Transnational Inequities in Cardiovascular Diseases from 1990 to 2019：exploration based on the Global Burden of Disease Study 2019

Abstract

Background: To describe the burden and examine transnational inequities in overall cardiovascular disease (CVD) and ten specific CVDs across different levels of societal development. Methods: Estimates of disability-adjusted life-years (DALYs) for each disease and their 95% uncertainty intervals (UI) were extracted from the Global Burden of Diseases (GBD). Inequalities in the distribution of CVD burdens were quantified using two standard metrics, including the Slope Index of Inequality (SII) and the Concentration Index. Results: Between 1990 and 2019, there was a varied age and gender distribution of cases and rates of DALYs for global CVD. For overall CVD, the SII changed from 3760.40 (95% CI: 3758.26 to 3756.53) in 1990 to 3400.38 (95% CI: 3398.64 to 3402.13) in 2019. For ischemic heart disease, it shifted from 2833.18 (95% CI: 2831.67 to 2834.69) in 1990 to 1560.28 (95% CI: 1559.07 to 1561.48) in 2019. Regarding endocarditis, the figures shifted from -4.50 (95% CI: -4.64 to -4.36) in 1990 to 16.00 (95% CI: 15.88 to 16.12) in 2019. As for rheumatic heart disease, the data transitioned from -345.95 (95% CI: (-346.47 to -345.42)) in 1990 to -204.34 (95% CI: -204.67 to -204.01) in 2019. Moreover, the Concentration Index for overall CVD and each specific type also varied from 1990 to 2019. Conclusions: There's significant heterogeneity in the global DALYs case and rate distribution by age and gender for ten specific CVDs. Countries with higher levels of societal development bear the brunt of the CVD burden, with the extent of inequality intensifying over time.