Trends and disparities in China's cardiovascular disease burden from 1990 to 2019

Area of Science:

• Epidemiology
• Public Health
• Cardiovascular Disease Research

Background:

• Cardiovascular diseases (CVD) pose a significant public health challenge, necessitating systematic assessment of risk factors for effective prevention strategies.
• Understanding long-term trends and epidemiological characteristics of CVD in China is crucial given its large and aging population.

Purpose of the Study:

• To systematically assess the burden of cardiovascular diseases (CVD) in China using the Global Burden of Disease (GBD) 2019 study.
• To analyze long-term trends, epidemiological characteristics, and attributable risk factors of CVD in the Chinese population.

Main Methods:

• Comprehensive analysis of CVD burden metrics including prevalence, incidence, mortality, YLLs, YLDs, and DALYs using GBD 2019 data.
• Application of joinpoint regression, age-period-cohort (APC) models, and Bayesian APC (BAPC) for trend analysis and mortality/morbidity prediction.
• Investigation of CVD-attributable risk factors, with a focus on metabolic risks.

Main Results:

• CVD prevalence in China reached 120 million in 2019, a 140.02% increase from 1990, with a 52.56% rise in CVD-attributed DALYs.
• While incidence showed a fluctuating downward trend, mortality significantly declined. Recent generations exhibit higher prevalence, and prevalence is increasing within age groups.
• BAPC predictions suggest CVD prevalence and mortality will stabilize and decline between 2020-2030, particularly in males. High blood pressure was identified as the primary metabolic risk factor.

Conclusions:

• The substantial and increasing burden of CVD in China, exacerbated by an aging population, represents a major public health concern.
• Urgent development and implementation of practical strategies for CVD prevention and management are essential to mitigate this growing health challenge.