–1994 to 2015–2019, the relative risks of anxiety disorder incidence and DALY decreased by 5.6 and 7.3% in men and 4.3 and 11.7% in women, respectively. Conclusion The disease burden of anxiety disorders in middle-aged and older adults in China has been relieved over the past 30 years; however, recent ASDR, ASDR, period, and cohort effects have shown adverse trends. The incidence and DALY rate decreased with age in women, while men showed a trend of increasing first and decreasing afterwards.

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Age-Period-Cohort Analysis of Ischemic Heart Disease Morbidity and Mortality in China, 1990–2019

Cited by 12 publications

References 29 publications

Disease burden and risk factors of ischemic heart disease in China during 1990–2019 based on the Global Burden of Disease 2019 report: A systematic analysis

Disease burden and risk factors of ischemic heart disease in China during 1990–2019 based on the Global Burden of Disease 2019 report: A systematic analysis

Direct medical costs of ischemic heart disease in urban Southern China: a 5-year retrospective analysis of an all-payer health claims database in Guangzhou City

Trends in the disease burden of anxiety disorders in middle-aged and older adults in China

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