Rheumatic Heart Disease Burden: A Comparative Analysis between the United States and the European Union

Area of Science:

• Cardiology
• Epidemiology
• Public Health

Background:

• Rheumatic heart disease (RHD) presents a significant global health burden, particularly in low- and middle-income nations.
• While rare in high-income countries, RHD still poses a challenge, with limited data on its impact in these regions.
• This study addresses the data gap by examining RHD epidemiology in high-income settings.

Purpose of the Study:

• To compare the epidemiology of Rheumatic Heart Disease (RHD) in the United States of America (USA) and the European Union (EU).
• To analyze trends in RHD incidence and prevalence across these high-income regions.
• To identify regional differences in RHD burden and associated metrics.

Main Methods:

• Utilized data from the Global Disease Burden Study 2021 via the Global Health Data Exchange.
• Collected age-standardized rates for incidence (ASIR), prevalence (ASPR), death (ASDR), disability-adjusted life years (ASDALY), years lived with disability (ASYLD), and years of life lost (ASYLL).
• Calculated the estimated annual percentage change (EAPC) to assess trends from 1993 to 2021.

Main Results:

• In 2021, the USA had an ASPR of 123.4/100,000 with a decreasing trend since 1993, while the EU had an ASPR of 49.7/100,000 with a steeper decline.
• RHD incidence (ASIR) decreased in both the USA (10.6 to 10.0/100,000) and the EU (7.43 to 4.6/100,000) between 1993 and 2021.
• The EU reported higher age-standardized disability-adjusted life years and years of life lost compared to the USA, with both regions showing female predominance.

Conclusions:

• RHD epidemiology exhibits varied trends between the USA and EU, indicating distinct disease patterns.
• A reversal in the RHD burden was observed in the USA since 2007.
• Tailored, region-specific strategies are crucial for effectively managing RHD as a persistent global health concern.