Global Burden of Aortic Aneurysm and Attributable Risk Factors from 1990 to 2017

Abstract

Background: To date, our understanding of the global aortic aneurysm (AA) burden distribution is very limited. Objective: To assess a full view of global AA burden distribution and attributable risk factors from 1990 to 2017. Methods: We extracted data of AA deaths, disability-adjusted life years (DALYs), and their corresponding age-standardized rates (ASRs), in general and by age/sex from the 2017 Global Burden of Disease (GBD) study. The current AA burden distribution in 2017 and its changing trend from 1990 to 2017 were separately showed. The spatial divergence was discussed from four levels: global, five social-demographic index regions, 21 GBD regions, and 195 countries and territories. We also estimated the risk factors attributable to AA related deaths. Results: Globally, the AA deaths were 167,249 with an age-standardized death rate (ASDR) of 2.19/100,000 persons in 2017, among which the elderly and the males accounted for the majority. Although reductions in ASRs were observed in developed areas, AA remained an important health issue in those relatively underdeveloped areas and might be much more important in the near future. AA may increasingly affect the elderly and the female population. Similar patterns of AA DALYs burden were noted during the study period. AA burden attributable to high blood pressure and smoking decreased globally and there were many heterogeneities in their distribution. Discussion: AA maintained an incremental public health issue worldwide. The change pattern of AA burden was heterogeneous across locations, ages, and sexes and it is paramount to improve resource allocation for more effective and targeted prevention strategies. Also, prevention of tobacco consumption and blood pressure control should be emphasized.

The burden of aortic aneurysm in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019

“…In 2019, the mortality rate due to AA in males was almost triple that of females, in line with global data [ 11 , 13 ], possibly due to risk factor exposure in men, such as smoking, hypertension, and hypercholesteremia [ 22 ]. It was reported that the sex differences in aortic aneurysm formation were influenced by sex hormones [ 23 ].…”

“…The mortality rate increased consistently with age in both males and females [ 12 , 13 ]. Meanwhile, in line with the global trend [ 13 ], the percentage of elderly deaths from AA was growing (Supplementary Figure 2 ), and the population aged 60-80 sustained the highest YLLs due to AA in 2019, a shift from the most affected age group in 1990, aged 55-75, and this shift was mainly caused by the increased longevity of the population [ 15 ].…”

“…Meanwhile, China has the world's most smokers and the standardized smoking prevalence was estimated to be 24.9%-26.0% in the overall population aged 15 years or older and 47.0%-48.4% in men [ 34 ]. For the temporal trend of attributable risk factors, the expected decline was not as pronounced as that in high SDI countries [ 13 ]. In addition, the death rate attributed to high systolic blood pressure and smoking increased with age.…”

“…AA is one of the major cardiovascular diseases with an increased number of years of life lost (YLLs) and deaths globally [ 11 ]. Previously, a few studies analyzed the mortality trend of AA at the global and national levels using data derived from GBD 2010 [ 12 ] and GBD 2017 [ 13 , 14 ], but studies on the AA burden in China are scarce.…”

Projection of global burden and risk factors for aortic aneurysm – timely warning for greater emphasis on managing blood pressure

“…However, as observed by the most recent analysis using 1990–2017 Global Burden of Disease Study (GBD) data, the decreasing mortality trend due to AA in the past few years has begun to plateau worldwide. AA-related mortality has increased in many regions, such as Central Asia, North Africa, and Central and Eastern Europe [ 6 , 7 ]. As an important cardiovascular disease, the global burden of AA may further increase due to population ageing and the proliferation of other important behavioural and metabolic risk factors, such as smoking, hypertension, non-alcoholic fatty liver disease, and hyperlipidaemia, especially in developing countries [ 8–10 ].…”